[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100622942":3},{"organization":4,"armGroups":7,"interventions":20,"overallOfficials":26,"centralContacts":26,"locations":31,"responsibleParty":51,"collaborators":55,"id":59,"slug":60,"hasResults":61,"nctId":62,"briefTitle":63,"officialTitle":64,"acronym":65,"eligibilityCriteria":66,"healthyVolunteers":61,"sex":67,"minAge":68,"maxAge":26,"enrollmentInfo":69,"targetDuration":26,"studyType":72,"phases":73,"briefSummary":75,"conditions":76,"keywords":80,"overallStatus":34,"whyStopped":26,"lastUpdateSubmitDate":83,"lastUpdatePostDateStruct":84,"startDateStruct":87,"completionDateStruct":89,"leadSponsor":91,"locationsCount":92},{"fullName":5,"class":6},"Hospital San Carlos, Madrid","OTHER",[8,14],{"label":9,"type":10,"description":11,"interventionNames":12},"Control group (CPVI only)","ACTIVE_COMPARATOR","Modifications in fibrillation dynamics induced by CPVI will be evaluated. Therefore, an experimental protocol will be carried out in which, once CPVI has been completed, a new acquisition of non-invasive maps will be performed to characterize basal fibrillation dynamics and those under adenosine",[13],"Procedure: Control group ablation",{"label":15,"type":16,"description":17,"interventionNames":18},"Active group (CPVI plus extrapulmonary ablation of DFASI domains)","EXPERIMENTAL","Modifications in fibrillation dynamics induced by ablation distributed along the points of singularity of the maintaining reentries (or their inclusion in the CPVI if applicable) will be evaluated, as suggested by our preliminary results (Calvo D et al. Sci Rep. 2025 Dec 16;15(1):43892). Therefore, an experimental protocol will be carried out in which each DFASI reentrant domain will be addressed sequentially. After each ablation set, a new evaluation of noninvasive hierarchical organization patterns will be performed by acquiring new non-invasive maps in AF",[19],"Procedure: Active group ablation",[21,27],{"type":22,"name":23,"description":24,"armGroupLabels":25,"otherNames":26},"PROCEDURE","Active group ablation","In patients in the active group, changes in fibrillation dynamics induced by CPVI and ablation of DFASI domains will be evaluated, as suggested by our preliminary results (Calvo D et al. Sci Rep. 2025 Dec 16;15(1):43892). Therefore, an experimental protocol will be carried out in which, after CPVI, each DFASI domain will be addressed sequentially. The following will be determined: a) changes in hierarchical organization levels, b) the formation of new DFASI domains; c) if AF ends after ablation, the termination mechanisms will be described. Once all ablation sets on the identified DFASI reentrant domains have been completed, noninvasive maps will be acquired under the effect of adenosine in order to compare fibrillatory dynamics under basal adenosine vs. post-ablation.",[15],null,{"type":22,"name":28,"description":29,"armGroupLabels":30,"otherNames":26},"Control group ablation","Therefore, an experimental protocol will be carried out in which, once the CPVI has been completed, a new acquisition of non-invasive maps will be performed to characterize the basal fibrillation dynamics and those under adenosine.",[9],[32],{"facility":33,"status":34,"city":35,"state":35,"zip":36,"country":37,"countryCode":38,"cosmosGeoPoint":39,"geoPoint":44,"contacts":45},"Hospital Clínico San Carlos","RECRUITING","Madrid","28040","Spain","ES",{"type":40,"coordinates":41},"Point",[42,43],-3.70256,40.4165,{"lat":43,"lon":42},[46],{"name":47,"role":48,"phone":49,"phoneExt":26,"email":50},"David Calvo Cuervo","CONTACT","917044491","dcalvo307@secardiologia.es",{"type":52,"investigatorFullName":53,"investigatorTitle":54,"investigatorAffiliation":5,"oldNameTitle":26,"oldOrganization":26},"PRINCIPAL_INVESTIGATOR","Daivd Calvo Cuervo","Cardiologist electrophysiologist",[56],{"name":57,"class":58},"Instituto de Salud Carlos III","OTHER_GOV","100622942","ablation-of-human-cardiac-fibrillation-based-on-models-of-hierarchical-organization-of-tissue-excitation-100622942",false,"NCT07390175","Ablation of Human Cardiac Fibrillation Based on Models of Hierarchical Organization of Tissue Excitation","Ablación de la fibrilación Cardiaca Humana Basada en Modelos de organización jerárquica de la excitación Tisular.","TerFib","Inclusion Criteria:\n\n* Patients over 18 years of age with persistent AF lasting more than 6 months at the time of the experimental protocol (uninterrupted persistent AF) and clinical indication for an AF ablation procedure.\n\nor\n\n-Patients over 18 years of age with recurrent VF\u002FVT and poor control with conventional pharmacological measures.\n\nExclusion Criteria:\n\n* Lack of patient consent to participate in the study.\n* In patients with persistent AF, contraindication for the use of adenosine.\n* AF\u002FVF\u002FVPT secondary to endocrine-metabolic disorders and\u002For severe systemic disease (thyrotoxicosis, sepsis, pulmonary thromboembolism, etc.).\n* Contraindications for cardiac catheterization (e.g., intracardiac thrombus).\n* Impossibility of remote monitoring using an implantable Holter monitor or implantable defibrillator.","ALL","18 Years",{"count":70,"type":71},78,"ESTIMATED","INTERVENTIONAL",[74],"NA","The mechanisms that maintain persistent atrial fibrillation (AF) in humans remain unknown. In the research project PI18\u002F01268 funded in the previous call for Strategic Action in Health, the group has demonstrated that the hierarchical organization of (i) rotational domains, (ii) frequency domains and (iii) physiological responses to pharmacological provocation with adenosine, allow the identification of domains of high-frequency reentrant activity (hereinafter \"DFASI domains\") maintainers of AF. As a result, the investigators have developed non-invasive technological models and quantitative indices for the efficient localization of these domains, whose therapeutic approach through ablation has allowed to improve the clinical results of the patients studied, safely without increase in complications (Calvo D et al. Sci Rep. 2025 Dec 16;15(1):43892). Likewise, and in response to the objectives of the PI18\u002F01268 project, the investigators have identified hierarchical organization patterns in human ventricular fibrillation (VF) that indicate the existence of universal fibrillatory mechanisms, opening the door to new therapeutic opportunities (Europace 2022;24\\[11\\]:1788-1799).",[77,78,79],"Atrial Fibrillation (AF)","Ablation Treatment","TerFib_Hyerarchy",[81,77,82,79],"Hierarchical organization of tissue excitation","Ablation","2026-02-18",{"date":85,"type":86},"2026-02-20","ACTUAL",{"date":88,"type":86},"2025-01-20",{"date":90,"type":71},"2026-12-31",{"name":5,"class":6},1]