[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"atrial-fibrillation-persistent\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:atrial-fibrillation-persistent":29},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,14,0,[8,51,77,105,134,167,193,217,241,264,297,322,345,371],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":13,"acronym":14,"eligibilityCriteria":15,"healthyVolunteers":16,"sex":17,"minAge":18,"maxAge":19,"enrollmentInfo":20,"targetDuration":4,"studyType":23,"phases":24,"briefSummary":26,"conditions":27,"keywords":32,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":39,"lastUpdatePostDateStruct":40,"startDateStruct":43,"completionDateStruct":45,"leadSponsor":47,"locationsCount":50},"100528802","convergent-ablation-plus-left-atrial-appendage-isolation-for-the-treatment-of-persistent-atrial-fibrillation-100528802",false,"NCT06165510","Convergent Ablation Plus Left Atrial Appendage Isolation for the Treatment of Persistent Atrial Fibrillation","CLIP-AF","Inclusion Criteria:\n\n* Age \\> 18 years; \\\u003C 80 years\n* Persistent AF \\> 1-year duration\n* Left atrium size \\\u003C 6cm\n* Pts should be able to provide written informed consent.\n\nExclusion Criteria:\n\n* Subjects currently enrolled in another investigational study except in case of observational registry with no associated treatments.\n* Subject has a reversible cause of AF or transient AF\n* Subject is absent of LAA or if the LAA is previously surgically ligated\n* Subject has had previous cardiac surgery or abdominal surgery.\n* Subject has contraindication to anticoagulation.\n* Patients with hypertrophic cardiomyopathy.\n* Patients with significant valve disease.\n* Subject has had previous catheter or surgical ablation",true,"ALL","18 Years","80 Years",{"count":21,"type":22},48,"ESTIMATED","INTERVENTIONAL",[25],"NA","A randomised controlled clinical trial to assess efficacy of convergent ablation with the LARIAT procedure, as compared to standard endocardial catheter ablation in patients with long-standing persistent atrial fibrillation (AF).",[28,29,30,31],"Persistent Atrial Fibrillation","Atrial Fibrillation, Persistent","Atrium; Fibrillation","Atrial Arrhythmia",[33,34,35,36,37],"Catheter ablation","Convergent procedure","Left atrial appendage","Hybrid ablation","Cardiac arrhythmias","RECRUITING","2026-06-24",{"date":41,"type":42},"2026-06-25","ACTUAL",{"date":44,"type":42},"2024-08-02",{"date":46,"type":22},"2026-11",{"name":48,"class":49},"Barts & The London NHS Trust","OTHER",1,{"id":52,"slug":53,"hasResults":11,"nctId":54,"briefTitle":55,"officialTitle":56,"acronym":57,"eligibilityCriteria":58,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":59,"targetDuration":4,"studyType":23,"phases":61,"briefSummary":62,"conditions":63,"keywords":4,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":67,"lastUpdatePostDateStruct":68,"startDateStruct":70,"completionDateStruct":72,"leadSponsor":74,"locationsCount":76},"100470880","hybrid-ablation-of-atrial-fibrillation-in-heart-failure-100470880","NCT05411614","Hybrid Ablation of Atrial Fibrillation in Heart Failure","A Randomised Controlled Trial Comparing Convergent Hybrid Ablation to Catheter Ablation in Patients With Persistent Atrial Fibrillation and Heart Failure","HALT AF","Inclusion Criteria:\n\n* Age ≥ 18 years\n* Persistent or Long-standing Persistent AF\n* Dilated left atrium (at least moderately dilated)\n* Suitable for either procedure\n* LVEF \\\u003C 50%\n\nExclusion Criteria:\n\n* Not yet optimised from a medical or lifestyle perspective for AF or heart failure\n* Unable to provide written consent\n* Previous open-heart surgery\n* Active infection, oesophageal ulcer stricture or oesophageal varices\n* Prior catheter ablation of atrial fibrillation (prior ablation for atrial flutter \u002F supraventricular tachycardia or ventricular arrhythmia acceptable)\n* Contraindication to anticoagulation, or active thrombus in the left atrium despite therapeutic anticoagulation\n* Severe valvular heart disease\n* Unstable coronary artery disease\n* Uncontrolled ventricular arrhythmia\n* Heart attack or stroke within the last 90 days\n* Pregnant, breastfeeding, or women of childbearing age who plan to get pregnant within six months\n* Severe concomitant condition or presence of an implanted device that would preclude the patient from undergoing trial procedures",{"count":60,"type":22},120,[25],"A randomised controlled trial to assess the efficacy of staged hybrid ablation when compared with standard catheter ablation in patients with non-paroxysmal atrial fibrillation (AF) and Heart Failure",[28,29,31,64,65,66],"Atrial Fibrillation","Heart Failure","Left Ventricular (LV) Systolic Dysfunction","2025-11-23",{"date":69,"type":42},"2025-11-28",{"date":71,"type":42},"2022-06-25",{"date":73,"type":22},"2027-10",{"name":75,"class":49},"St. George's Hospital, London",7,{"id":78,"slug":79,"hasResults":11,"nctId":80,"briefTitle":81,"officialTitle":82,"acronym":83,"eligibilityCriteria":84,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":85,"targetDuration":4,"studyType":23,"phases":87,"briefSummary":88,"conditions":89,"keywords":91,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":95,"lastUpdatePostDateStruct":96,"startDateStruct":98,"completionDateStruct":100,"leadSponsor":102,"locationsCount":104},"100580118","atrioventricular-node-ablation-and-conduction-system-pacing-in-patients-with-well-controlled-permanent-atrial-fibrillation-af-heart-failure-and-preserved-ejection-fraction-heart-rate-regularization-versus-medical-rate-control-100580118","NCT06833138","Atrioventricular Node Ablation and Conduction System Pacing in Patients With Well Controlled Permanent Atrial Fibrillation (AF), Heart Failure and Preserved Ejection Fraction: Heart Rate Regularization Versus Medical Rate Control","Atrioventricular (AV) Node Ablation and Conduction System Pacing in Patients With Well Controlled Permanent Atrial Fibrillation (AF), Heart Failure and Preserved Ejection Fraction: Heart Rate Regularization vs. Medical Rate Control","HF-RELIEF","Inclusion Criteria:\n\n* Permanent atrial fibrilation \\> 6 months\n* Preserved Left Ventricular Ejection Fraction ≥ 50%\n* ≥ 1 heart failure hospitalization in the previous year\n* NYHA (New York Heart Association) score ≥ 2\n* Presence of at least one of the following criteria related to diastolic dysfunction:\n\n  * E\u002Fe' ratio \\> 9\n  * Left Ventricular mass \\> 95 g\u002Fm2 (female) or \\> 115 g\u002Fm2 (male) with h\u002FR ratio \\> 0.42\n  * NT pro BNP (B-type Natriuretic Peptide) \\> 365 pg\u002FmL or BNP (B-type Natriuretic Peptide) \\> 105 pg\u002FmL\n* Narrow QRS ≤ 120 ms\n* Average heart rate ≤ 110\u002Fmin on 24 hours Holter monitoring\n* Age over 18-year-old\n* Capacity to understand the nature of the study, legal ability and willingness to give informed consent\n* Patient covered by a social insurance\n* Effective contraception and a negative pregnancy test in women of a childbearing age\n\nExclusion Criteria:\n\n* Patient eligible for atrial fibrilation catheter ablation\n* Life expectancy \\\u003C 12 months\n* Severe chronic kidney disease (estimated Glomerular Filtration Rate ≤ 20 ml\u002F1,73 m2)\n* Severe respiratory disease (severe chronic obstructive pulmonary disease with Gold ≥ 3 and\u002For chronic oxygen therapy)\n* Class III obesity (Body Mass Index ≥ 40)\n* Confirmed or suspected infiltrative cardiomyopathy (amyloidosis, sarcoidosis, Fabry disease, others)\n* Obstructive hypertrophic cardiomyopathy\n* Previous implanted devices (Pacemaker \u002F Implantable Cardioverter-Defibrillator \u002F Cardiac Resynchronization Therapy)\n* Other indication for pacemaker implantation\n* Indication for implantable cardioverter-defibrillator\n* Ambulatory ≤ 50% of time\n* Pregnant women\n* Breast-feeding women",{"count":86,"type":22},266,[25],"The goal of this clinical trial is to assess the clinical efficacy of physiological pacing combined with atrioventricular node ablation, in patients with Heart Failure with preserved Ejection Fraction (HFpEF) and well controlled permanent atrial fibrillation.The main question it aims to answer is that heart rate regularization added to physiological pacing - preventing the deleterious effect of right ventricular apical pacing - would reduce mortality and heart failure hospitalizations.\n\nResearchers will compare physiological pacing combined with atrioventricular node ablation (intervention arm) versus optimal pharmacological therapy (control arm) to see if physiological pacing combined with atrioventricular node ablation reduce time to the composite of all-cause mortality or hospitalization due to heart failure or intravenous diuretics (time frame 24 months).\n\nParticipants will :\n\n* Be randomized in intervention arm or control arm.\n* Visit the clinic 3 months, 12 months and 24 months after the randomization for checkups and tests.",[90,29],"Heart Failure With Preserved Ejection Fraction",[92,93,94],"Heart failure","Cardiac Resynchronization Therapy","Conduction System Pacing","2025-09-17",{"date":97,"type":42},"2025-09-22",{"date":99,"type":42},"2025-09-10",{"date":101,"type":22},"2029-12-31",{"name":103,"class":49},"French Cardiology Society",15,{"id":106,"slug":107,"hasResults":11,"nctId":108,"briefTitle":109,"officialTitle":110,"acronym":111,"eligibilityCriteria":112,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":113,"targetDuration":4,"studyType":23,"phases":115,"briefSummary":116,"conditions":117,"keywords":121,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":125,"lastUpdatePostDateStruct":126,"startDateStruct":128,"completionDateStruct":130,"leadSponsor":132,"locationsCount":50},"100409069","value-of-screening-and-treatment-of-sahs-in-the-management-of-af-ablation-candidates-100409069","NCT04606693","Value of Screening and Treatment of SAHS in the Management of AF Ablation Candidates","Value of Screening and Treatment of Sleep Apnea-Hypopnea Syndrome in the Management of Atrial Fibrillation Ablation Candidates","SLEEP-AF","Inclusion Criteria:\n\n* Patients with paroxysmal or persistent atrial fibrillation\n* Recurrent atrial fibrillation despite treatment with at least one class I or III antiarrhythmic\n* No previous diagnosis of apnea-hypopnea syndrome\n\nExclusion Criteria:\n\n* Patients \\\u003C18 years\n* Pregnant women\n* Doubts about the patient's ability to perform a home respiratory polygraphy\n* Doubts about the patient's ability to acquire rhythm records with the Kardia system (smartphone required)\n* Unavailability for follow-up at our center for at least 1 year.",{"count":114,"type":22},50,[25],"The present prospective cohort study (not randomized) analyses the value of screening and treatment of SAHS in the management of patients with AF refractory to antiarrhythmics drugs, potentially candidates for ablation.\n\nPatients at low risk of suffering from SAHS will follow conventional management of their AF, according to the usual criteria of the Arrhythmia Unit. Patients with high or intermediate risk of SAHS, will undergo respiratory polygraphy. If the result is positive, they will be treated as standard for this syndrome and their heart rate will be monitored for 3 months. After this, the patient's arrhythmic load will be reevaluated differentiating patients into two groups, those that must be ablated from those that have improved their condition and the clinical criteria is no longer ablation but follow-up.",[118,29,119,120],"Atrial Fibrillation Paroxysmal","Apnea Syndrome","Hypopnea Syndrome",[64,122,123,124],"Apnea","Hypopnea","SAHS","2025-09-09",{"date":127,"type":42},"2025-09-15",{"date":129,"type":42},"2020-11-05",{"date":131,"type":22},"2026-12-31",{"name":133,"class":49},"Hospital San Carlos, Madrid",{"id":135,"slug":136,"hasResults":11,"nctId":137,"briefTitle":138,"officialTitle":139,"acronym":140,"eligibilityCriteria":141,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":142,"targetDuration":4,"studyType":23,"phases":144,"briefSummary":145,"conditions":146,"keywords":147,"overallStatus":156,"whyStopped":4,"lastUpdateSubmitDate":157,"lastUpdatePostDateStruct":158,"startDateStruct":160,"completionDateStruct":162,"leadSponsor":164,"locationsCount":166},"100581036","re-ablation-of-persistent-atrial-fibrillation-100581036","NCT06845085","Re-ablation of Persistent Atrial Fibrillation","Re-ablation of Persistent Atrial Fibrillation: a Randomized Study, Evaluating Vein of Marshall Ethanol Ablation in Combination With Block of Mitral and Tricuspid Isthmuses and Dome Line","Re-AF","Inclusion Criteria:\n\n* Previous pulmonary vein isolation for atrial fibrillation\n* Indication for catheter ablation with at least two episodes of symptomatic PsAF during the last 12 months\n* Age \\> 18 years\n* Expected survival \\> 12 months\n* Able to provide informed consent\n\nExclusion Criteria:\n\n* Previous extrapulmonary atrial ablation other than cavotricuspid isthmus line, roof- or dome line or posterior wall isolation\u002Fablation\n* Atypical atrial flutter in addition to atrial fibrillation\n* Atrial fibrillation secondary to a transient abnormality\n* Uncontrolled hypertension\n* Acute coronary syndrome, cardiac surgery, or TIA\u002Fstroke within the last 3 months\n* Planned cardiac surgery within 1 year\n* Dialysis or severe renal failure\n* Active substance or alcohol abuse (\\>14 units\u002Fweek)",{"count":143,"type":22},180,[25],"Pulmonary vein re-isolation plus Vein of Marshall ethanol ablation in combination with block of mitral and tricuspid isthmuses and dome line will be compared to pulmonary vein re-isolation alone in patients undergoing re-ablation for persistent atrial fibrillation in this investigator initiated, randomized, patient-assessor blinded multicenter trial. Patients are followed with standard ECG at 3 months, with standard ECG, 5-days' ECG monitoring and quality of life assessment after 12 months, with standard ECG and quality of life assessment after 24 months, through patient files at 60 months after the ablation.\n\nPrimary endpoint: Change in AFEQT score between baseline and 12 months.",[29],[148,149,150,151,152,153,154,155],"Persistent atrial fibrillation","Radiofrequency ablation","Pulsed field ablation","Vein of Marshall alcohol ablation","Cavotricuspid isthmus line","Mitral isthmus line","Dome line","Pulmonary vein re-isolation","NOT_YET_RECRUITING","2025-02-26",{"date":159,"type":42},"2025-02-28",{"date":161,"type":22},"2025-03",{"date":163,"type":22},"2032-10",{"name":165,"class":49},"Aarhus University Hospital",3,{"id":168,"slug":169,"hasResults":11,"nctId":170,"briefTitle":171,"officialTitle":172,"acronym":4,"eligibilityCriteria":173,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":174,"targetDuration":4,"studyType":23,"phases":176,"briefSummary":177,"conditions":178,"keywords":179,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":184,"lastUpdatePostDateStruct":185,"startDateStruct":187,"completionDateStruct":189,"leadSponsor":191,"locationsCount":50},"100566378","electrical-cardioversion-as-a-predictor-in-postoperative-preservation-of-sinus-rhythm-100566378","NCT06654401","Electrical Cardioversion As a Predictor in Postoperative Preservation of Sinus Rhythm","Electrical Cardioversion As a Predictor in Postoperative Preservation of Sinus Rhythm in Patients with Persistent Atrial Fibrillation Before Radio Frequency Pulmonary Vein Isolation","Inclusion Criteria:\n\n* Informed consent signed by the patient to participate in the study.\n* Persistent atrial fibrillation resistant to antiarrhythmic drugs for 6 months or more\n* The size of the left atrium is less than 55 mm, volume is less than 130 ml, volume index (LP) is less than 55 ml\u002Fm2\n\nExclusion Criteria:\n\n* Reversible causes of atrial fibrillation (hyperthyroidism, pericarditis, myocarditis).\n* Patients in need of myocardial revascularization and\u002For heart valvular disease correction.\n* Any previous intervention (including MAZE surgery, thoracoscopic ablation; implanted occluder of the auricle of the left atrium.).\n* Patients with severe concomitant pathology requiring correction.\n* Contraindications for administration of anticoagulant therapy.\n* Documented presence of a blood clot in the cavity of the left atrium or other reasons preventing the insertion of catheters into the left atrium.\n* BMI of 40 or more",{"count":175,"type":22},125,[25],"The aim of this study is to evaluate benefits of electric cardioversion in the early and long-term postoperative period in patients after radiofrequency catheter isolation of pulmonary veins. Parameters of the left atrium will be evaluated by transthoracic echocardiography and electroanatomic mapping. Preservation of the sinus rhythm will be assessed by 24-hour electrocardiographic monitoring.\n\nThe main question that is planned to be answered is:\n\nDoes a reverse remodeling of the left atrium and\u002For a decrease in the progression of the fibrosis zone occur after performing electrical cardioversion (and before subsequent catheter ablation) in patients with persistent and long-standing persistent atrial fibrillation (AF)? Can performed electrical cardioversion serve as a predictor of AF freedom in this group of patients?\n\nParticipants will undergo a follow-up examinations (echocardiography, ECG, 24-hour ECG monitoring) at the 3rd, 6th and 12th months after catheter ablation. Based on the results of these examinations, the recurrence rate of AF will be estimated.\n\nTwo groups of patients will include both persistent and long-standing persistent AF. Experimental group will include patients who underwent electrical cardioversion before the intervention, and active comparator group will include those patients who did not undergo it. The experimental group will be subdivided into a persistent AF patients who were successfully cardioverted in sinus rhythm and persistent AF patients who failed to restore sinus rhythm during DC at the time of catheter ablation. Analysis and comparison of subgroups will be performed.",[64,29],[64,180,33,181,182,183],"Cardioversion","Late recurrence","Left atrial voltage","Left atrial volume","2024-12-17",{"date":186,"type":42},"2024-12-20",{"date":188,"type":42},"2024-11-01",{"date":190,"type":22},"2026-01-01",{"name":192,"class":49},"Saint Petersburg State University, Russia",{"id":194,"slug":195,"hasResults":11,"nctId":196,"briefTitle":197,"officialTitle":198,"acronym":199,"eligibilityCriteria":200,"healthyVolunteers":11,"sex":17,"minAge":201,"maxAge":4,"enrollmentInfo":202,"targetDuration":4,"studyType":23,"phases":204,"briefSummary":205,"conditions":206,"keywords":4,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":207,"lastUpdatePostDateStruct":208,"startDateStruct":210,"completionDateStruct":212,"leadSponsor":214,"locationsCount":216},"100532021","atrial-fibrillation-ablation-versus-atrioventricular-nodal-ablation-with-conduction-system-pacing-in-heart-failure-100532021","NCT06207383","Atrial Fibrillation Ablation Versus Atrioventricular Nodal Ablation with Conduction System Pacing in Heart Failure","Catheter ABlation of Atrial Fibrillation Versus Atrioventricular Nodal Ablation with CondUction System Pacing in Persistent Atrial Fibrillation and Heart Failure","ABACUS","Inclusion Criteria:\n\n(i) Persistent AF with symptomatic HF despite medical therapy, considered to be suitable for AF ablation, with at most one previous PVI procedure.\n\n(ii) At least one prior hospital admission, or emergency room \u002F HF clinic visit for HF in the past 2 years, with NT-pro-BNP \\> 1000 pg\u002Fml or BNP \\> 250 pg\u002Fml measured at any timepoint during this interval.\n\n(iii) Previous or current rate or rhythm control drug therapy. (iv) Age \\> 60 years\n\nExclusion Criteria:\n\n(i) NYHA Class IV and systolic blood pressure ≤80 mmHg despite optimized therapy.\n\n(ii) Life expectancy \\\u003C 2 years. (iii) Need for major surgical intervention. (iv) Myocardial infarction, stroke or PCI within the previous 3 months. (v) Previously implanted or planned implantation of CRT device or pacemaker. Implantable cardioverter defibrillator (ICD) implantation without a pacing indication is acceptable.\n\n(vi) Participation in another controlled trial. (vii) Inability to sign and informed consent form.","60 Years",{"count":203,"type":22},220,[25],"The goal of this clinical trial is to evaluate two treatment strategies in patients with chronic atrial fibrillation and heart failure, who are eligible for atrial fibrillation ablation. Patients will be randomized to either atrial fibrillation ablation or to implantation of a pacemaker with conduction system pacing followed by atrioventricular node ablation. The effect of treatment allocation on total mortality, cardiovascular hospitalization and heart failure hospitalization will be compared.",[29,65],"2024-12-03",{"date":209,"type":42},"2024-12-06",{"date":211,"type":42},"2024-10-01",{"date":213,"type":22},"2028-12",{"name":215,"class":49},"University Hospital, Geneva",18,{"id":218,"slug":219,"hasResults":11,"nctId":220,"briefTitle":221,"officialTitle":222,"acronym":223,"eligibilityCriteria":224,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":225,"enrollmentInfo":226,"targetDuration":4,"studyType":23,"phases":228,"briefSummary":229,"conditions":230,"keywords":4,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":231,"lastUpdatePostDateStruct":232,"startDateStruct":234,"completionDateStruct":236,"leadSponsor":238,"locationsCount":240},"100550312","optimal-pacing-rate-for-cardiac-resynchronization-therapy-100550312","NCT06445439","Optimal Pacing Rate for Cardiac Resynchronization Therapy","Optimal Pacing Rate for Cardiac Resynchronization Therapy After Atrioventricular Node Ablation in Persistent Atrial Fibrillation and Heart Failure","OPT-RATE AF","Inclusion Criteria:\n\n1. Age 18 years or older\n2. History of persistent or permanent atrial fibrillation\n3. Implantation of CRT or conduction system pacing in prior 3 months to 5 years of study start\n4. History of intrinsic AVN block or have undergone AVN ablation in prior 3 months to 5 years of study start\n5. LVEF ≥ 50%\n6. N-terminal pro-B-type natriuretic peptide (NT-proBNP) \\>400 pg\u002FmL in the last 24 months\n7. Clinical HF diagnosis or NYHA class II or higher\n8. Able to provide informed consent\n\nExclusion Criteria:\n\n1. LVEF \\\u003C50%\n2. Wide QRS (greater than 150ms)\n3. Isolated RV pacing\n4. Severe valvular disease\n5. Severe coronary artery disease as defined by one of the following:\n\n   1. ACS or PCI within 1 year\n   2. Any angina (CCS class 1+)\n   3. Unrevascularizable severe CAD (\\>70% stenosis in 1+ major vessels and\u002For based on functional assessment)\n6. ESRD\n7. Significant primary pulmonary disease on home oxygen\n8. Major orthopedic issues, such as being wheelchair bound and\u002For unable to perform a six-minute walk test\n9. Ventricular ectopy \\>15% premature ventricular contractions (PVC)\n10. End stage cancer diagnosis\n11. Life expectancy less than one year\n12. Palliative or hospice care\n13. Hypertrophic cardiomyopathy (HCM)\n14. Uncorrected ventricular septal defect\n15. Infiltrative cardiomyopathy (CM)\n16. Uncontrolled hypertension as defined by blood pressure \\>160\u002F100 mm Hg on two measurements ≥15 minutes apart\n17. Hemoglobin \\\u003C7 g\u002FdL\n18. Age \\>90 years old\n19. Pregnant or intends to become pregnant","90 Years",{"count":227,"type":22},60,[25],"This is a prospective, randomized crossover study. The objective of the study is to determine if a pacing rate of 80 beats per minute (bpm) improves exercise tolerance during the 6-minute walk test. The investigators will randomly assign half of the participants to a starting rate of 60 bpm and then switch them to a rate of 80 bpm for 3 months, and vice versa.",[29],"2024-10-09",{"date":233,"type":42},"2024-10-15",{"date":235,"type":42},"2023-12-19",{"date":237,"type":22},"2025-08",{"name":239,"class":49},"Medstar Health Research Institute",5,{"id":242,"slug":243,"hasResults":11,"nctId":244,"briefTitle":245,"officialTitle":246,"acronym":4,"eligibilityCriteria":247,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":19,"enrollmentInfo":248,"targetDuration":4,"studyType":23,"phases":249,"briefSummary":250,"conditions":251,"keywords":252,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":255,"lastUpdatePostDateStruct":256,"startDateStruct":258,"completionDateStruct":260,"leadSponsor":262,"locationsCount":50},"100560564","comparison-of-catheter-plus-marshall-vein-ablation-vs-catheter-ablation-alone-in-persistent-af-with-heart-failure-100560564","NCT06578793","Comparison of Catheter Plus Marshall Vein Ablation vs. Catheter Ablation Alone in Persistent AF With Heart Failure","Comparison of Catheter Ablation Combined With Ethanol Ablation of the Marshall Vein vs. Catheter Ablation Alone in Persistent Atrial Fibrillation With Heart Failure: A Multicenter Randomized Controlled Study","Inclusion Criteria:\n\n1. Age between 18 and 80 years\n2. For symptomatic patients with persistent atrial fibrillation: At least a 6-month history of atrial fibrillation; atrial fibrillation duration exceeding 7 days without spontaneous conversion to sinus rhythm; at least two episodes of persistent atrial fibrillation in the past 6 months even after rhythm conversion; poor tolerance or resistance to at least one Class I, II, or III antiarrhythmic drug\n3. Diagnosed with heart failure: Echocardiogram showing left ventricular ejection fraction (LVEF) ≤40%\n4. Patient willing to receive medication or surgical treatment\n5. Patient willing to comply with the requirements before the study, during the study, and during follow-up and to sign an informed consent form\n6. Capable of completing a 6-minute walk test\n7. For women of childbearing potential, a negative pregnancy test result is required\n\nExclusion Criteria:\n\n1. Presence of thrombus in the left atrium\n2. Left atrial diameter greater than 65 millimeters in the parasternal long-axis view, or left atrial volume exceeding 200 milliliters as measured by MRI or CT\n3. Presence of significant congenital abnormalities or medical issues, deemed by the researcher as inappropriate for participation in the study\n4. Reversible causes of atrial fibrillation, such as pericarditis, thyroid disease, acute alcohol intoxication, recent major surgery, or trauma\n5. Currently suffering from valvular heart disease requiring surgical intervention\n6. Currently suffering from coronary artery disease requiring surgical or percutaneous intervention\n7. History of atrioventricular node ablation\n8. Liver failure\n9. Renal failure requiring dialysis\n10. Contraindicated use of appropriate anticoagulation therapy\n11. Participation in other experimental drug or device studies\n12. Severe pulmonary disease\n13. Previous catheter ablation for atrial fibrillation in the left atrium\n14. Documented thromboembolic event within the past 90 days\n15. Pregnant women",{"count":60,"type":22},[25],"This multicenter, randomized controlled trial aims to compare the clinical efficacy and safety of combining catheter ablation with Marshall vein ethanol ablation versus catheter ablation alone in patients with persistent atrial fibrillation (AF) and concomitant heart failure. Persistent AF is a common arrhythmia that significantly impacts the quality of life and survival rates, especially when coexisting with heart failure. While catheter ablation is a standard treatment for AF, its effectiveness in persistent AF, particularly in patients with heart failure, remains suboptimal. The addition of Marshall vein ethanol ablation may enhance treatment outcomes by targeting arrhythmogenic substrates. This study will enroll 120 participants across three centers to evaluate whether this combined approach can reduce AF recurrence, improve heart function, and enhance patient outcomes compared to catheter ablation alone.",[29,65],[64,65,253,254],"Catheter Ablation","Marshall Vein","2024-08-28",{"date":257,"type":42},"2024-08-29",{"date":259,"type":42},"2024-08-01",{"date":261,"type":22},"2026-01-31",{"name":263,"class":49},"Second Xiangya Hospital of Central South University",{"id":265,"slug":266,"hasResults":11,"nctId":267,"briefTitle":268,"officialTitle":269,"acronym":270,"eligibilityCriteria":271,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":272,"enrollmentInfo":273,"targetDuration":4,"studyType":23,"phases":275,"briefSummary":276,"conditions":277,"keywords":281,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":288,"lastUpdatePostDateStruct":289,"startDateStruct":291,"completionDateStruct":293,"leadSponsor":295,"locationsCount":50},"100547026","ablation-of-focal-activation-in-atrial-fibrillation-100547026","NCT06402617","Ablation of Focal Activation in Atrial Fibrillation","Ablation of Focal Activation During Persistent Atrial Fibrillation to Determine the Characteristics of Focal Drivers","RETRO-AF","Inclusion Criteria:\n\n* Persistent atrial fibrillation with clinical indication for catheter ablation\n* Clinically suitable candidate for catheter ablation\n* Signed informed consent\n\nExclusion Criteria:\n\n* Previous atrial fibrillation or other catheter ablation procedure\n* Clinical contraindication to catheter ablation or general anaesthetic, including history of adverse reaction to contrast media, or presence of intracardiac thrombus, or inadequate anticoagulation in the preceding 6 weeks\n* Valvular disease graded moderate or greater, or presence of a prosthetic valve\n* Moderate-to-severe heart failure, defined as left ventricular ejection fraction \\\u003C35% and\u002For New York Heart Association class III-IV\n* Any form of cardiomyopathy\n* Active infection or fever\n* Severe cerebrovascular disease\n* Active gastrointestinal bleeding\n* Bleeding or clotting disorders, clinically high bleeding risk, or clinical contraindication to receiving heparin\n* Baseline serum creatinine \\>200umol\u002FL\n* Currently receiving or at risk of requiring renal replacement therapy\n* Uncontrolled diabetes (HbA1c ≥73mmol\u002Fmol or HbA1c ≤64mmol\u002Fmol and fasting blood glucose ≥9.2mmol\u002FL)\n* Malignancy necessitating therapy\n* Life expectancy shorter than the duration of the trial\n* Pregnancy, or childbearing potential and not using a highly effective method of contraception\n* Inability to provide informed consent to participate in the trial","85 Years",{"count":274,"type":22},110,[25],"Recurrent focal electrical activation (or ectopy) superseding sinus activation is the only mechanism proven to drive paroxysmal atrial fibrillation (AF). However, it has not been possible to show similar focal drivers during AF, owing to the limitations of mapping in persistent AF. RETRO-Mapping has been developed as a method to generate activation maps during AF to test the hypothesis that persistent AF is also maintained by focal drivers.\n\nRETRO-Mapping is able to locate sites of focal activation that were isolated, intermittent, or recurrent during persistent AF. However, a 30-second segment of AF can have approximately 150 wavefronts in a small area of myocardium. Screening for focal activation and manually validating these prior to ablation was not feasible using current commercial systems.\n\nRETRO-Mapping can automatically detect focal activation and a recording system that enables the intracardiac signals to be directly analysed by the RETRO-Mapping software. This will allow RETRO-Mapping to build a detailed classification of focal activation types and study the impact of ablation of these sites on the AF cycle length, to address the hypothesis that persistent AF is maintained by focal drivers.",[64,29,278,279,280],"Arrhythmia","Arrhythmias, Cardiac","Cardiac Arrhythmia",[282,283,284,285,286,287],"ablation","electrophysiology","mapping","local activation time","pulmonary vein isolation","atrial fibrillation cycle length","2024-05-02",{"date":290,"type":42},"2024-05-07",{"date":292,"type":42},"2024-04-30",{"date":294,"type":22},"2026-10",{"name":296,"class":49},"Imperial College London",{"id":298,"slug":299,"hasResults":11,"nctId":300,"briefTitle":301,"officialTitle":302,"acronym":4,"eligibilityCriteria":303,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":4,"enrollmentInfo":304,"targetDuration":4,"studyType":23,"phases":306,"briefSummary":307,"conditions":308,"keywords":309,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":314,"lastUpdatePostDateStruct":315,"startDateStruct":317,"completionDateStruct":319,"leadSponsor":320,"locationsCount":50},"100535247","left-roof-linear-mitral-isthmus-linear-and-left-anterior-septal-linear-ablation-for-non-paroxysmal-af-promised-trial-100535247","NCT06249347","Left Roof Linear, Mitral Isthmus Linear and Left Anterior Septal Linear Ablation for Non-paroxysmal AF: PROMISED Trial.","Pulmonary Vein Isolation and Left Roof Linear, Mitral Isthmus Linear, and Left Anterior Septal Linear Ablation, and Left Atrial Appendage Device Occlusion in Patients With Non-paroxysmal Atrial Fibrillation: PROMISED Trial.","Inclusion criteria:\n\n1. Age \\> 18 years;\n2. Persistent AF (AF duration \\> 7 days);\n3. CHA2DS2-VASc score ≥2;\n4. Presence of at least one of the following conditions:\n\n   * Unsuitable for long-term standardized anticoagulation therapy;\n   * Stroke or embolism still occurred based on long-term standardized anticoagulation therapy;\n   * HAS-BLED score ≥3;\n   * Unwillingness for long-term anticoagulation therapy;\n\nExclusion Criteria:\n\n1. Previous atrial fibrillation ablation\n2. Transthoracic echocardiography suggests that the anteroposterior diameter of the left atrium is greater than 60 mm;\n3. persistent AF that lasts \\>10 years\n4. Scheduled cardiac surgical intervention.\n5. Documented left atrial thrombus\u002F left atrial appendage thrombus or another abnormality that precludes catheter\u002FLAAC introduction\n6. Life expectancy less than 1 year",{"count":305,"type":22},166,[25],"The purpose of this prospective randomized study is to assess whether a new treatment strategy consisting of circumferential Pulmonary vein isolation (PVI), left ROof linear (RL), Mitral Isthmus linear (MIL), and left anterior SEptal linear (ASL) ablation and left atrial appendage (LAA) Device occlusion (PROMISED procedure) is superior to the PVI combined LAA closure in enhancing the long-term success rate of catheter ablation in non-paroxysmal atrial fibrillation (AF) patients.",[64,29],[310,311,312,313],"non-paroxysmal atrial fibrillation","left atrial anterior wall ablation","roof linear ablation","mitral isthmus linear ablation","2024-02-08",{"date":316,"type":42},"2024-02-12",{"date":318,"type":42},"2024-01-28",{"date":131,"type":22},{"name":321,"class":49},"Second Affiliated Hospital of Wenzhou Medical University",{"id":323,"slug":324,"hasResults":11,"nctId":325,"briefTitle":326,"officialTitle":326,"acronym":327,"eligibilityCriteria":328,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":19,"enrollmentInfo":329,"targetDuration":4,"studyType":23,"phases":331,"briefSummary":332,"conditions":333,"keywords":334,"overallStatus":38,"whyStopped":4,"lastUpdateSubmitDate":336,"lastUpdatePostDateStruct":337,"startDateStruct":339,"completionDateStruct":341,"leadSponsor":343,"locationsCount":166},"100417418","thoracoscopic-surgical-versus-catheter-ablation-approaches-for-primary-treatment-of-persistent-atrial-fibrillation-100417418","NCT04715425","Thoracoscopic Surgical Versus Catheter Ablation Approaches for Primary Treatment of Persistent Atrial Fibrillation","APPROACH AF","Inclusion Criteria:\n\n* Age is between 18 and 80 years\n* Persistent AF as defined following the ESC 2016 Guidelines, evidenced by 1) ongoing AF on the ECG or 2) documentation of AF necessitating cardioversion.\n* AF documented by ECG or Holter \\\u003C 1 year ago.\n* At least one class I or III anti-arrhythmic drug in standard dosage has failed or is not tolerated.\n* Left atrial volume index ≤ 45 ml\u002Fm2\n* Legally competent and willing to sign the informed consent.\n* Willing and able to adhere to the follow-up visit protocol.\n* Life expectancy of at least 2 years.\n\nExclusion Criteria:\n\n* Prior intervention (catheter ablation or minimally-invasive thoracoscopic ablation) for AF.\n* AF is secondary to electrolyte imbalance, thyroid disease or other reversible or non-cardiovascular causes.\n* Documentation of CTI dependent atrial flutter\n* Valvular AF\n* Paroxysmal AF\n* Long standing Persistent AF, defined as AF continuously present for longer than 1 year.\n* Body mass index \\>35kg\u002Fm2\n* NYHA class IV heart failure symptoms or left ventricular ejection fraction \\\u003C35%.\n* NYHA class III heart failure symptoms, unless caused or aggravated by AF.\n* Myocardial infarction within the preceding 2 months.\n* Active infection or sepsis (as evidenced by increased white blood cell count, elevated CRP level or fever \\>38,5 °C).\n* Known and documented carotid stenosis \\> 80%\n* Planned cardiac surgery for other purposes than AF.\n* Pregnancy or child bearing potential without adequate anticonception.\n* Requirement of anti-arrhythmic drugs for ventricular arrhythmias.\n* Presence of intracardiac mass or thrombus (discovery of any thrombus or intracardiac mass after signing of the informed consent will result in withdrawal of the subject from the study)\n* Co-morbid condition that possesses undue risk of general anesthesia or port access cardiac surgery (in the opinion of the operator).\n* History of previous radiation therapy on the thorax\n* Circumstances that prevent follow-up\n* No vascular access for catheterization.\n* History of previous thoracotomy.\n* Factors precluding transseptal puncture for catheterization.",{"count":330,"type":22},170,[25],"Rationale: Atrial fibrillation (AF) is a highly prevalent cardiac arrhythmia. AF is classified as paroxysmal or persistent AF, based on the duration and persistency of the arrhythmia. Despite state-of-the-art pharmacological therapies targeting the ventricular rate or aiming to restore sinus rhythm, many patients with persistent AF stay symptomatic. Catheter ablation, endocardial pulmonary vein isolation (PVI) in particular, is the most commonly applied approach to treat drug refractory persistent AF, but particularly in this patient group results are modest. Alternatively, the PVs can be approached epicardially by thoracoscopic surgery to isolate the PVs. This approach is more efficacious, at the cost of a more invasive procedure and longer hospital stay. However, no studies have been conducted comparing catheter with thoracoscopic ablation in patients with persistent AF as a primary invasive procedure after failing treatment with anti-arrhythmic medication.\n\nObjective: This current study aims to assess a patient specific therapy plan for patients with persistent AF by randomizing thoracoscopic versus catheter ablation for PVI without adjuvant substrate ablation in those patients.\n\nStudy design: This is a prospective, non-blinded randomized multicenter study. Subjects will be randomized (1:1) to one of the two study-arms (thoracoscopic surgical or catheter PVI). The follow-up will last 5 years, with heart rhythm monitoring at three and six months, one year and yearly in the following years. In case AF recurs during the first year, the subject will receive the treatment of the otherother arm, or according to patient choice or clinical routine.\n\nStudy population: Patients with an indication for invasive treatment of persistent AF.\n\nIntervention: Thoracoscopic surgical or catheter PVI without additional lesions.",[29],[33,335],"Thoracoscopic ablation","2024-01-24",{"date":338,"type":42},"2024-01-25",{"date":340,"type":42},"2019-09-25",{"date":342,"type":22},"2028-09",{"name":344,"class":49},"Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)",{"id":346,"slug":347,"hasResults":11,"nctId":348,"briefTitle":349,"officialTitle":349,"acronym":350,"eligibilityCriteria":351,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":19,"enrollmentInfo":352,"targetDuration":4,"studyType":23,"phases":354,"briefSummary":355,"conditions":356,"keywords":358,"overallStatus":156,"whyStopped":4,"lastUpdateSubmitDate":362,"lastUpdatePostDateStruct":363,"startDateStruct":365,"completionDateStruct":367,"leadSponsor":369,"locationsCount":4},"100523691","a-prospective-study-of-repeat-ablation-in-patients-with-recurrent-persistent-atrial-fibrillation-pulmonary-vein-isolation-vs-adjunct-posterior-wall-isolation-repair-pers-af-study-100523691","NCT06098989","A Prospective Study of REPeat Ablation In Patients With Recurrent PERSistent Atrial Fibrillation: Pulmonary Vein Isolation vs. Adjunct Posterior Wall Isolation (REPAIR PERS-AF Study)","REPAIR PERS-AF","Inclusion Criteria:\n\n* Symptomatic patients with persistent AF and indication for repeat ablation\n* procedure.\n* Patients with recurrent persistent AF (with a duration \\\u003C3 year, at least one episode longer than 7 days during the last 6 months and have been electrically cardioverted at least once during the last 12 months) after previous catheter ablation.\n* Patients with up to two previous catheter ablations for AF are included if the procedures only involved PVI. Previous PVI procedure(s) with both cryoablation and radiofrequency ablation are accepted.\n* Patients have taken at least one antiarrhythmic drug.\n* Patients are willing to participate in the study and sign the patient information form.\n* Age: 18-80 years old.\n* Patients must be on continuous anticoagulation with warfarin (INR 2-3) or direct oral anticoagulant for \\>4 weeks prior to the ablation.\n\nExclusion Criteria:\n\n* Patients with \\>2 ablation procedures in the LA for AF or atrial flutter\n* Previous ablation procedures for AF involving ablation strategies beyond PVI\n* Duration of persistent AF \\>3 years\n* Presence of atrial flutter or atrial tachycardia\n* Presence of an intracavitary thrombus\n* Uncontrolled heart failure\n* Severe valvular disease\n* LA diameter \\> 60 mm\n* Structural heart disease involving more than moderate valvular stenosis and\u002For\n* Insufficiencies\n* Rheumatic heart disease\n* Cardiac surgery for valvopathy or for congenital heart disease\n* Patients with contraindications to systemic anticoagulation\n* Severe renal dysfunction\n* Patients who are or may potentially be pregnant.\n* Patient not able to be followed up.",{"count":353,"type":22},150,[25],"This study aims to investigate the best strategy for repeat ablation of recurrent persistent atrial fibrillation (AF) after previous persistent AF ablation involving pulmonary vein isolation (PVI) along. Patients with low voltage areas on the posterer wall will be randomized to PVI alone or the posterer wall isoaltion (PWI) in addition to PVI.",[29,357],"Atrial Fibrillation Recurrent",[359,149,360,361],"Atrial fibrillation","Posterior wall isolation","Pulmonary vein isolation","2023-10-22",{"date":364,"type":42},"2023-10-25",{"date":366,"type":22},"2023-11-15",{"date":368,"type":22},"2026-11-15",{"name":370,"class":49},"Haukeland University Hospital",{"id":372,"slug":373,"hasResults":11,"nctId":374,"briefTitle":375,"officialTitle":376,"acronym":4,"eligibilityCriteria":377,"healthyVolunteers":11,"sex":17,"minAge":18,"maxAge":378,"enrollmentInfo":379,"targetDuration":4,"studyType":23,"phases":380,"briefSummary":382,"conditions":383,"keywords":384,"overallStatus":156,"whyStopped":4,"lastUpdateSubmitDate":390,"lastUpdatePostDateStruct":391,"startDateStruct":393,"completionDateStruct":395,"leadSponsor":396,"locationsCount":398},"100511410","phase-3-first-line-cryoablation-for-early-treatment-of-persistent-atrial-fibrillation-100511410","NCT05939076","First-line Cryoablation for Early Treatment of Persistent Atrial Fibrillation","First-line Cryoablation for Early Treatment of Persistent Atrial Fibrillation - a Randomized Study Comparing Early Trigger Isolation Using the Cryoballoon Versus Antiarrhythmic Medication","Inclusion Criteria:\n\n* Non-longstanding persistent symptomatic AF with at least 2 episodes within last 24 months, the latest episode within the previous 6 months and one documented on a 12 lead ECG or Holter monitor, that is classified as either\n\n  1. Classical persistent AF (continuously sustained beyond 7 days and \\\u003C12 months in duration) as defined by ESC guidelines14 OR\n  2. Persistent AF which has progressed from paroxysmal AF (patients who have been cardioverted within 7 days of onset provided a history of spontaneous conversion to sinus rhythm is lacking during the past 24 months).\n* Candidate for rhythm control therapy; AF ablation or AAD based on symptomatic AF.\n\nExclusion Criteria:\n\n1. Regular daily use of AAD class I or III at adequate therapeutic dosages (pill-in-the-pocket permitted, beta-blockers permitted).\n2. Previous AF ablation or surgery.\n3. Severe heart failure (NYHA III-IV).\n4. Reduced left ventricular ejection fraction (LVEF ≤40 % during sinus rhythm).\n5. Hypertrophic cardiomyopathy (septal or posterior wall thickness \\>1.5 cm)\n6. Severely enlarged LA with left atrial volume indexed to body surface area (LAVI, ml\u002Fm2) \\> 48.\n7. Significant valvular disease requiring treatment or valve prothesis.\n8. Severe Chronic Obstructive Pulmonary Disease (COPD) stage III or chronic kidney disease (eGFR\\\u003C 30 umol\u002Fl)).\n9. Planned cardiac intervention within the next 12 months or cardiac surgery last 6 months.\n10. Myocardial infarction, revascularisation previous 6 months.\n11. Stroke or Transient Ischemic Attack (TIA) within previous 6 months.\n12. Tachycardiomyopathy.\n13. Dependent on VVI (ventricular single chamber inhibited) pacing.\n14. Conventional contraindications for AF ablation including AF due to reversible causes and contraindications for both class IC and class III antiarrhythmic drugs.\n15. Expected survival less than 3 years, alcohol or drug abuse.\n16. Participation in another trial or absence of consent.","75 Years",{"count":203,"type":22},[381],"PHASE3","The goal of this multicentre, prospective, randomized, open, blinded for evaluation of end point (PROBE) controlled parallel-group superiority trial, is to compare the efficacy of antiarrhythmic drug (AAD) therapy and cryoballoon pulmonary vein isolation (PVI) regarding freedom from atrial fibrillation (%) assessed by an implantable cardiac monitor (ICM), ECG tracing or Holter at 12 months in patients with persistent AF. The main question\\[s\\] it aims to answer are:\n\n* Will first-line cryoballoon ablation for PVI compared to AAD, result in 25 % higher freedom from atrial tachyarrhythmias lasting \\> 6 minutes at 12 months (primary outcome) excluding three months initial blanking period, in patients with symptomatic and recurrent persistent AF?\n* Will first-line cryoablation for PVI, compared to AAD result in a superior improvement in health related Quality of Life (HRQoL), AF\u002FAT burden, AF\u002FAT progression and reversion, more reverse atrial remodeling, cognitive function, healthcare utilization with associated costs, better safety, at 12-24-36 months as compared with drug use? Participants will be randomized 1:1 to first-line PVI using the cryoballoon or to first-line antiarrhythmic drug therapy and during 3 years follow-up undergo regular;\n\n  * Continuous ECG monitoring for assessment of first AF recurrence and AF burden using an implantable cardiac monitor,\n  * Regular echocardiographic exams for reverse atrial remodelling assessment,\n  * HRQoL questionnaires\n  * Assessment of cognitive function\n  * Atrial fibrillation evaluation regarding structured characterisation and AF progression\u002Fregression\n  * Assessment of Health care use and costs\n  * Safety",[29],[385,282,386,387,388,389],"atrial fibrillation","first-line","antiarrhythmics","burden","symptoms","2023-07-02",{"date":392,"type":42},"2023-07-11",{"date":394,"type":22},"2023-08-21",{"date":213,"type":22},{"name":397,"class":49},"Region Örebro County",6]