STrategies for Catheter Ablation of peRsistent Atrial Fibrlllation

  • End date
    Dec 28, 2023
  • participants needed
  • sponsor
    Montreal Heart Institute
Updated on 28 June 2021
left ventricular dysfunction
catheter ablation
antiarrhythmic drug


The objective of this study is to compare the efficacy of three different ablation strategies in patients with persistent AF:

  1. PV antral isolation alone (PVAI)
  2. PV antral isolation plus ablation of drivers (PVAI+drivers)
  3. PV antral isolation plus isolation of posterior wall (PVAI+box) All three strategies will employ contemporary catheter ablation technology using more efficient open irrigated tip cooling and contact force sensing.

Condition Dysrhythmia, Arrhythmia, Atrial Fibrillation, Atrial Fibrillation (Pediatric)
Treatment Wide Circumferential Pulmonary Vein Antrum Isolation (PVAI), Pulmonary Vein Antrum Isolation Plus Driver Ablation (PVAI+drivers), Pulmonary Vein Antrum Isolation Plus Box Isolation of Posterior Wall (PVAI+box)
Clinical Study IdentifierNCT04428944
SponsorMontreal Heart Institute
Last Modified on28 June 2021


Yes No Not Sure

Inclusion Criteria

Patients 18 years of age or older
Patients undergoing first-time ablation procedure for AF
Patients with persistent AF defined as a sustained episode more than 3 months but less than three years
Patients with symptomatic AF - symptomatic patients are those who have been aware of their AF at any time within the last 5 years prior to enrolment. Symptoms may include, but are not restricted to, palpitations, shortness of breath, chest pain, fatigue, left ventricular dysfunction, or other symptoms or any combination of the above
Patients whose AF has been refractory to at least one antiarrhythmic drug
At least one episode of AF must have been documented by ECG, holter, loop recorder, telemetry, trans-telephonic monitor or implanted device within the last 2 years from enrolment
Patients must be able and willing to provide written informed consent to participate in the study

Exclusion Criteria

Patients with paroxysmal AF (no episodes lasting > 7 days)
Patients with early persistent AF, sustained episode 3 months
Patients with very long lasting persistent AF (episodes lasting > 3 years)
Patients with CHA2DS2-VASc score of 0
Patients for whom cardioversion or sinus rhythm will never be attempted/pursued
Patients with AF felt to be secondary to an obvious reversible cause
Patients with contraindication to oral anticoagulation or systemic anticoagulation with heparin
Patients with left atrial diameter > 60 mm in the parasternal long axis view
Patients who are pregnant
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