Specific Electrophenotypes in Atrial Fibrillation (INSPECT-AF)

  • STATUS
    Recruiting
  • End date
    Jun 10, 2026
  • participants needed
    300
  • sponsor
    Imperial College London
Updated on 4 October 2022
stroke
arrhythmia
fibrillation
scar
cardioversion

Summary

This study will investigate a common heart rhythm disturbance (arrhythmia), atrial fibrillation (AF), to improve understanding of how best to treat it in different patients. Direct current cardioversion (DCCV) is a procedure that can revert the heart to a normal rhythm, however almost all patients will only have a transient benefit, and their heart will return to the abnormal rhythm, AF. Ablation is an invasive procedure that creates scar tissue within the heart to reduce the arrhythmias, with a longer lasting effect than DCCV. It has been used with success in AF that occurs occasionally (paroxysmal) but is not as effective in AF that is more long-lasting, also known as persistent AF. Persistent AF is major cause of symptoms of breathlessness and palpitations and significantly increases the risk of stroke. Doctors are unable to accurately predict which patients will benefit most from an ablation, this can lead to as many as 50% of patients not benefitting from the procedure. The aim is to better predict which patients will benefit from an ablation. The study will include patients undergoing AF ablation or DCCV and perform additional tests including blood tests a heart MRI scan, a special type of heart tracing with up to 252 points and a short period of extra recordings from within the heart during the ablation procedure. Several techniques will be used to analyse this data, including machine learning, to develop a means predict which patients will benefit the most from the ablation procedure, without needing to use any recordings from within the heart.

Details
Condition Atrial Fibrillation
Treatment Biomarkers, electrocardiographic imaging, intracardiac electrograms, cardiac magnetic resonance imaging
Clinical Study IdentifierNCT05366530
SponsorImperial College London
Last Modified on4 October 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Suitable candidate for catheter mapping/ablation for arrhythmias or direct current cardioversion for atrial fibrillation
Signed Informed Consent

Exclusion Criteria

Severe cerebrovascular disease
Moderate to severe renal impairment (eGFR < 30)
Active gastrointestinal bleeding
Active infection or fever
Short life expectancy
Significant anaemia
Severe uncontrolled systemic hypertension
Severe electrolyte imbalance
Congestive heart failure - NYHA Class IV
Recent myocardial infarction
Bleeding or clotting disorders
Uncontrolled diabetes
Inability to receive IV or oral Anticoagulants
Unable to give informed consent
Pregnancy
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