Lesion Contiguity in Very High Power-short Duration Ablation

University of Barcelona

Status: Unknown

Conditions: Atrial Fibrillation

Study type: Observational

Funder types: Other

Identifiers

NCT05368610

QDOT-MRI

Details and patient eligibility

About

This observational trial investigates the effect of very high power-short duration radiofrequency ablation on lesion contiguity as assessed by late gadolinium enhancement cardiovascular magnetic resonance (LGE-CMR). Patients with paroxysmal or early persistent atrial fibrillation (AF) scheduled for pulmonary vein isolation (PVI) undergo point-by-point ablation using the QDOT micro catheter applying Qmode+ (90W over 4 seconds). All patients receive an LGE-CMR 3 months after the procedure for ablation lesion assessment. Contiguity of LGE-CMR-detected ablation lesions will be compared with a matched control group of patients that have undergone PVI accomplished by ablation index-guided ablation with 40 W following the CLOSE protocol.

Enrollment: 128 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• paroxysmal or early persistent (max. 3 months) atrial fibrillation
• scheduled for PVI-only catheter ablation

Exclusion criteria

• long-standing persistent atrial fibrillation
• previous left atrial ablation
• claustrophobia preventing CMR
• sever renal insufficiency (GFR >30 ml/min)
• gadolinium contrast allergy
• presence of implantable devices not compatible with magnetic resonance
• pregnancy and lactation

Trial design

128 participants in 2 patient groups

Very high power-short duration ablation

Description:

PVI performed by point-by-point very high power-short duration radiofrequency ablation (QDOT-micro catheter, Biosense Webster; Qmode+; 90 W; 4 sec; target intertag distances: posterior wall 4 mm, proximity of the esophagus 5 mm, all other 3 mm)

Matched control group conventional ablation

Description:

PVI performed by conventional point-by-point radiofrequency ablation (40 W; ablation index-guided: posterior wall 350, other 450; target intertag distance 3.0 - 5.0 mm)