Evaluation of Proper Radiofrequency Catheter Ablation Strategy for the Patients Who Were Changed to Paroxysmal Atrial Fibrillation From Persistent Atrial Fibrillation

Study Overview
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Brief Summary
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1. Purpose of the study 1) To compare clinical outcome, procedure time, complication rate of patients who were changed to paroxysmal atrial fibrillation from persistent atrial fibrillation between ablation with conventional pulmonary vein isolation and ablation with conventional pulmonary vein isolation with conventional linear ablation. 2. Scientific evidence of the study In atrial fibrillation patients, the maintenance of normal sinus rhythm showed significant reduction of mortality. drug therapy with anti-arrhythmic drug showed many complications and side effect, thus non-drug therapy such as catheter ablation is developed. catheter ablation has been performed for 10years world-wide, and showed superior treatment outcome compared with drug therapy. However, there are no consensus for proper ablation strategy in patients who were changed to paroxysmal atrial fibrillation from persistent atrial fibrillation . additional ablation make extent of myocardial injury and paradoxically increase recurrence rate, thus still controversial. Therefore, we will compare conventional pulmonary vein isolation with additional conventional linear ablation. 3. Methods Treatment of All patients with atrial fibrillation is performed according to the standard treatment guideline of atrial fibrillation. there is no additional blood sampling, imaging study, or any other invasive procedure according to the inclusion of the study. 4. study contents 1) to evaluate superior ablation strategy in patients who were changed to paroxysmal atrial fibrillation from persistent atrial fibrillation compare conventional pulmonary vein isolation with additional liner ablation, both strategies are conventional ablation strategies being performed world-wide.

Conditions
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Atrial Fibrillation

Intervention / Treatment
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* Procedure: linear ablation
* Procedure: pulmonary vein isolation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1) patients who undergoing catheter ablation of atrial fibrillation due to symptomatic, drug refractory atrial fibrillation Exclusion Criteria: patients who do not agree with study inclusion permanent AF refractory to electrical cardioversion AF with valvular disease ≥ grade 2 Patients with left atrial diameter greater than 60mm patients with age less than 19

Ages Eligible for Study
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Minimum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: linear ablation<br>The group of positive control is the operation to add in conventional liner ablation to conventional pulmonary vein isolation with in patients based on patients who were changed to paroxysmal atrial fibrillation from persistent atrial fibrillation | Procedure: linear ablation<br>* The group of positive control is the operation to add in conventional liner ablation to conventional pulmonary vein isolation with in patients based on patients who were changed to paroxysmal atrial fibrillation from persistent atrial fibrillation<br>|
| Experimental: pulmonary vein isolation<br>The group of negative is the operation to patients with only pulmonary vein isolation based on patients who were changed to paroxysmal atrial fibrillation from persistent atrial fibrillation | Procedure: pulmonary vein isolation<br>* The group of negative is the operation to patients with only pulmonary vein isolation based on patients who were changed to paroxysmal atrial fibrillation from persistent atrial fibrillation<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| number of Clinical recurrence of atrial fibrillation (AF) after catheter ablation | lifelong, checked per every outpatient clinic visit | 1 year |