ECGI in Patients With Persistent Atrial Fibrillation

Study Overview
=================
Brief Summary
-----------------
To determine the values and limitations of ECGI in guiding ablation and risk stratification in patients with persistent atrial fibrillation.

Detailed Description
-----------------
The patient population will include symptomatic persistent AF patients (N=50). The total of fifty patients will be studied to determine: The values and limitations of ECGI in identifying atrial fibrillation (AF) triggers, AF initiators and AF perpetuators as targets sites for catheter ablations in patients with persistent AF. The mechanisms of residual atrial tachycardia/flutter (Res-AT/AFl) after AF substrate ablations by targeting complex fractionated atrial electrograms (CFAE). If there is a relationship between primary CFAE sites and driver sites or other distinct patterns from the ECGI mapping system. The rate of AF termination to sinus rhythm after ablation at target sites identified by ECGI

Official Title
-----------------
Identification of AF Triggers, Initiators and Perpetuators by Electro Cardio-Graphic Imaging (ECGI) in Patients With Persistent Atrial Fibrillation

Conditions
-----------------
Atrial Fibrillation

Intervention / Treatment
-----------------
* Procedure: Radiofrequency ablation


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patients are diagnosed as persistent AF. Persistent AF was defined as continuous AF from 7 days to 12 months and long- lasting AF beyond twelve months. Patients who are symptomatic Patients who are willing to sign consent and be followed post procedure in an out- patient arrhythmia clinic Exclusion Criteria: Patients under 18 years or over 85 years of age. Patients with chronic alcoholism. Recent myocardial infarction within one month of the study. Significant debilitating diseases or a terminal disease. Patients with documented left atrial thrombus. Medical or mental conditions precluding a long-term follow-up.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Radiofrequency ablation|RF applications were delivered with a maximal temperature of 43°C at the catheter tip (SmartTouch Navistar Thermocool catheter) and at the power between 25-50 watts. The primary end points during RF ablation were either complete elimination of areas with CFAE or conversion of AF to normal sinus rhythm (SR). When areas with CFAE were completely eliminated but the atrial arrhythmias persisted (organized atrial flutter or atrial tachycardia), they were subsequently mapped and ablated (occasionally in conjunction with ibutilide, 1 - 2 mgs intravenously over 10 minutes).|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Freedom from Atrial Fibrillation | termination via ablation from atrial fibrillation during follow up period | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| termination via ablation from atrial fibrillation during procedure | Termination of AF to NSR during procedure | over 6 months |