Clinical Benefits of Additional Complex Fractionated Atrial Electrogram Targeted Catheter Ablation for Longstanding 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 persistent atrial fibrillation patients between conventional additional linear ablation and additional complex fractionated atrial electrogram targeted catheter 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 longstanding persistent atrial fibrillation. additional ablation make extent of myocardial injury and paradoxically increase recurrence rate, thus still controversial. Therefore, we will compare conventional linear ablation with additional complex fractionated atrial electrogram targeted catheter 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 to evaluate superior ablation strategy in longstanding persistent atrial fibrillation compare conventional linear ablation with additional complex fractionated atrial electrogram targeted catheter ablation. both strategies are conventional ablation strategies being performed world-wide. compare complex fractionated atrial electrogram before and after linear ablation.

Conditions
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Atrial Fibrillation

Intervention / Treatment
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* Procedure: atrial electrogram and liner ablation


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 |
| --- | --- |
| Experimental: the operation to add in CFAE to conventional liner ablation<br>The group of positive control is the operation to add in CFAE to conventional liner ablation in persistent atrial fibrillation patients | Procedure: atrial electrogram and liner ablation<br>* The group of positive control is the operation to add in CFAE to conventional liner ablation in persistent atrial fibrillation patients The group of negative is the operation to only doing conventional liner ablation with persistent atrial fibrillation<br>|
| Active Comparator: only doing conventional liner ablation<br>The group of negative is the operation to only doing conventional liner ablation with persistent atrial fibrillation | Procedure: atrial electrogram and liner ablation<br>* The group of positive control is the operation to add in CFAE to conventional liner ablation in persistent atrial fibrillation patients The group of negative is the operation to only doing conventional liner ablation with 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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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atrial fibrillation, catheter ablation, recurrence