A New Approach for Catheter Ablation of Atrial Fibrillation

Study Overview
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Brief Summary
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This is a retrospective cohort study of radiofrequency ablation for the treatment atrial fibrillation(AF). Based on the electrophysiological phenomena found in these cases, the investigators propose a hypothesis regarding the underlying electrophysiological mechanism of AF, as well as a novel approach for catheter ablation of AF.

Detailed Description
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The investigators propose a new electrophysiological mechanism for AF: the superposition hypothesis. The investigators tested this hypothesis by conducting the retrospective cohort study to determine if superposition potentials (SP) can identify the critical regions where AF is sustained and if ablating SPs can improves the long-term efﬁcacy. The study consecutively collected patients with underwent the first catheter ablation for symptomatic AF in a university hospital from March 2021 to June 2022, including paroxysmal AF (lasting <7 days), persistent AF (lasting >7 days and <1 year without electrical cardioversion) and long-term persistent AF (lasting >1 year), aged between 18 and 80 years old. AF recurrence was evaluated at 3, 6, 9, and 12 months using 72-hour Holter monitoring at each clinic visit. The eligible patients were divided into two groups: the pulmonary vein isolation(PVI) alone group (n=56) and the PVI + SPs ablation group(n=60).Comprehensive clinical history and procedural data of patients were collected from electronic medical records.

Official Title
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A New Approach for Catheter Ablation of Atrial Fibrillation: a Retrospective Cohort Study

Conditions
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Atrial Fibrillation

Intervention / Treatment
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* Procedure: PVI alone
* Procedure: PVI + SPs ablation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients with underwent the first catheter ablation for symptomatic AF Exclusion Criteria: patients with more than one missing follow-up would be excluded

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| PVI alone group<br>Patients who undergo PVI alone using ThermoCool SmartTouch catheter. | Procedure: PVI alone<br>* pulmonary vein isolation<br>|
| PVI + SPs ablation group<br>Patients who undergo PVI + SPs ablation using ThermoCool SmartTouch catheter. | Procedure: PVI + SPs ablation<br>* pulmonary vein isolation + SPs ablation<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| freedom from AF within 12 months | AF recurrence was evaluated at 3, 6, 9, and 12 months using 72-hour Holter monitoring at each clinic visit. AF recurrence was defined as the occurrence of AF lasting at least 30 seconds after the 3-month blanking period. | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the acute termination of AF during the procedure | Conversion of AF to normal sinus rhythm or atrial tachyarrhythmias during ablation procedure. | during the procedure |