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| Name | Class |
|---|---|
| Northwell Health | OTHER |
| The Methodist Hospital Research Institute | OTHER |
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This study seeks to assess the effect of apnea (breath hold) during atrial fibrillation (AF) ablation by having all ablations performed under apnea. By prospectively studying the effects of apnea on AF ablation, the investigators wish to demonstrate its feasibility, safety and impact on patient outcomes. This is a prospective study that includes both an apnea arm and a control arm. The subjects who consent to the apnea arm will undergo an atrial fibrillation ablation with periods of apnea. The subjects who consent to the control arm will agree to have their data from their standard of care atrial fibrillation be collected for comparison.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Apnea | Experimental | Patients will undergo an atrial fibrillation ablation and will have induced periods of apnea throughout the procedure. |
|
| Control | Active Comparator | Patients who choose not to participate in the apnea arm will have the opportunity to consent to the control arm. These patients will undergo an atrial fibrillation ablation per standard of care without periods of apnea throughout the procedure. This data will be collected to use as a comparator to the apnea arm. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Periods of Apnea | Other | Periods of apnea throughout atrial fibrillation ablation. |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Catheter Stability Metrics as measured by contact force variability. | Contact force variability: Catheter stability metrics will be calculated as standard deviations of contact forces measured during the course of reach ablation region. Contact forces and their standard deviations will range between 0 and 60 grams. | Day 1 |
| Catheter Stability Metrics as measured by maximum and minimum contact force. | Maximum contact force: range between 0 and 60 grams | Day 1 |
| Catheter Stability Metrics as measured by average contact force. | Average contact force: range between 0 and 60 grams | Day 1 |
| Catheter Stability Metrics as measured by catheter displacement. | Catheter displacement (mean): range 0-10 mm | Day 1 |
| Efficacy as measured by time to pulmonary vein isolation. | Time to pulmonary vein isolation (minutes): expected range 60 - 180 minutes | Day 1 |
| Efficacy as measured by percentage of veins isolated after first pass. | Percentage of veins isolated after first pass: 0-100% | Day 1 |
| Catheter Stability Metrics as measured by time to impedance drop. | Time to 5 ohm and 10 ohm impedance drop: range 1 to 60 seconds | Day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Procedural time as measured by the length of time from start to end of procedure. | Length of procedure time determined by time lapsed per report from start of procedure to end of procedure. | Day 1 |
| Clinical Outcomes as measured by recurrence of atrial fibrillation at six months post procedure. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jim Cheung, MD | Weill Medical College of Cornell University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Southside Hospital | Bay Shore | New York | 11706 | United States | ||
| North Shore Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36752460 | Derived | Gabriels JK, Ying X, Purkayastha S, Braunstein E, Liu CF, Markowitz SM, Mountantonakis S, Thomas G, Goldner B, Willner J, Goyal R, Ip JE, Lerman BB, Carter J, Bereanda N, Fitzgerald MM, Anca D, Patel A, Cheung JW. Safety and Efficacy of a Novel Approach to Pulmonary Vein Isolation Using Prolonged Apneic Oxygenation. JACC Clin Electrophysiol. 2023 Apr;9(4):497-507. doi: 10.1016/j.jacep.2022.10.030. Epub 2023 Jan 18. |
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| ID | Term |
|---|---|
| D001281 | Atrial Fibrillation |
| D001145 | Arrhythmias, Cardiac |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Control Arm - No Periods of Apnea |
| Other |
Standard of care atrial fibrillation ablation. |
|
Percentage of subjects with atrial fibrillation on 5 day event monitor at 6 months post-intervention. |
| month six |
| Clinical Outcomes as measured by recurrence of atrial fibrillation at 12 months post procedure. | Percentage of subjects with atrial fibrillation on 5 day event monitor at 12 months post-intervention. | month 12 |
| Safety, as measured by number of subjects with at least one adverse event. | Adverse events will include any unfavorable and unintended sign, symptom, or disease temporally associated with the procedure. | End of study (12 months) |
| Manhasset |
| New York |
| 11030 |
| United States |
| New York Presbyterian Hospital - Weill Cornell Medicine | New York | New York | 10065 | United States |
| Lenox Hill Hospital | New York | New York | 10075 | United States |
| Long Island Jewish Medical Center | Queens | New York | 11040 | United States |
| Houston Methodist Hospital | Houston | Texas | 77030 | United States |