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Ablation of consecutive atrial tachycardia (AT) after ablation of atrial fibrillation (AF) or cardiac surgery can be challenging due to complex substrate and AT mechanisms. A substantial portion of patients is known to show various tachycardias and recurrences occur in a noticeable number of cases. With the availability of novel ultra-high-density mapping techniques characterization and understanding of AT mechanisms and underlying substrate can be improved. Aim of this prospective, multi-center, randomized study is to compare a standard AT ablation approach versus minimalized ablation of the clinical AT in regards to arrhythmia free survival.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard approach | Experimental | Patients will receive a standard approach for ablation of atrial tachycardia. |
|
| Minimalized approach | Experimental | Patients will receive a minimalized approach for ablation of atrial tachycardia. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Catheter ablation | Procedure | Catheter-based ablation of arrhythmias using radiofrequency. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Recurrence of any sustained arrhythmia (>30 sec.) | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Inducibility of atrial tachycardia (AT) after ablation of clinical/primary AT (partial success) | Categorical variable (yes/no) | Intraprocedural |
| Predictability of secondary AT by analysis of clinical AT map and voltage map |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Christian Meyer, MD | Contact | 00492119191855 | christian.meyer@evk-duesseldorf.de |
| Name | Affiliation | Role |
|---|---|---|
| Christian Meyer, MD | Evangelic Hospital Düsseldorf | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Asklepios St. Georg | Recruiting | Hamburg | Free and Hanseatic City of Hamburg | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41435855 | Background | Meyer C, Kahle AK, Dagres N, Derval N, Dewland TA, Drago F, Eckardt L, Frontera A, Gerstenfeld EP, Hardy C, Jais P, Kalman J, Kistler PM, Martin C, Purerfellner H, Takigawa M, Wong T, Zeppenfeld K. Management of patients with atrial tachycardia: a clinical consensus statement of the European Heart Rhythm Association (EHRA) of the ESC, endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), the Latin American Heart Rhythm Society (LAHRS), and the Association for European Paediatric and Congenital Cardiology (AEPC). Europace. 2025 Dec 1;27(12):euaf324. doi: 10.1093/europace/euaf324. | |
| 32748442 |
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| ID | Term |
|---|---|
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D001281 | Atrial Fibrillation |
| ID | Term |
|---|---|
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D017115 | Catheter Ablation |
| ID | Term |
|---|---|
| D000078703 | Radiofrequency Ablation |
| D000078702 | Radiofrequency Therapy |
| D013812 | Therapeutics |
| D055011 | Ablation Techniques |
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| Intraprocedural |
| Procedure duration time | Intraprocedural |
| Fluoroscopy time | intraprocedural |
| Total radiofrequency application time | intraprocedural |
| Ablated area (cm2) | intraprocedural |
| Number of blocked lines | intraprocedural |
| Area of low voltage in sinus map (cm2) | Intraprocedural |
| Evangelic Hospital Düsseldorf | Recruiting | Düsseldorf | North Rhine-Westfalia | 40217 | Germany |
|
| Vivantes Klinikum Am Urban Berlin | Recruiting | Berlin | Germany |
|
| Evangelic Hospital Hagen-Haspe | Recruiting | Hagen | Germany |
|
| Städtisches Klinikum Karlsruhe | Recruiting | Karlsruhe | Germany |
|
| Universitätsklinikum Schleswig Holstein | Recruiting | Kiel | Germany |
|
| Background |
| Jungen C, Akbulak R, Kahle AK, Eickholt C, Schaeffer B, Scherschel K, Dinshaw L, Muenkler P, Schleberger R, Nies M, Gunawardene MA, Klatt N, Hartmann J, Merbold L, Jularic M, Willems S, Meyer C. Outcome after tailored catheter ablation of atrial tachycardia using ultra-high-density mapping. J Cardiovasc Electrophysiol. 2020 Oct;31(10):2645-2652. doi: 10.1111/jce.14703. Epub 2020 Aug 11. |
| 32703564 | Background | Derval N, Takigawa M, Frontera A, Mahida S, Konstantinos V, Denis A, Duchateau J, Pillois X, Yamashita S, Berte B, Thompson N, Hooks D, Pambrun T, Sacher F, Hocini M, Bordachar P, Jais P, Haissaguerre M. Characterization of Complex Atrial Tachycardia in Patients With Previous Atrial Interventions Using High-Resolution Mapping. JACC Clin Electrophysiol. 2020 Jul;6(7):815-826. doi: 10.1016/j.jacep.2020.03.004. Epub 2020 May 27. |
| 31400216 | Background | Meyer C. High-density mapping-based ablation strategies of cardiac rhythm disorders: the RHYTHMIA experience at new horizons. Europace. 2019 Aug 1;21(Supplement_3):iii7-iii10. doi: 10.1093/europace/euz154. No abstract available. |
| 31004777 | Background | Takigawa M, Martin CA, Derval N, Denis A, Vlachos K, Kitamura T, Frontera A, Martin R, Cheniti G, Lam A, Bourier F, Thompson N, Wolf M, Massoulie G, Escande W, Andre C, Zeng LJ, Nakatani Y, Roux JR, Duchateau J, Pambrun T, Sacher F, Cochet H, Hocini M, Haissaguerre M, Jais P. Insights from atrial surface activation throughout atrial tachycardia cycle length: A new mapping tool. Heart Rhythm. 2019 Nov;16(11):1652-1660. doi: 10.1016/j.hrthm.2019.04.029. Epub 2019 Apr 18. |
| D013514 |
| Surgical Procedures, Operative |