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Atrial fibrillation (AF) is a prevalent cardiac arrhythmia affecting millions globally, with projections indicating a doubling of cases by 2050. AF is linked to heightened cardiovascular risks like stroke and increased healthcare costs. Ablation, targeting the arrhythmia substrate, is a method to manage AF, yet recurrence rates remain high (20-45% in the first year). Studies highlight the impact of comorbidities, AF characteristics, ablation techniques, and myocardial remodeling markers on AF progression and ablation efficacy. However, there's no definitive guidance on selecting these factors for predicting treatment success.
The aim of this study is to investigate predictors of successful AF ablation in the following areas: (a) clinical factors, (b) electrophysiological, (c) electrocardiographic, (d) ultrasound, (e) cardiac anatomy, (f) biomarkers.
AF is a multifactorial disease influenced by many possible mechanisms. This study will examine several different predictors of successful AF ablation: (a) clinical factors, (b) electrophysiological, (c) electrocardiographic, (d) ultrasound, (e) cardiac anatomy, (f) biomarkers. Analysis of these factors will help determine the optimal combination of predictors of successful ablation. This combination of prognostic factors can then be used to tailor therapeutic decisions specifically to individual patients and to improve patient selection for invasive treatment. Better patient selection and choice of ablation type can help increase success rates and avoid unnecessary procedures and their associated risks.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PPG-based remote heart rhythm/rate monitoring | Diagnostic Test | PPG-based remote heart rhythm/rate monitoring | ||
| ECG-based remote heart rhythm/rate monitoring | Diagnostic Test | ECG-based remote heart rhythm/rate monitoring | ||
| Transthoracic and transesophageal echocardiography examination | Diagnostic Test | Transthoracic and transesophageal echocardiography examination | ||
| Liver ultrasound examination | Diagnostic Test | Liver ultrasound examination | ||
| Rotational angiography with three-dimensional reconstruction | Diagnostic Test | Rotational angiography with three-dimensional reconstruction | ||
| Measure | Description | Time Frame |
|---|---|---|
| Late AF recurrence | Late AF recurrence | 3-12 months after ablation |
| Measure | Description | Time Frame |
|---|---|---|
| Late recurrence of AF or atrial tachycardia or atrial flutter | Late recurrence of AF or atrial tachycardia or atrial flutter | 3-12 months after ablation |
| Early recurrence of AF | Early recurrence of AF |
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Inclusion Criteria:
Exclusion Criteria:
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Patients undergoing first-time ablation (radiofrequency or pulsed field)
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| Name | Affiliation | Role |
|---|---|---|
| Monika Gawałko, MD, PhD | 1st Department of Cardiology, Medical University of Warsaw | Principal Investigator |
| Paweł Balsam, MD, PhD | 1st Department of Cardiology, Medical University of Warsaw | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Medical University of Warsaw | Warsaw | Poland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41972517 | Derived | Krzowski B, Jablonska M, Gawlik M, Zaborska-Dworak M, Gawalko M, Marchel M, Lodzinski P, Balsam P, Grabowski M, Peller M. Perioperative parameters and myocardial necrosis: a real-world comparison of Farapulse and Varipulse. Cardiol J. 2026;33:e00226036. doi: 10.5603/cj.106769. |
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Blood
| Blood-derived biomarker analysis |
| Diagnostic Test |
Blood-derived biomarker analysis |
| Mobile health-based spirometry | Diagnostic Test | Mobile health-based spirometry |
| <3 months after ablation |
| Early recurrence of AF or atrial tachycardia or atrial flutter | Early recurrence of AF or atrial tachycardia or atrial flutter | <3 months after ablation |
| Time to AF recurrence and the impact of early recurrence on late AF recurrence | Time to AF recurrence and the impact of early recurrence on late AF recurrence | <3 and 3-12 months after ablation |
| The superiority of monitoring using mobile health devices over traditional heart rhythm monitoring | The superiority of monitoring using mobile health devices over traditional heart rhythm monitoring | 3 months after ablation |
| Progression or regression of AF | Progression of AF (from paroxysmal to persistent or persistent to permanent) or regression of AF (from persistent to paroxysmal) | 3-12 months after ablation |
| Modification of treatment, including antiarrhythmic treatment | Modification of treatment, including antiarrhythmic treatment | 3-12 months after ablation |
| AF-related quality of life and symptoms | AF-related quality of life and symptoms | Before, 3 and 12 months after ablation |
| Periprocedural complications | Periprocedural complications (e.g. cardiac tamponade, vascular complications, pseudoaneurysm, arteriovenous fistula, stroke, transient ischemic attack) | Around ablation |
| Heart rate variability and rate | Heart rate variability and rate | <3 months after ablation |
| Blood biomarker levels | Blood biomarker levels | Before, 3 and 12 months after ablation |
| Ablation procedure parameters | Ablation procedure parameters (e.g. ablation time, procedure time, number of applications, amount of painkillers used) | At ablation |
| Cardiac remodelling | Cardiac remodelling based on transthoracic and transesophageal echocardiography parameters | Before, 3 and 12 months after ablation |
| 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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