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The study is a prospective, exploratory observational study with the ECGenius® System and the PFAnalyzer software module in PFA cases using the FaraPulse PFA system. The cohort will be patients with paroxysmal or persistent atrial fibrillation (AF) who undergo PVI using this system.
Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with a five-fold increase in stroke. Pulmonary vein isolation (PVI) has become accepted treatment for AF. Historically, this has been achieved using thermal energy. However, more recently a new energy source known as pulsed field ablation (PFA) has been introduced. As PFA is tissue selective, it preserves the function of nearby structures such as the esophagus and phrenic nerve making it safer to use. As PFA is delivered in short bursts of high energy, it is also more efficient and leads to shorter procedures. However, the catheters designed to deliver PFA differ to those used previously and may not provide the same information about efficacy, making it more difficult for the operator to ascertain if the lesions have durably isolated the pulmonary vein. This exploratory observational study will assess the utility of a software module designed to measure the local potential derived from the unipolar electrogram recorded at the electrode that has delivered the PFA. During the procedure, the study will collect data only and all analysis of the output of the PFAnalyzer software module will be made off-line once the procedure is complete. The operator will follow the hospital's standard of care during the procedure, and the software module will not be used to guide therapy, nor will there be any additional time added to the procedure.
The study is a prospective, exploratory observational study with the ECGenius® System and the PFAnalyzer software module in PFA cases using the FaraPulse PFA system. The cohort will be patients with paroxysmal or persistent atrial fibrillation (AF) who undergo PVI using this system.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pulmonary vein isolation ablation | Device | Electrical isolation of the pulmonary veins to treat atrial fibrillation |
| Measure | Description | Time Frame |
|---|---|---|
| Pulmonary vein isolation | assess the agreement between pulmonary vein isolation status as determined by the operator using entrance block as well as exit block during PV pacing and as classified by the PFAnalyzer software based on unipolar local potential characteristics analyzed off-line, post procedure. | intra-procedural |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical utility | Assessment of the operators' subjective experience of clinical utility of the PFAnalyzer software measured through a 17-item questionnaire. | intra-procedural |
| Identify a clinically meaningful threshold for residual potentials after PFA delivery. |
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Inclusion Criteria:
Eligible subjects will meet all of the following inclusion criteria:
Exclusion Criteria:
Eligible subjects will not meet any of the following exclusion criteria:
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Patients diagnosed with paroxysmal atrial fibrillation and referred for a denovo pulmonary vein isolation ablation procedure using pulsed field ablation
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Karl P Firth, MSc | Contact | +45 31324745 | kpf@cathvision.com |
| Name | Affiliation | Role |
|---|---|---|
| Suneet Mittal, MD | Valley Health Systems | Principal Investigator |
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| ID | Term |
|---|---|
| D001281 | Atrial Fibrillation |
| ID | Term |
|---|---|
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
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Identify a clinically meaningful threshold for residual potentials after PFA delivery by comparing the amplitude of manually expert labelled local potentials to none local potential signals. |
| intra-procedural |
| Feasibility of guiding rotation | Determine the feasibility of using PFAnalyzer to assist in optimizing rotation and placement of the catheter by measuring changes in local potential amplitude during rotation. | intra-procedural |
| D013568 |
| Pathological Conditions, Signs and Symptoms |