Pulsed Field Ablation With Concomitant Radiofrequency Cardioneuroablation in Patients With Paroxysmal Atrial Fibrillation
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Pulmonary Vein Isolation using Point-by-Point Bipolar Pulsed-Field Ablation, Selective Radiofrequency Ablation of the Superior Paraseptal Parasympathetic Ganglion.
- Who it may be relevant to
- Registry conditions: Atrial Fibrillation (Paroxysmal). Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Poland
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Evaluation of the Safety and Efficacy of Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation Using Point-by-Point Bipolar Pulsed Field Ablation Combined With Thermal Ablation of the Superior Paraseptal Parasympathetic Ganglion Region
Overview
Pulsed-field ablation (PFA) is a novel, non-thermal method for the treatment of atrial fibrillation (AF). It uses short, high-voltage electrical pulses to selectively ablate cardiomyocytes. PFA has demonstrated a high safety profile with reduced complication rates compared to thermal ablation. Thermal ablation of parasympathetic ganglia during conventional pulmonary vein isolation (PVI) may improve long-term procedural outcomes by reducing AF recurrence. However, due to its non-thermal nature, PFA may not significantly affect cardiac autonomic innervation, which could be clinically relevant in vagally mediated AF or tachycardia-bradycardia syndrome. This randomized study compares two strategies: (1) PFA-only PVI, and (2) PFA combined with selective thermal ablation (radiofrequency energy) of the superior paraseptal parasympathetic ganglion. The primary objective is to evaluate whether adjunctive thermal ablation improves clinical outcomes and reduces intraprocedural bradyarrhythmic events.
Interventions
- Procedure Pulmonary Vein Isolation using Point-by-Point Bipolar Pulsed-Field Ablation
Pulmonary vein isolation is performed via transseptal access to the left atrium using a point-by-point bipolar pulsed-field ablation catheter - Procedure Selective Radiofrequency Ablation of the Superior Paraseptal Parasympathetic Ganglion
Targeted application of radiofrequency energy at the anterior aspect of the right superior pulmonary vein, corresponding to the anatomical location of the superior paraseptal parasympathetic ganglion.
Primary outcome measures
- Recurrence of atrial fibrillation [Time frame: 12 months post-procedure]
Secondary outcome measures (2)
- Intraprocedural bradyarrhythmic episodes [Time frame: During ablation procedure]
- Requirement for intraprocedural cardioversion [Time frame: During ablation procedure]
Eligibility criteria
Inclusion criteria
- Age ≥18 years
- Documented paroxysmal atrial fibrillation (AF) lasting ≥30 seconds on ECG or Holter monitoring
- Willingness and ability to provide written informed consent
- Life expectancy >1 year
Exclusion criteria
- Persistent AF lasting >7 days or long-standing AF >1 year
- Secondary AF due to electrolyte imbalance, thyroid disease, alcohol abuse, or other non-cardiac causes
- Left atrial anteroposterior diameter ≥45 mm on transthoracic echocardiography
- Clinically significant coexisting arrhythmias other than AF
- Significant valvular heart disease or valve prosthesis
- Chronic heart failure NYHA class III/IV
- Previous AF or atrial flutter ablation
- Prior closure of atrial septal defect or left atrial appendage
- Atrial myxoma
- Implanted pacemaker or defibrillator
- History of pericarditis
- Congenital heart disease
- Coagulopathy or bleeding disorders
- Contraindications to oral anticoagulation
- Contraindications to CT or MRI
- Pregnancy or breastfeeding
- Body Mass Index >30
- History of organ transplantation
- Severe pulmonary disease
- Estimated Glomerular Filtration Rate <30 mL/min/1.73 m²
- Active malignancy
- Significant infection
- Life expectancy <1 year
- Psychiatric disorders preventing study participation
- Refusal or inability to provide informed consent
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
Poland · 1 center
- St. Joseph's Heart Rhythm Center — Rzeszów
Identifiers
NCT: NCT07171463 · 12/2025/B