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Left Atrial Isolation Using Radiofrequency Catheter Ablation: An Alternative to Pacemaker and AV Node Ablation (LA Isolation)

LA Isolation

Left Atrial Isolation Using Radiofrequency Catheter Ablation: An Alternative to Pacemaker and AV Node Ablation

Lead PI & Sponsor

Dr. Allan Skanes

Local PI

Dr. Allan Skanes

Research Staff

Megan Smith

Objective

The purpose of this study is to evaluate whether mapping and disconnecting the electrical connections between the heart’s upper chambers can isolate atrial fibrillation to the left atrium, providing symptom control similar to “pace and ablate” while reducing long-term pacemaker dependence and its associated risks.

Target Number of Patients

10

Currently Enrolled

0

Primary Outcomes

  • Proportion of patients with successful disconnection of lower inter-atrial connection at the coronary sinus (CS)

Secondary Outcomes

  • Proportion of patients with successful disconnection of the superior inter-atrial connections, (at Bachmann’s Bundle)
  • Proportion of patients with disconnection of both upper and lower inter-atrial connections
  • Proportion of patients with ongoing connections from the left atrium to the AV node directly
  • Proportion of patients who continue to sinus rhythm in the right atrium at 3 months

Inclusion Criteria

  • Age ≥18 years
  • Patients with paroxysmal or persistent AF undergoing pacemaker and AV Node ablation at LHSC
  • Prior echocardiogram in the last year

Exclusion Criteria

  • Prior single chamber (VVI) pacemaker
  • Prior cardiac surgery
  • Prior SVT ablation procedure
  • Inability to apply informed consent

Atrial fibrillation (AF) is the most common arrhythmia in clinical practice and is associated with an increased risk of stroke, heart failure and death. One strategy to treatment AF is Catheter Ablation (CA). The optimal CA strategy for persistent AF remains unknown. Current data highlights the need for a better understanding of the substrate and mechanisms of arrhythmia maintenance in this population. Atrial scar-based catheter ablation has recently emerged as a promising strategy for ablation of AF. The Investigators hypothesize that catheter ablation of persistent AF (PeAF) tailored to abolish abnormal atrial substrate identified by intracardiac atrial scar mapping in addition to pulmonary vein isolation (PVI) will result in higher procedural success rates when compared to PVI alone.