Real-world Experience of Catheter Ablation for the Treatment of Paroxysmal and Persistent Atrial Fibrillation

Brief Summary
The primary purpose of this Registry is to assess procedural safety and long-term effectiveness of catheter ablations in the treatment of subjects with PAF, PsAF, and VA. The Registry will utilize real world clinical data obtained from the use of commercially available CARTO™ technologies under the authority of a health care practitioner within a legitimate practitioner-subject relationship. Data from the registry will be used to assess clinical outcomes, including procedural efficiency, safety, and long-term effectiveness of catheter ablation with novel technologies for arrhythmia patients.
Brief Title
Real-world Experience of Catheter Ablation for the Treatment of Arrhythmias
Detailed Description
The REAL Registry is an observational, prospective, multi-center, non-randomized registry designed to obtain real-world clinical experience of ablation using Biosense Webster, Inc. (BWI) CARTO technologies (e.g., THERMOCOOL SMARTTOUCH®, THERMOCOOL SMARTTOUCH® SF, QDOT MICRO™, VARIPULSE™). Future new Biosense Webster, Inc. technologies, including new thermal and/or pulsed field ablation (PFA), may be included as they become commercially available.

Current clinical practice guidelines recommend ablation for ventricular arrhythmias (VA) and atrial fibrillation (AF)1,2. Therefore, REAL AF will include subjects with symptomatic paroxysmal AF (PAF), persistent AF (PsAF) who meet all eligibility criteria and in the opinion of the investigator, are candidates for AF catheter ablation. CORE-VA will include all subjects with documented ventricular arrhythmia appropriate for catheter ablation.

All subjects will be treated with commercially approved BWI ablation catheters, and the ablation procedure will be conducted based on the participating Site's current standard of care (SOC). Participation in the Registry does not influence treatment decisions. All consecutive subjects presenting at the Site considered for an ablation procedure should be screened by the Investigator or a designated member of the research team for eligibility.

The objective of this registry is to assess clinical outcomes, including procedural efficiency, safety, long-term, effectiveness of RF ablations in the treatment of patients with Paroxysmal or Persistent atrial fibrillation. The outcomes of the registry are: 1) long term effectiveness defined as freedom from Arrhythmia recurrence post 90-day blanking period, 2) acute safety defined by serious complications within 7 days post ablation and up to 30 days post ablation.

Sites and Investigators considered for inclusion in the Registry will be assessed to determine if their practice patterns align, minimally, with what is outlined in VISIT SCHEDULE AND DATA COLLECTION of this protocol for the specific cohort in which the investigators will be enrolling. Investigators need to only align with the requirements of one cohort, but can participate in both, if qualified, and selected in each cohort. The Registry does not require any additional visits above what is considered standard of care follow-up for the Registry subject population.
Central Contacts
Central Contact Role
Contact
Central Contact Phone
1-629-335-8261
Central Contact Email
jwhite@hrcrs.com
Central Contact Role
Contact
Central Contact Email
josorio@hrcrs.com
Completion Date
Completion Date Type
Estimated
Conditions
PAROXYSMAL ATRIAL FIBRILLATION
PERSISTENT ATRIAL FIBRILLATION
VENTRICULAR ARRHYTHMIA
Eligibility Criteria
REAL AF Cohort

Inclusion Criteria:

* Symptomatic PAF (AF episode terminate spontaneously within 7 days) or PsAF (AF sustained beyond 7 days, but less than 365 days) subjects who, in the opinion of the investigator, are candidates for catheter ablation.
* \>18 years of age.
* Will be treated with Biosense Webster Inc. ablation technologies
* All AF ablations performed with BWI catheters are included. This includes repeat ablations where the index procedure was performed with a non-BWI catheter.
* Able and willing to participate in baseline and follow up evaluations
* Willing and able to provide informed consent, if applicable.

Exclusion Criteria:

* Enrolled in an investigational drug or device clinical trial, or any trial that dictates the treatment plan
* Long-standing persistent AF (AF greater than one year)
* In the opinion of the investigator, any known contraindication to an ablation procedure

CORE VA Cohort

Inclusion Criteria:

* Documented ventricular arrhythmia appropriate for catheter ablation.
* \>18 years of age.
* Will be treated with Biosense Webster Inc. ablation technologies
* Able and willing to participate in baseline and follow up evaluations
* Willing and able to provide informed consent, if applicable.

Exclusion Criteria:

* Enrolled in an investigational drug or device clinical trial, or any trial that dictates the treatment plan.
* In the opinion of the investigator, any known contraindication to an ablation procedure.
Inclusion Criteria
Inclusion Criteria:

* Symptomatic PAF (AF episode terminate spontaneously within 7 days) or PsAF (AF sustained beyond 7 days, but less than 365 days) subjects who, in the opinion of the investigator, are candidates for catheter ablation.
* \>18 years of age.
* Will be treated with Biosense Webster Inc. ablation technologies
* All AF ablations performed with BWI catheters are included. This includes repeat ablations where the index procedure was performed with a non-BWI catheter.
* Able and willing to participate in baseline and follow up evaluations
* Willing and able to provide informed consent, if applicable.

Inclusion Criteria:

* Documented ventricular arrhythmia appropriate for catheter ablation.
* \>18 years of age.
* Will be treated with Biosense Webster Inc. ablation technologies
* Able and willing to participate in baseline and follow up evaluations
* Willing and able to provide informed consent, if applicable.

Gender
All
Gender Based
false
Keywords
CORE VA
REAL AF
Healthy Volunteers
No
Last Update Submit Date
Minimum Age
18 Years
NCT Id
NCT04088071
Org Class
Other
Org Full Name
Heart Rhythm Clinical and Research Solutions, LLC
Org Study Id
RAF
Overall Status
Recruiting
Primary Completion Date
Primary Completion Date Type
Estimated
Official Title
Real-world Experience of Catheter Ablation for the Treatment of Arrhythmias Symptomatic Using Novel CARTO Technologies: REAL Registry
Primary Outcomes
Outcome Description
Freedom from arrhythmia recurrence at 90 days post procedure.
Outcome Measure
Effectiveness at 90 days
Outcome Time Frame
90 days
Outcome Description
Freedom from subject reported arrhythmia recurrence through 12 months post procedure.
Outcome Measure
Effectiveness at 12 months
Outcome Time Frame
12 months
Outcome Description
Incidence of late onset complications, 30 days post-ablation which are procedure and/or device related
Outcome Measure
Long-term Safety
Outcome Time Frame
30 days post ablation
Secondary Outcomes
Outcome Description
Recurrence seen during monitoring with Dual/ CRT Pacer or ICD; Event Monitor; LinQ; Holter; EKG; TTE
Outcome Time Frame
12 months
Outcome Measure
Arrhythmia recurrence
Outcome Description
Treatments for arrhythmia post-procedure
Outcome Time Frame
12 months
Outcome Measure
Post-procedure arrhythmia treatments
Outcome Description
Presence of: weakness, fluttering, SOB, fatigue, dizziness, decrease in exercise tolerance, chest pain/pressure, heart racing/palpitations, and other (yes/no)
Outcome Time Frame
12 months
Outcome Measure
Arrhythmia related symptoms
Outcome Description
Antiarrhythmic drug use (and type) post procedure and 12 months
Outcome Time Frame
12 months
Outcome Measure
AAD Usage
Outcome Description
Oral anticoagulant use at 12 months and drug type
Outcome Time Frame
12 months
Outcome Measure
OAC usage
Outcome Description
An estimation of stroke risk for patients with Atrial Fibrillation. Composite score of: Age (\<65= 0; 65-74=1; \>75=2) + Sex (Female=1; Male=0) + Congestive Heart Failure (Yes =1; No=0) + Hypertension (Yes= 1; No= 0) + Stroke, Transient Ischemic Attack (TIA) or thromboembolism (Yes=2; No=0) + Vascular Disease (Yes=1; No=0) + Diabetes (Yes=1; No=0). Scores range from 0 to 9, with higher scores indicating greater risk for stroke.
Outcome Time Frame
12 months
Outcome Measure
CHA2DS2VASC
Outcome Description
How do you feel now compared to pre-ablation?
Outcome Time Frame
12 months
Outcome Measure
Patient reported outcome
Start Date
Start Date Type
Actual
Status Verified Date
First Submit Date
First Submit QC Date
Study Population
Study population consists of adults age 18 years or older with symptomatic Paroxysmal and Persistent Atrial Fibrillation who are candidates for ablation in the REAL AF Cohort and adults age 18 years or older with documented ventricular arrhythmia appropriate for catheter ablation in the CORE VA Cohort.
Std Ages
Adult
Older Adult
Maximum Age Number (converted to Years and rounded down)
999
Minimum Age Number (converted to Years and rounded down)
18
Investigators
Investigator Type
Principal Investigator
Investigator Name
Luigi Dibiase
Investigator Email
ldibiase@montefiore.org
Investigator Phone
347-271-1637
Categories Mesh Debug
Heart/Cardiovascular --- ATRIAL FIBRILLATION
Heart/Cardiovascular --- ARRHYTHMIAS, CARDIAC
Brain, Spinal Cord & Nervous System --- HEART DISEASES
Heart/Cardiovascular --- HEART DISEASES
Blood Disorders --- CARDIOVASCULAR DISEASES
Heart/Cardiovascular --- CARDIOVASCULAR DISEASES
MeSH Terms
ATRIAL FIBRILLATION
ARRHYTHMIAS, CARDIAC
HEART DISEASES
CARDIOVASCULAR DISEASES
PATHOLOGIC PROCESSES
PATHOLOGICAL CONDITIONS, SIGNS AND SYMPTOMS
CATHETER ABLATION
RADIOFREQUENCY ABLATION
RADIOFREQUENCY THERAPY
THERAPEUTICS
ABLATION TECHNIQUES
SURGICAL PROCEDURES, OPERATIVE