Use of a High Density Mapping System to Complete Wide Area Circumferential Ablation of the Pulmonary Veins and Avoid Ostial Segmental Ablation (HD-WACA)
Atrial Fibrillation
About this trial
This is an interventional treatment trial for Atrial Fibrillation focused on measuring Atrial Fibrillation
Eligibility Criteria
Inclusion Criteria:
- ECG documented AF
- Listed for AF ablation by referring physician
- Planned ablation includes a first-time PVI.
- Patient signed informed consent form
Exclusion Criteria:
- Age <18 or >80
- LA diameter >60mm
- AF secondary to transient correctible abnormalits (e.g. electrolyte imbalance, thyrotoxicosis, recent infective or inflammatory process)
- Intra-atrial thrombus or tumour
- Renal failure requiring haemodialysis
- Heart failure with NYHA III-IV or EF<35%
Sites / Locations
- Hammersmith Hospital
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Group A - Standard Care
Group B - Rhythmia mapping
The operator will attempt to complete the WACA lesion set using standard techniques. These include ablating any obvious gaps in the lesion set, ablating at the WACA line in a location radial to the earliest PV signal measured by the Orion catheter situated within the PV, and guided by amplitude and dV/dt of signals along the WACA lesion set measured using the mapping catheter. If this fails the operator will resort to OSA as per their usual practice.
The operator will form Rhythmia maps focussing on the region of the WACA line surrounding the non-isolated vein(s) whilst pacing from CS. This will be used as a means of targeting RF ablation to gaps in the WACA line (in addition to use of standard observation of signals as per group A). If this fails then the operator will resort to OSA as per their usual practice.