HCM-AF Ablation With ACUTUS
Atrial Fibrillation, Hypertrophic Cardiomyopathy
About this trial
This is an interventional treatment trial for Atrial Fibrillation
Eligibility Criteria
Inclusion Criteria:
- Paroxysmal or persistent AF (time in persistent AF < 12 months duration) including re-ablations
- Able to give written informed consent
- Age >18 years old and ≤ 80 years
- Fulfil established clinical criteria for diagnosis of HCM and catheter ablation of atrial fibrillation
- Normal LV ejection fraction and no evidence of other significant structural heart disease
Exclusion Criteria:
- Reversible causes of AF/flutter/tachycardia
- Recent cardiovascular event including TIA
- Intolerance or unwillingness to oral anticoagulation with Warfarin or NOAC
- Bleeding disorder
- Contraindication to CT or CMR scan
- Presence of intra-cardiac thrombus
- Vascular disorder preventing access to femoral veins
- Cardiac congenital abnormality different from HCM
- Severe, life threatening non cardiac disease
- Active malignant disease and recent (<5 years) malignant disease
- Presence of ASD or PFO closure device
- Previous ASD or PFO surgical closure
- Unable or unwilling to comply with F/U requirements
- Pregnancy
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Group1 - PVI first step
Group2 - PVI last step
Catheter ablation procedure: Dipole map of RA and LA at baseline (5 times for both, each for 20sec, +/- Adenosine IV) PVI as first step Remap to assess any change in activation Ablate all rotors (API) in LA until SR or DCCV Deployment of RA CTI line and demonstration of bidirectional block
Catheter ablation procedure: Dipole map of RA and LA at baseline (5 times for both, each for 20sec, +/- Adenosine IV) Ablate all rotors (API) in LA until SR or DCCV Remap to assess any change in activation PVI as last step even when SR achieved earlier Deployment of RA CTI line and demonstration of bidirectional block