Ablation of Human Cardiac Fibrillation Based on Hierarchical Models of Tissue Excitation Organization

What this Trial Is About

Researchers are investigating the mechanisms that sustain persistent atrial fibrillation AF and ventricular fibrillation VF in humans. This study focuses on understanding how specific areas of high-frequency electrical activity, called DFASI domains, maintain these heart rhythm disorders. The project aims to explore how targeting these domains with ablation therapy affects AF dynamics and clinical outcomes, and to extend these findings to improve treatment options for patients with recurrent VF. The study involves two groups a control group receiving circumferential pulmonary vein isolation CPVI alone, and an active group receiving CPVI plus additional ablation targeting DFASI domains identified through non-invasive mapping. After CPVI in both groups, researchers will perform non-invasive mapping to assess fibrillation patterns, with the active group undergoing sequential ablation of the DFASI domains. Adenosine will be used to evaluate changes in fibrillation dynamics before and after ablation. Participants will undergo detailed non-invasive mapping during the procedure to identify reentrant areas with high activation frequency. Researchers will measure changes in fibrillation dynamics during and after ablation, and track arrhythmia burden over follow-up visits at 3, 6, and 12 months. The study includes safety monitoring and aims to improve understanding of fibrillation physiology and treatment effectiveness over time.

Ablation of Human Cardiac Fibrillation Based on Models of Hierarchical Organization of Tissue Excitation