Actively Recruiting

Phase Not Applicable
Age: 18Years +
All Genders
ID05411614

A Randomised Controlled Trial Comparing Convergent Hybrid Ablation to Catheter Ablation in Patients With Persistent Atrial Fibrillation and Heart Failure

Led by St. George's Hospital, London · Updated on 2025-11-28

120

Participants Needed

7

Research Sites

74 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are evaluating the safety and effectiveness of a staged hybrid ablation procedure compared to the standard catheter ablation in patients with non-paroxysmal atrial fibrillation (AF) and heart failure. This randomized controlled trial aims to determine which approach better prevents persistent atrial arrhythmia over a follow-up period extending to 24 months after treatment. Participants will be randomly assigned to one of two treatment groups. One group will undergo a staged convergent hybrid ablation, consisting of a minimally invasive surgical epicardial ablation with optional left atrial appendage exclusion followed by an endocardial catheter ablation. The other group will receive the standard percutaneous endocardial catheter ablation alone. The trial compares these two device-based procedures to assess their impact on heart rhythm and heart function. During the study, participants will be closely monitored for heart rhythm changes, heart chamber remodeling, and quality of life using various assessments before treatment and at 12 and 24 months afterward. The main outcome measured is freedom from persistent atrial arrhythmia after a single procedure without certain medications. Safety is also tracked within 30 days and beyond. Overall, the trial will last at least two years for each participant, including follow-up evaluations at multiple time points.

CONDITIONS

Brief Title

Hybrid Ablation of Atrial Fibrillation in Heart Failure

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Age 18 years or older
  • Persistent or long-standing persistent atrial fibrillation
  • Moderately or more dilated left atrium
  • Suitable for either the staged hybrid ablation or standard catheter ablation procedure
  • Left ventricular ejection fraction less than 50%
Not Eligible

You will not qualify if you...

  • Not optimized medically or lifestyle-wise for atrial fibrillation or heart failure
  • Unable to provide written consent
  • Previous open-heart surgery
  • Active infection, esophageal ulcer, stricture, or varices
  • Prior catheter ablation of atrial fibrillation
  • Contraindication to anticoagulation or active left atrial thrombus despite treatment
  • Severe valvular heart disease
  • Unstable coronary artery disease
  • Uncontrolled ventricular arrhythmia
  • Heart attack or stroke within the last 90 days
  • Pregnant, breastfeeding, or planning pregnancy within six months
  • Severe other health condition or implanted device preventing trial procedures

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

Treatment

Duration - Up to 24 months with assessment after a 3-month blanking period

Participants undergo either the staged Convergent hybrid ablation procedure involving a minimally-invasive surgical epicardial ablation followed by endocardial catheter ablation, or standard endocardial catheter ablation for atrial fibrillation and heart failure.

1 to 2 procedure visits depending on treatment assignment and follow-up visits at 12 and 24 months

Trial Site Locations

Total: 7 locations

1

Ashford & St Peters Hospital NHS Trust

Chertsey, United Kingdom

Actively Recruiting

2

Epsom General Hospital

Epsom, United Kingdom

Actively Recruiting

3

Cromwell Hospital

London, United Kingdom

Active, Not Recruiting

4

Royal Surrey County Hospital

London, United Kingdom

Actively Recruiting

5

St Anthonys Hospital

London, United Kingdom

Active, Not Recruiting

6

St Georges at Kingston Hospital

London, United Kingdom

Actively Recruiting

7

St Georges University of London

London, United Kingdom

Actively Recruiting

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Research Team

R

Riyaz A Kaba

O

Omar Ahmed

How is the study designed?

Study Type

INTERVENTIONAL

Masking

SINGLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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