ECG-I mapping of AF
Research type
Research Study
Full title
ECG-I Mapping of Atrial Fibrillation to Optimise Patient Selection and Targeting of Ablation Therapy.
IRAS ID
218367
Contact name
Gurpreet Dhillon
Contact email
Sponsor organisation
Barts Health Centre, Queen Mary University of London
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Atrial Fibrillation (AF) is an irregular heart rhythm associated with significant mortality and morbidity. Catheter ablation (CA) is an established treatment using catheters that are passed into the heart to isolate and disrupt heart tissue causing and maintaining AF. Success rates of CA of persistent AF are approximately 30-60%. It is thought that AF is maintained by multiple re-entry circuits in the atria of the heart.
The ECG-I is an electrical mapping system that involves wearing a jacket consisting of ECG electrodes. A CT scan localises the electrodes relative to the heart, and computer modelling is used to reconstruct the movements of electricity on the surface of the heart and suggest location of tissue that can cause and maintain (drivers of AF) AF.
We aim to study the efficacy of the ECG-I in identifying the drivers of AF and investigate the properties of these drivers to better understand the mechanisms of AF.
There are 2 arms to this study. The ‘Combined approach’ study arm will involve mapping to look for evidence of drivers at locations predicted by ECG-I followed by targeted ablation of these areas and then standard ablation therapy for AF. These patients will then be followed up for one year. This will provide insight into whether targeted ablation of drivers of AF lead to higher rates of freedom from AF. This is standard treatment.
The ‘staged approach’ study arm will involve 2 phases. Phase 1 will involve ECG-I analysis followed by standard ablation targeting the pulmonary veins to see if activation patterns can predict who will respond to standard ablation. Those patients with recurrent AF after phase 1 will progress to phase 2 where they will undergo ablation targeting the drivers of AF directly based on ECG-I analysis and will be followed up to evaluate their response.
REC name
East Midlands - Leicester South Research Ethics Committee
REC reference
17/EM/0333
Date of REC Opinion
10 Oct 2017
REC opinion
Further Information Favourable Opinion