High Density Mapping for WACA Completion
Research type
Research Study
Full title
Use of a High Density Mapping System to Complete Wide Area Circumferential Ablation of the Pulmonary Veins and Avoid Ostial Segmental Ablation
IRAS ID
171870
Contact name
Phang Boon Lim
Contact email
Sponsor organisation
Joint Research Compliance Office Imperial College of London
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Atrial fibrillation (AF) is the commonest abnormal heart rhythm and leads to serious illness (such as stroke) and death. Minimally invasive ablation (burning) therapies are accepted as a useful part of the treatment for AF.
The most important goal of ablation is isolating the regions of the atria surrounding the veins draining from the lungs. This used to be performed by positioning burns near the veins (ostial segmental ablation - OSA). A newer method is wide-area circumferential ablation (WACA) where the burns are positioned further out. This technique is more effective and safer and has therefore become the standard procedure.
Unfortunately with WACA alone it is often difficult to isolate the veins and the OSA burns need to be done in addition. We think we may have identified a way to avoid this using a new mapping technique. The Rhythmia system is able to rapidly collect a more detailed electrical and anatomical map than other systems. We have found it useful in test cases in identifying gaps in the WACA ablation and completing the WACA without resorting to OSA. We now plan to perform a trial in order to assess whether use of the system can significantly enhance the ability to fill gaps in WACA ablations.
To do this we will compare standard techniques with use of Rhythmia mapping. Approximately 40 patients will be randomly assigned to trying to complete a WACA procedure with and without Rhythmia maps of the veins which are not fully isolated. We hypothesize that the use of Rhythmia will better allow the operator to complete the isolation of the veins with a reduced amount of further burning and less need for OSA. If this is proven then it is likely to change the way we perform these procedures at our institution and further afield.REC name
South Central - Berkshire B Research Ethics Committee
REC reference
15/SC/0543
Date of REC Opinion
19 Aug 2015
REC opinion
Favourable Opinion