The effect of early PV re-isolation on AF recurrence V1
Research type
Research Study
Full title
Pulmonary vein RE-isolation as a routine Strategy: a SUccess Rate Evaluation (PRESSURE)
IRAS ID
87617
Contact name
Dhiraj Gupta
Contact email
Sponsor organisation
Liverpool Heart and Chest Hospital NHS Foundation Trust
Research summary
Atrial fibrillation (AF) is the most common abnormality of heart rhythm and is associated with significant health problems and healthcare costs. Radiofrequency ablation (applying burns) within the heart around the junctions with the veins returning blood from the lungs (pulmonary veins) has been increasingly used for patients with on-going symptoms despite drug therapy. This procedure is intended to permanently create electrical block between the pulmonary veins and the heart, and is termed “pulmonary vein isolation” (PVI). However, a substantial proportion of patients relapse at various time-points after undergoing PVI, usually due to the development of gaps in the lines of electrical block, and have to undergo a repeat procedure. In our study, participants will be assigned to one of two groups: a “standard care” group undergoing a single PVI procedure, and a “repeat study” group, who will have a repeat procedure 8-10 weeks after their initial PVI procedure. We aim to identify how many patients in the “repeat study” group have developed electrical gaps after 8-10 weeks and whether closing these gaps with further ablation will lower the risk of a relapse during follow-up.
Additionally, it is thought that these gaps are related to the quality of the ablation lesions performed. Lesion quality is felt to be linked to a combination of the contact between the ablation catheter tip and the atrial wall, the duration of ablation in a single location, and the energy delivered. A new computer software programme, to be used in conjunction with existing computer systems, is able to record measurements of these factors for each individual ablation lesion that is performed. We aim to use this software to identify what lesion quality characteristics are needed to avoid electrical gaps by comparing the recorded data at sites of gaps to those from sites where block has persisted.
REC name
North West - Preston Research Ethics Committee
REC reference
13/NW/0679
Date of REC Opinion
4 Oct 2013
REC opinion
Further Information Favourable Opinion