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Can adding a second ablation target stop atrial fibrillation from coming back?

NCT ID NCT07745543

Disease control Sponsor: University Hospital, Basel, Switzerland Source: ClinicalTrials.gov ↗

What the study statuses mean

This study's is highlighted.

Recruitment status, easiest to join first

Recruiting now
This trial is taking on new participants right now.
Not yet recruiting This study
Registered, but not yet taking participants.
By invitation only
Not open to general applications. Only people the study team invites can take part.
Paused
Paused for now. It may or may not start again.
Ongoing
Running, but no longer taking on new participants.
Completed
The trial has finished. Results may not be published yet.
Stopped early
Stopped early, before it reached the end. That can be for many reasons, including safety.
Cancelled
Cancelled before anyone took part.

Expanded access (not trials)

Expanded access
Not a trial. This treatment can be requested outside a study, case by case, for people who qualify.
Expanded access (paused)
Not a trial. The treatment can normally be requested outside a study, but is unavailable right now.
Expanded access (ended)
Not a trial. The treatment could once be requested outside a study, but no longer can.
Approved
The treatment has been approved, so it is available normally rather than through this programme.

When the status isn't known

Details not published
The full record has not been published yet, so there is little to show here.
Status unknown
This status has not been confirmed recently, so it may be out of date.

First seen Aug 04, 2026 · Last updated Aug 05, 2026 · Updated 1 time

Summary

This study is testing two ways to perform a repeat ablation procedure in people with atrial fibrillation (an irregular heartbeat) that has returned after a first treatment. Both approaches use pulsed-field ablation to isolate the pulmonary veins, but one also adds ablation of the back wall of the left atrium. The goal is to see which strategy better prevents any atrial arrhythmia from recurring within a year, using an implantable monitor to track heart rhythm continuously.

What this could mean

Our plain-language read of the trial. This is informational only, not medical advice or a prediction.

Active substance
Pulsed-field ablation procedure (pulmonary vein isolation with or without posterior wall ablation)
What this could lead to
If successful, this could identify the more effective ablation strategy for people with atrial fibrillation who need a repeat procedure, potentially reducing the chance of the arrhythmia returning.
What could go wrong
This is a randomized trial, but results are not yet available. The added posterior wall ablation may not improve outcomes and could carry extra risks, such as damage to nearby structures like the phrenic nerve.

This is an AI summary of the original study and may miss details. Read our disclaimer.

Study facts

What this study's own registry entry says, in plain language.

Phase

Not a phased trial

Phase numbers describe drug development. The registry uses this when they do not apply, as it does for trials of devices, procedures or behaviour changes, and for observational studies.

Participants

About 270 people

The number the study aims to enrol. It can still change while the study runs.

Expected to start

Aug 2026

An estimate. Start dates often move.

Expected to finish

Jul 2031

An estimate. End dates often move.

Lead sponsor

Other sponsor

The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Ages

18 years and older

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Documented recurrence of paroxysmal or persistent AF following single prior catheter ablation with PVI, confirmed by 12-lead ECG, Holter monitoring, or ICM within the last 2 years. 2. Candidate for repeat catheter ablation according to current European Society of Cardiology (ESC) AF management guidelines. 3. Continuous oral anticoagulation with a vitamin K antagonist or non-vitamin K oral anticoagulant (NOAC) for ≥ 4 weeks prior to the ablation, or transoesophageal echocardiography (TEE) and/or cardiac computed tomography (CT) within 48 hours before the procedure excluding LA thrombus. 4. Age ≥ 18 years at the time of informed consent. 5. Written informed consent obtained prior to any study-related procedures. Exclusion Criteria: 1. Previous LA surgery 2. \> 1 prior LA ablation 3. LA ablation outside of the PVs in the first LA ablation 4. LA diameter \>60 mm in the parasternal long axis 5. Patients in persistent AF lasting \>3 years 6. AF due to reversible causes (e.g. hyperthyroidism, cardiothoracic surgery) 7. Pre-existing PV stenosis or PV stent 8. Pre-existing hemidiaphragmatic paralysis 9. Contraindication to anticoagulation or radiocontrast materials 10. Prior mitral valve surgery 11. Severe mitral regurgitation or moderate/severe mitral stenosis 12. Myocardial infarction during the 3-month period preceding the consent date 13. Ongoing triple antithrombotic/anticoagulation therapy 14. Cardiac surgery during the 3-month interval preceding the informed consent date or scheduled cardiac surgery/transcatheter aortic valve implantation procedure 15. Significant congenital heart defect (including atrial septal defects or PV abnormalities but not including a patent foramen ovale) 16. New York Heart Association (NYHA) class III or IV congestive heart failure 17. Left ventricular ejection fraction (LVEF) \<35% 18. Hypertrophic cardiomyopathy or left septal wall thickness \>1.5 cm 19. Significant chronic kidney disease (eGFR \<30 ml/min) 20. Uncontrolled hyperthyroidism 21. Cerebral ischemic event (stroke or TIA) during the 6-month interval preceding the informed consent date 22. Ongoing systemic infections 23. Cardiac amyloidosis 24. Pregnancy (to exclude pregnancy a blood test (HCG) is performed in women \< 50 years before inclusion) 25. Life expectancy less than one year per physician opinion 26. Currently participating in any other clinical trial, which may confound the results of this trial. 27. Unwilling or unable to comply fully with the study procedures and FU.

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Conditions

The condition(s) this trial relates to.

atrial fibrillation

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

Atrial fibrillation (AF)

How to take part

Only the study team decides who joins. These are the ways to reach them.

  1. The places running it

    5 sites. The list below names each one and where it is.

  2. The official record

    ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.

    Open the record ↗

  3. A doctor treating you

    A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.

Contacts and locations

Locations

  • Bern University Hospital

    Bern, 3010, Switzerland

  • Cantonal Hospital of St. Gallen

    Sankt Gallen, 9007, Switzerland

  • University Hospital Basel

    Basel, 4031, Switzerland

  • University Hospital Lausanne

    Lausanne, 1011, Switzerland

  • University Hospital Zurich,

    Zurich, 8091, Switzerland

More trials for these conditions

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