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EXPORT Randomized Trial

NCT07197931 · Status: NOT_YET_RECRUITING · Phase: NA · Type: INTERVENTIONAL · Enrollment: 406

Last updated 2025-09-30

No results posted yet for this study

Summary

Pulmonary Vein Isolation (PVI)-Only Group

1. Pulmonary vein isolation (PVI) will be performed, and the procedure will be terminated without the administration of isoproterenol following the standard waiting period.
2. In cases where spontaneous triggers are observed following PVI, mapping and ablation of the identified triggers are permitted.
3. Post-procedural rhythm monitoring and follow-up will be conducted in accordance with the predefined study protocol.

Additional Non-Pulmonary Vein (Non-PV) Trigger Ablation Group

Isoproterenol will be administered starting at 5 μg/min, with stepwise increases to 10 μg/min and 20 μg/min at 3-5 minute intervals, as tolerated, aiming to achieve 85% of the maximum predicted heart rate, with a maximum dose of 30 μg/min.The total infusion duration will be at least 10 minutes.

* If systolic blood pressure (SBP) decreases by ≥20 mmHg from the baseline (prior to infusion), the isoproterenol infusion will be discontinued.
* If hypotension is anticipated or occurs during isoproterenol infusion, phenylephrine infusion may be administered to maintain SBP between 120-140 mmHg.
* For patients with a history of coronary artery disease, heart failure, or valvular heart disease, the maximum isoproterenol infusion rate may be limited to ≤10 μg/min at the discretion of the operator.

Conditions

Interventions

PROCEDURE

Additional extra-pulmonary vein trigger ablation group

1. Circumferential PVI is performed in all patients. 2. After PVI, isoproterenol is infused starting at 5 μg/min, increased every 3-5 min to 10 and 20 μg/min (max 30 μg/min) to reach 85% of predicted heart rate for ≥10 min. 2-1) If AF persists, internal cardioversion (5-30 J) is performed using catheters in the right atrium and coronary sinus. 2-2) If sinus rhythm is present, a 15-beat drive train (10 mA, 2 ms) is delivered at 250 ms, shortened by 10 ms to 180 ms or until capture fails, up to three times, to induce AF or AT. Isoproterenol continues for 2 min. If arrhythmia occurs, cardioversion is repeated. 3. After cardioversion, isoproterenol is stopped and the patient is observed for 10 min. 4. Sustained or reproducible arrhythmias are defined as non-PV triggers. 5. These are localized with activation mapping, P-wave analysis, and high-density mapping. 6. Ablation is performed with the same catheter. 7. Reassessment is done with the same protocol.

PROCEDURE

Empirical pulmonary vein isolation group

1. Circumferential pulmonary vein isolation (PVI) is performed in all patients. 2. After PVI, a waiting period of at least 20 minutes is observed, followed by reassessment of pulmonary vein isolation before concluding the procedure. 3. Additional linear ablation or CFAE ablation not specified in the study protocol should be avoided whenever possible. 4. In cases where typical atrial flutter has been documented prior to the procedure or is induced during the procedure, cavo-tricuspid isthmus (CTI) ablation is performed. At the operator's discretion, CTI ablation may also be permitted even in patients without a prior history or inducibility. 5. If atypical atrial flutter involving these pathways is induced during the procedure, additional linear ablation (e.g., roof line, posterior-inferior line, left lateral isthmus, or anterior line) may be performed.

Sponsors & Collaborators

  • Yonsei University

    lead OTHER

Study Design

Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Model
PARALLEL

Eligibility

Min Age
19 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2025-10-31
Primary Completion
2029-08-31
Completion
2030-08-31

Countries

  • South Korea

Study Locations

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Entities

Diseases

Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT07197931 on ClinicalTrials.gov