Pragmatic Evaluation of a Pentaspline Pulsed Field Ablation System to Treat Atrial Fibrillation and Related Arrhythmias

Running, not enrolling · Phase 4

Conditions studied: Persistent Atrial Fibrillation, Paroxysmal Atrial Fibrillation, Long-standing Persistent Atrial Fibrillation

In brief

The purpose of this pragmatic study is to evaluate the safety, performance and effectiveness of the FARAPULSE catheter system (FARAWAVE catheter used in combination with the FARASTAR generator), to treat patients with atrial fibrillation during clinically-indicated ablation procedures

Key facts

Study ID: NCT06765356
Run by: Vivek Reddy
People needed: 275
Starts: 2025-04-15
Expected to finish: 2027-03-30
Last updated by the study team: 2026-04-14

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Age 18 or older
Diagnosed with atrial fibrillation with or without concomitant atrial flutter by ECG at some point in the past, and by any criteria (ECG or clear symptoms within the past year)
Previous catheter ablation for other arrhythmias (including left-sided ablation, but not for AF) is allowed
Planned for a clinically-indicated catheter ablation procedure for managing paroxysmal or persistent atrial fibrillation in accordance with the following recommendations in the ACC/AHA/ACCP/HRS guidelines
In patients with symptomatic AF in whom antiarrhythmic drugs have been ineffective, contraindicated, not tolerated or not preferred, and continued rhythm control is desired, catheter ablation is useful to improve symptoms.(Class 1)
In selected patients (generally younger with few comorbidities) with symptomatic paroxysmal AF in whom rhythm control is desired, catheter ablation is useful as first-line therapy to improve symptoms and reduce progression to persistent AF. (Class 1)
In patients (other than younger with few comorbidities) with symptomatic paroxysmal or persistent AF who are being managed with a rhythm-control strategy, catheter ablation as first-line therapy can be useful to improve symptoms. (Class 2a)
In selected patients with asymptomatic or minimally symptomatic AF, catheter ablation may be useful for reducing progression of AF and its associated complications. (Class 2b)
In patients who present with a new diagnosis of HFrEF and AF, arrhythmia-induced cardiomyopathy should be suspected, and an early and aggressive approach to AF rhythm control is recommended. (Class 1)
In appropriate patients with AF and HFrEF who are on GDMT, and with reasonable expectation of procedural benefit, catheter ablation is beneficial to improve symptoms, QOL, ventricular function, and cardiovascular outcomes. (Class 1)
In appropriate patients with symptomatic AF and HFpEF with reasonable expectation of benefit, catheter ablation can be useful to improve symptoms and improve QOL. (Class 2a)
In athletes who develop AF, catheter ablation with PVI is a reasonable strategy for rhythm control because of its effectiveness and low risk of detrimental effect on exercise capacity. (Class 2a)
Have in place or have plans for implantation of a loop recorder, pacemaker or cardiac defibrillator capable of recording atrial rhythm (e.g. dual chamber) (ideally, this implantable device would be present for at least 4 weeks pre-PFA)
Able and willing to provide written consent and comply with all testing and follow-up requirements

You may not qualify if…

Documented "active" left atrial thrombus (patients may later undergo the procedure if this is no longer present, eg, with anticoagulation treatment)
Reversible cause of AF (e.g., post-operative, thyroid disorder, etc.)
Conditions that make an AF ablation procedure unlikely to be successful (e.g., advanced infiltrative cardiomyopathies like amyloid, severe mitral stenosis or regurgitation, and cor pulmonale)
PCI/STEMI within the prior 1 month
Active systemic infection or sepsis
Contraindication to all anticoagulation
Significant congenital anomaly or medical problem that in the opinion of the investigator would preclude an ablation procedure
Women who are pregnant, lactating, or who are of childbearing age and plan on becoming pregnant during this trial.
Life expectancy or other disease processes likely to limit survival to less than 12 months
Currently, enrolled in an investigational study evaluating another device, biologic, or drug, that would interfere with this trial.

Where it is running

Arrhythmia Research Group — Jonesboro, Arkansas, United States
Cardiology Associates Medical Group — Ventura, California, United States
Naples Comprehensive Health — Naples, Florida, United States
Mount Sinai Morningside — New York, New York, United States
The Mount Sinai Hospital — New York, New York, United States
Ohio Health Research Institute — Columbus, Ohio, United States
UPMC Pinnacle Hospitals — Harrisburg, Pennsylvania, United States
Trident Medical Center — North Charleston, South Carolina, United States
Sentara Health Research Center — Virginia Beach, Virginia, United States

Full record on ClinicalTrials.gov

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