Computed Tomography of Pulse-Field Ablation

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Conditions studied: Atrial Fibrillation (AF), Arrhythmia

In brief

Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) reduces left atrial (LA) volume post-ablation, a phenomenon termed reverse atrial remodeling, indicative of successful reversal of atrial cardiomyopathy progression. In contrast, pulse field ablation (PFA), a novel non-thermal technology, offers a promising efficacy and safety profile without inducing persistent atrial fibrosis. While RFCA-associated reverse atrial remodeling is well-documented, it remains uncertain whether PFA, operating on a non-thermal paradigm, also promotes this remodeling, which would enhance its physiological relevance in AF treatment. Additionally, RFCA studies show that LA wall thickness at the pulmonary vein (PV) antrum can predict PV reconnection and arrhythmia recurrence, but whether PFA affects LA thinning or enables similar predictions from post-treatment computed tomography (CT) scans is unknown. Moreover, epicardial adipose tissue (EAT), strongly linked to LA abnormalities and AF recurrence, can be quantified via CT, yet the impact of PFA on LA EAT remains unexplored. Finally, PFA's versatility, particularly in isolating the LA posterior wall (LAPW) in non-paroxysmal AF, raises questions about its effect on posterior wall thinning or EAT changes, factors associated with post-ablation recurrence

Key facts

Study ID: NCT07395089
Run by: Assistance Publique - Hôpitaux de Paris
People needed: 200
Starts: 2026-02-01
Expected to finish: 2026-02-01
Last updated by the study team: 2026-02-09

Who can join

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

You may qualify if…

Age≥18 years at the time of AF ablation
AF ablation by pulse-field ablation (BOSTON SCIENTIFIC FARAPULSE) or by radiofrequency (any manufacturer) between 2020 and 2024
Paroxysmal or non-paroxysmal AF
Pre-ablation CT data available and of high quality
Post-ablation CT data available and of high quality
Post-ablation CT performed 3-months (+- 2 weeks) after AF ablation

You may not qualify if…

Low quality CT, non-homogeneous contrast agent perfusion
Post-ablation CT performed in another center
Patients in which pre- and post-ablation CTs do not share common phases
Patients who underwent ethanol infusion in the vein of Marshall

Where it is running

Hôpital Pitié Salpêtrière — Paris, Île-de-France Region, France

Full record on ClinicalTrials.gov

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