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Cardiac ArrhythmiaRESET-PFANCT07185412

Spanish Registry of Redo Procedures Following Pulmonary Vein Ablation by Pulsed Field Ablation Technology: RESET-PFA

An observational study of Cardiac Arrhythmia and Atrial Fibrillation, run by Instituto de Investigación Sanitaria Aragón at 1 site in Spain.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

RESET-PFA is a prospective, multicenter, non-randomized post-market study. All patients will be treated according to the standard care followed by each center. The protocol requires enrollment of consecutive patients from each center, according to eligibility criteria. Read more about this study

Who is it for?
Any age
What is being tested?
Pulsed Field ablation: Ablation to treat atrial fibrillation
Type of treatment
Medical device
How many people
1,100 participants
Where
1 siteSpain
Study dates
1 Oct 2025to 31 Dec 2030
How long will I take part?
1 Year
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Study population: All consecutive patients, clinically indicated for AF ablation, will be enrolled after signing an informed consent form and an authorization to use and disclose health information

Who may be able to join

  • Patients with an indication to a pulsed-field ablation procedure of Atrial Fibrillation according to current international and local guidelines (and future revisions), existing IFU or per physician discretion
  • Patients who are willing and capable of providing informed consent, participating in all testing at an approved clinical investigational center or such consent will be provided by a legal representative, if required by local law or regulation.

Who cannot join

  • Patients who are currently enrolled in another investigational study or registry that would directly interfere with the current study, except when the subject is participating in a mandatory governmental registry, or a purely observational registry with no associated treatments
  • Patients who are unwilling or unable to sign an authorization to use and disclose health information or an Informed Consent.
  • Patients unavailable or not willing to complete follow up visits and examination for the duration of the study at the center.
  • Life expectancy ≤ 12 months per physician judgment.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Javier Ramos Maqueda, MD, PhD contact

0034615382731

javierramos.iias@gmail.com

Spain1 site
  • Unidad de Arritmias. Departamento de Cardiología. Hospital Universitario Lozano Blesa.

    Zaragoza, Zaragoza, 50009

    Javier Ramos Maqueda, MD, PhD, 0034615382731

Other trials in Spain

About this study

RESET-PFA is a prospective, multicenter, non-randomized post-market study. All patients will be treated according to the standard care followed by each center. The protocol requires enrollment of consecutive patients from each center, according to eligibility criteria. During the 12 months follow-up period, clinical atrial fibrillation recurrence, occurrence of all kinds of atrial arrhythmias and of all Adverse Events in the study population will be collected.

The purpose of this study is to prospectively evaluate during time a large population of patients with an indication for ablation of AF, collecting data on procedural success in the acute and medium- to long-term follow-up. The primary objective of the study is the determination of up to 10 clinical and procedural parameters predicting a repeat ablation procedure after the blanking period in patients that had undergone an AF ablation with pulsed field ablation through a standard of care pathway.

Read the detailed description

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in clinical practice in the Western world, significantly impacting patient morbidity and mortality. Catheter ablation, specifically pulmonary vein isolation, has become the treatment of choice for rhythm control in patients with drug-refractory AF. Historically, thermal therapies such as radiofrequency (RF) and cryoablation have been used for pulmonary vein isolation. However, numerous studies have shown that a portion of AF recurrences pulmonary vein ablation can be attributed to pulmonary vein reconnections, suggesting suboptimal lesion durability. Pulsed field ablation (PFA), a novel non-thermal ablation technique using high-voltage, short-duration electrical pulses, has emerged as a promising alternative. PFA induces myocardial cell death via irreversible electroporation, achieving pulmonary vein isolation. Initial clinical trials demonstrated PFA's efficacy, efficiency, and safety, with favorable rates of durable pulmonary vein isolation at 3 months post-ablation.

Following commercialization and widespread adoption, multicenter registries have further confirmed PFA's efficacy and safety. Comparative studies have suggested superior long-term pulmonary vein isolation rates with PFA compared to conventional thermal therapies. Consequently, PFA has the potential to improve lesion durability and clinical outcomes for AF patients. While several studies have investigated pulmonary vein isolation durability in redo procedures in patients with clinical recurrences after PFA, results have been variable (isolation durability range: 63% - 71%), and more data is needed to fully understand the patterns of reconnection.

To our knowledge, all previous studies primarily focused on PFA during the technology's early stages and operator learning curves, potentially biasing results towards suboptimal isolation rates due to inexperience. Additionally, most studies were retrospective and single-center, with only one multicenter registry involving seven hospitals. Furthermore, none of these studies have analyzed the workflow of the index pulmonary vein isolation procedure to explain variations in lesion durability.

Therefore, the investigators present a multicenter, national, retrospective/prospective study of experienced operators to evaluate pulmonary vein isolation durability in patients with AF recurrences after PFA, focusing on the association between index procedure workflow and lesion durability.

The previous considerations seem to suggest the need to conduct a large multicentric registry of experienced operators aimed at observing current clinical practice. The registry should allow the analysis of clinical practice in relation to the current procedural recommendations, the observation of the type of methods and ablation workflow adopted and the reasons for the choices. The long-term follow-up of the patients would allow the estimation of the incidence of arrhythmic occurrences and the evaluation of the outcome, according to the clinical characteristics, the ablative strategy of the index procedure and the validation criteria at the end of the procedure. Furthermore, the prospective observation of a large number of patients treated in clinical practice approached with different ablation approaches would allow to evaluate lesion durability and residual pulmonary vein gaps that have a decisive weight in evaluating the real effectiveness of the therapy and the consequent ablation strategy during repeated ablation. These data could be extremely useful and could guide EPs in choosing the best treatment options.

The primary objective of the study is the determination of up to 10 independent predictors of repeated ablation procedure after the blanking-period in patients undergoing pulsed-field ablation of atrial fibrillation ablation through a standard of care pathway.

Secondary objectives of the study are: 12 months clinical success rate defined as freedom from any clinical atrial arrhythmia and the use of any Type I or Type III antiarrhythmic medication for the treatment of AF, AFL, or AT after the blanking period, rate and characteristics of repeated ablation procedures, association between additional applications (at the operator's discretion) at the index procedure on the durability of pulmonary vein isolation, association between occurrence of atrial arrhythmias and peri-procedural variables and ablation workflow at the index procedure, association between occurrence of atrial arrhythmias and ablation workflow at the repeated ablation procedure, analysis of repeat ablation procedures after an index PFA ablation with focus on lesion durability and type of arrhythmia recurrence.

Being tested
Pulsed Field ablation: Ablation to treat atrial fibrillation
Keywords
Pulsed Field Ablation, Atrial fibrillation, Pulmonary vein isolation, Redo procedure, Mapping system
Medical subject headings
Arrhythmias, Cardiac, Atrial Fibrillation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Pulsed Field ablation: Ablation to treat atrial fibrillationDevice

    Pulsed Field Ablation

Study groups in NCT07185412
Study groupRoleWhat they receive
AF ablationPatients with standard indications to AF ablation
Receives: Device: Pulsed Field ablation: Ablation to treat atrial fibrillation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Title: Predictive Value of Procedural Workflow Parameters for Repeat Ablation

    Association between specific procedural variables during the index procedure (e.g., number of PFA applications per vein, lesion validation method, total procedure time, voltage and activation map characteristics) as potential predictors of repeat ablation procedures and pulmonary vein isolation durability. Pulmonary vein isolation status will be assessed by electro-anatomical mapping systems in the repeat ablation procedure. The incidence of patients with isolated/not isolated pulmonary veins will be correlated with each procedural variable of the index procedure (number of PFA applications per vein, lesion validation method, total procedure time, voltage and activation map characteristics). All variables will be assessed individually and by multivariable logistic regression to establish odds ratio values.

    Measured: Index procedure through 12-month follow-up

  2. Predictive Value of Baseline Clinical Characteristics for Repeat Ablation

    Association individual baseline characteristics (e.g., age, sex, AF type, history of cardiac comorbidities, antiarrhythmic therapy) as potential predictors of repeat ablation procedures and pulmonary vein isolation durability. Pulmonary vein isolation status will be assessed by electro-anatomical mapping systems in the repeat ablation procedure. The incidence of patients with isolated/not isolated pulmonary veins will be correlated with baseline characteristics of the patient. All variables will be assessed individually and by multivariable logistic regression to establish odds ratio values.

    Measured: 12 months post-index ablation

Secondary outcomes (12)
  1. Percentage of patients free from any clinical arrhythmia and use of Type I or Type III antiarrhythmic medication

    Proportion (%) of patients with documented arrhythmias and the use of any Type I or Type III antiarrhythmic medication for the treatment of atrial fibrillation, atrial flutter, or atrial tachycardia occurring after the 8-week post-ablation blanking period. Arrhythmias include atrial fibrillation, atrial flutter, or atrial tachycardia episodes lasting >30 seconds, detected by ECG, Holter monitor, or implantable loop recorder.

    Measured: 12 months post-index ablation

  2. Rate of Repeat Ablation Procedure After Blanking Period

    Proportion (%) of patients who undergo a repeat catheter ablation procedure for atrial arrhythmia recurrence occurring after the 8-week post-ablation blanking period. Arrhythmias include atrial fibrillation, atrial flutter, or atrial tachycardia episodes lasting >30 seconds, detected by ECG, Holter monitor, or implantable loop recorder.

    Measured: 12 months post-index ablation

  3. Durability of Pulmonary Vein Isolation at Repeat Procedure

    Proportion of pulmonary veins (%) that remain durably isolated at the time of repeat ablation procedure due to atrial arrhythmia recurrence occurring after the 8-week post-ablation blanking period. Pulmonary veins isolation will be assessed by using high-density mapping.

    Measured: At time of repeat ablation (if performed within 12 months)

  4. Technical workflow variables of the PFA Procedure Over Time

    This outcome aims at evaluating changes in technical periprocedural variables, such as total skin-to-skin time (from first puncture to final catheter withdrawal), catheter dwell time (from transeptal time to final catheter withdrawal), ablation time (from first PFA application to final PFA application) and fluoroscopy time (during the entire procedure) across the study period. Temporal milestones will be evaluated to reflect improvements in workflow efficiency as operator experience increases.

    Measured: Measured during index procedure

  5. Electroanatomical Voltage Characteristics as Predictors of Arrhythmia Recurrence

    Assessment of baseline left atrial voltage characteristics, measured as the mean electrical voltage of bipolar signals in the pulmonary veins and posterior wall healthy tissue during index procedure by using electro-anatomical mapping systems, as predictors of atrial arrhythmia recurrence after the 8-week blanking period.

    Measured: 12 months post-index ablation

  6. Activation Map Patterns as Predictors of Predictors of Arrhythmia Recurrence.

    Assessment of differential left atrial activation patterns obtained during the index procedure by means of mapping with an electro-anatomical mapping system, as predictors of atrial arrhythmia recurrence after the 8-week blanking period.

    Measured: 12 months post-index ablation

  7. Acute lesion validation during Index Procedure as Predictor of Arrhythmia Recurrence

    Assessment of whether performing or no acute lesion validation of pulmonary vein isolation, by means of entrance/exit block, or differential pacing response, during the index ablation may be a predictor of arrhythmia recurrence during follow-up.

    Measured: 12 months post-index ablation

  8. Acute lesion validation during Index Procedure as Predictor of pulmonary vein isolation

    Assessment of whether performing or no acute lesion validation of pulmonary vein isolation (by means of entrance/exit block, or differential pacing response) during the index ablation may be a predictor of pulmonary vein isolation during the repeat ablation procedure due to atrial arrhythmia recurrence occurring after the 8-week post-ablation blanking

    Measured: 12 months post-index ablation

  9. Number of PFA applications during Index Procedure as Predictor of pulmonary vein isolation

    Correlation of number of applications in each pulmonary vein, and the use of additional application at operator's discretion during the index ablation procedure, with the pulmonary vein isolation status during repeated ablation procedure due to atrial arrhythmia recurrences.

    Measured: 12 months post-index ablation

  10. Impact of Pre-procedural Imaging on Arrhythmia Recurrence

    Assessment of the percentage of patients with any pre-procedural imaging of the left atria available to guide ablation with documented arrhythmias and the use of any Type I or Type III antiarrhythmic medication for the treatment of atrial fibrillation, atrial flutter, or atrial tachycardia occurring after the 8-week post-ablation blanking period. Evaluation if the availability of any pre-procedural imaging is associated with a lower recurrence of atrial arrhythmia after ablation compared with those without previous imaging.

    Measured: 12 months post-index ablation

  11. Number of patients with antiarrhythmic therapy discontinued after ablation compared to the baseline status.

    Rate of patients (%) in which the antiarrhythmic therapy was discontinued after ablation compared to the baseline pharmacological status during the 12-month period of follow-up.

    Measured: 12 months post-index ablation

  12. Differential evolution of AF category after ablation

    Rate of patients (%) with a change in the AF typus or evolution (from paroxysmal to persistent AF; or from persistent to paroxysmal AF) registered in the repeated ablation procedure, compared to the index baseline status. AF will be recorded by ECG, Holter monitor, or implantable loop recorder.

    Measured: 12 months post-index ablation

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Sep 2025
  2. Study start1 Oct 2025 (estimated)
  3. Primary completion31 Dec 2030 (estimated)
  4. Study completion31 Dec 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
1,100 participants (estimated)
Target duration
1 Year
IDs, dates and publications
ClinicalTrials.gov ID
NCT07185412
Sponsor's protocol ID
PI24/545
Acronym
RESET-PFA
Status last verified
Sep 2025
First submitted
9 Jul 2025
Last updated
22 Sep 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Cardiac Arrhythmia and Atrial Fibrillation, run by Instituto de Investigación Sanitaria Aragón at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 22 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Javier Ramos Maqueda, MD, PhD (0034615382731, javierramos.iias@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Title: Predictive Value of Procedural Workflow Parameters for Repeat Ablation (time frame: Index procedure through 12-month follow-up). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Sep 2025.

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