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.
Who can participate
Age range
19 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
* Patients aged ≥19 years with persistent atrial fibrillation scheduled for catheter ablation.
* Refractory to or intolerant of at least one Class I or III antiarrhythmic drug.
* Undergoing first-time catheter ablation for atrial fibrillation.
Exclusion Criteria:
* Acute coronary syndrome within the past 3 months.
* Severe unrevascularized coronary artery disease: ≥70% stenosis in at least one major epicardial vessel with a diameter ≥2 mm.
* History of stroke or transient ischemic attack (TIA) within the past 3 months.
* Uncontrolled severe hypertension (systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥120 mmHg).
* Severe untreated aortic valve stenosis.
* Symptomatic moderate-to-severe valvular heart disease.
* Aortic dissection.
* Heart failure with reduced ejection fraction (LVEF \<40%).
* Severe pulmonary hypertension (resting RVSP \>60 mmHg).
* Left atrial anteroposterior diameter \>60 mm.
* Presence of cyanotic congenital heart disease.
* Obstructive hypertrophic cardiomyopathy (resting or provoked LVOT pressure gradient ≥30 mmHg).
* History of prior maze surgery or catheter ablation for atrial fibrillation.
* Active internal bleeding.
* Contraindications to anticoagulation therapy or rhythm control treatment.
* Presence of severe comorbid conditions or life expectancy \<1 year.
* Drug or alcohol abuse.
* Pregnancy.
* Any other condition that, in the investigator's judgment, makes the patient unsuitable for study participation.
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.