Empirical Anatomy-Based Ablation vs Emphasize Map-Guided Substrate Ablation in Persistent Atrial Fibrillation : (COMPASS-AF)

Summary

This study is aimed to compare the clinical efficacy of two different catheter ablation strategies in patients with persistent atrial fibrillation. Participants will be randomized 1:1 into either the Anatomy-based group or the Emphasize map-guided group * Anatomy-based group : Pulmonary vein isolation (PVI) using pulsed-field ablation (PFA) with a single-shot multielectrode catheter. * Emphasize map-guided group : PVI using radiofrequency (RF) ablation followed by additional EnSite X-guided pathologic substrate modification. Participants will be followed for 1 year to compare the incidence of any atrial tachyarrhythmia and other clinical parameters between the two groups.

Eligibility

Inclusion Criteria:

* Adults aged 19 years or older who have voluntarily provided written informed consent to participate in the study
* Patients diagnosed with persistent atrial fibrillation (AF) who are scheduled to undergo catheter ablation for AF.

Exclusion Criteria:

* History of prior catheter ablation or MAZE surgery for atrial fibrillation.
* Left atrial (LA) diameter exceeding 60 mm.
* Patients with end-stage renal disease (ESRD).
* History of prior open-heart surgery.
* Women who are pregnant, lactating, or of childbearing potential.
* Heart failure corresponding to New York Heart Association (NYHA) functional class IV.
* Acute coronary syndrome (ACS) experienced within the past 3 months.
* Patients with terminal illness and a life expectancy of less than one year.
* Any other condition that the investigator deems inappropriate for participation in the study.

Conditions2

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