Renal Denervation + AF Ablation for Atrial Fibrillation

(ULTRA-HFIB Trial)

No longer recruiting at 16 trial locations
SC
BE
CS
MK
JL
Overseen ByJeff Lam, MS
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Vivek Reddy
Must be taking: Antihypertensives
Stay on Your Current MedsYou can continue your current medications while participating
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 3 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether adding renal denervation—a procedure that reduces nerve activity affecting the kidneys—can help prevent atrial fibrillation (AF) from recurring in individuals already scheduled for a standard AF ablation procedure (also known as catheter ablation or pulmonary vein isolation). Participants will be randomly assigned to receive either the standard ablation alone or the ablation plus renal denervation. This trial suits individuals planning their first AF ablation, who have high blood pressure, and are open to follow-up visits. As an unphased trial, it offers participants the chance to contribute to innovative research that could enhance future treatment options.

Do I need to stop my current medications for the trial?

The trial information does not specify if you need to stop taking your current medications. However, since it mentions a history of hypertension and the use of antihypertensive medication as part of the inclusion criteria, it seems likely that you can continue those medications. It's best to discuss this with the trial coordinators for specific guidance.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that combining renal denervation (RDN) with catheter ablation can safely treat atrial fibrillation (AF), a type of irregular heartbeat. In studies, patients receiving both treatments experienced fewer AF recurrences compared to those undergoing only the usual procedure, pulmonary vein isolation. Notably, adding RDN did not increase side effects. This suggests that combining these treatments is generally well-tolerated and may improve outcomes for some patients.12345

Why are researchers excited about this trial's treatments?

Unlike the standard treatment for atrial fibrillation, which typically involves catheter ablation alone, the investigational approach combines catheter ablation with renal denervation. This combination is unique because it not only targets the heart to disrupt abnormal electrical signals but also addresses the autonomic nervous system by modifying the renal nerves, which may help reduce blood pressure and stabilize heart rhythms more effectively. Researchers are excited about this novel approach as it holds the potential to enhance the success rate of atrial fibrillation treatment by tackling the condition through multiple mechanisms simultaneously.

What evidence suggests that this trial's treatments could be effective for Atrial Fibrillation?

Research shows that catheter ablation, one of the treatments in this trial, can effectively reduce the recurrence of atrial fibrillation (AF), a type of irregular heartbeat. One study found a 48% decrease in AF recurrence over four years. Another study reported that after one to four ablation procedures, 67% of patients no longer experienced irregular heartbeats.

In this trial, some participants will receive both catheter ablation and renal denervation. Research suggests that renal denervation may improve outcomes for AF patients with high blood pressure. A review of several studies has found that adding renal denervation to standard treatment can lead to better results for those with a history of high blood pressure. Additionally, renal denervation can lower nerve activity in the heart, which might help reduce AF episodes.678910

Who Is on the Research Team?

Vivek Reddy, MD - Physician's Channel ...

Vivek Reddy, MD

Principal Investigator

Icahn School of Medicine at Mount Sinai

Are You a Good Fit for This Trial?

This trial is for adults over 18 with a history of high blood pressure and planned first-ever AF ablation procedure. They must be willing to follow the study plan and have controlled hypertension, either Stage III or on medication. Excluded are those with long-term persistent AF, severe heart failure, poor kidney function, known allergies to contrast media not treatable, pregnant or nursing women, single functioning kidney individuals, drug/alcohol dependency issues, concurrent enrollment in conflicting trials.

Inclusion Criteria

I have a history of high blood pressure.
I am scheduled for my first AF ablation procedure and it must be completed successfully before I can join.
I have high blood pressure and am on medication for it.
See 1 more

Exclusion Criteria

Patients concurrently enrolled in any other investigational drug or device trial that would interfere with the conduction of this trial
I do not have a current drug or alcohol problem and can follow study instructions.
My AFib is caused by a heart valve issue or a temporary condition.
See 15 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo AF ablation with or without renal sympathetic denervation

90 days

Follow-up

Participants are monitored for safety and effectiveness after treatment

12 months

What Are the Treatments Tested in This Trial?

Interventions

  • Catheter Ablation
  • Renal Denervation
Trial Overview The ULTRA-HFIB Pilot aims to see if adding renal denervation (RDN) to standard atrial fibrillation (AF) ablation helps prevent AF from coming back. Participants will be randomly assigned to just get an AF ablation or both an AF ablation and RDN.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Catheter ablation + renal denervationExperimental Treatment2 Interventions
Group II: Catheter ablation onlyActive Control1 Intervention

Catheter Ablation is already approved in European Union, United States, Canada for the following indications:

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Approved in European Union as Pulmonary Vein Isolation (PVI) for:
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Approved in United States as Pulmonary Vein Isolation (PVI) for:
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Approved in Canada as Pulmonary Vein Isolation (PVI) for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Vivek Reddy

Lead Sponsor

Trials
23
Recruited
5,700+

Citations

Effect of Catheter Ablation Using Pulmonary Vein Isolation ...After 12 months, 89 patients (52.4%) assigned to PVI with PWI were free from recurrent atrial arrhythmia without antiarrhythmic medication after ...
The Effectiveness of Ablation Therapy for Atrial FibrillationThe initial results of the CABANA study revealed a noteworthy reduction of 48% in AF recurrence during a 48-month observation period [7,12].
Incremental Efficacy for Repeat Ablation Procedures ...After 1 to 4 ablations, the success rate of the cohort was also 67%. Figure 4 shows the arrhythmia-free survival after 1, 2, 3, and 4 ablation ...
One-year outcomes of a conformable single-shot pulsed ...To determine 1-year outcomes of a single-shot, all-in-one mapping and ablation PFA catheter for treating paroxysmal atrial fibrillation (PAF).
Five-Year Follow-Up After Catheter Ablation of Persistent ...We report a limited 5-year multiple procedure success rates of 59% (20% on AAD) using the stepwise approach. However, AF termination can be achieved and the ...
Comparing efficacy and safety in catheter ablation strategies ...The risk of recurrence was significantly decreased compared to pulmonary vein isolation (PVI) alone for PVI with renal denervation (RR: 0.60, CI: 0.38–0.94), ...
Effect of Renal Denervation and Catheter Ablation vs ...This randomized trial compares the effects of pulmonary vein isolation with vs without renal denervation on freedom from atrial fibrillation ...
Renal Nerve Denervation After Pulmonary Vein Isolation ...Study Hypothesis: Catheter based RDN can prevent recurrence of AF in patient with persistent AF undergoing PVI by mechanism not related to hypertension control.
Renal denervation for atrial fibrillationThe study aims to compare clinical outcomes following renal denervation (RDN) in hypertensive patients with atrial fibrillation (AF).
Renal Sympathetic Denervation as Upstream Therapy ...However, in the meta-analysis, adjunctive RSDN to PVI appears to be safe, and improves clinical outcomes in AF patients with a history of hypertension.
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