COAST-AF

Characterization of Arrhythmia Substrate to Ablate Persistent Atrial Fibrillation

A multicentre, parallel group, two arm, single-blinded randomized clinical trial, assessing the efficacy of a patient-tailored catheter ablation (CA) strategy guided by atrial scar mapping in addition to pulmonary vein isolation (PVI) when compared to PVI alone in patients with persistent atrial fibrillation (AF).

Enrolment Criteria

Inclusion
- Age ≥18 years ;
- Subjects with symptomatic persistent AF AND clinically indicated catheter ablation for AF
- At least one episode of AF that is sustained beyond 3 months in duration ; documented on 12-lead ECG, Holter monitor, loop monitor or trans-telephonic monitor (TTM) within 36 months of enrollment in the study;
- Modified DR-FLASH score ≥3
Exclusion
- History of previous catheter ablation for AF or left atrial flutter;
- History of previous surgical ablation for AF;
- Known intracardiac thrombus;
- Contraindication to systemic oral anticoagulation therapy;
- Reversible causes of AF;
- Hypertrophic cardiomyopathy;
- Severe valvular disease (mitral/aortic stenosis or regurgitation);
- Subjects that are pregnant or breastfeeding;
- Comorbid condition with life expectancy < 1 year