Insulin resistance and the outcome of pulsed field ablation for atrial fibrillation
Looks at whether insulin resistance relates to ablation outcomes in adults with atrial fibrillation.
Plain-language title generated from the registry record
Registry title: Insulin Resistance as a Predictor of Pulsed Field Ablation Success in Atrial Fibrillation (HOMA-PULSE)
Key facts
- Where
- Třinec, CzechiaSee the site
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults without diabetes who are having their first catheter ablation for atrial fibrillation using pulsed field ablation.
- Age
- 18 years or older
- Sex
- All sexes can join
- Disease stage
- Atrial fibrillation, having a first catheter ablation using pulsed field ablation (PFA)
- Earlier treatment
- No earlier atrial fibrillation ablation by any method
Main reasons for not taking part
- Known diabetes or current treatment for diabetes
- Earlier atrial fibrillation ablation by any method
- Pregnancy
- Severe kidney problems (eGFR < 30 mL/min)
- Other severe illnesses that make follow-up hard
Read by machine on 9 November 2026.
Where in Czechia
- Kardiocentrum, Nemocnice AGEL Trinec-Podlesi a.s.Třinec, CzechiaNo longer taking part
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Nemocnice AGEL Trinec-Podlesi a.s.
- Trial code
- NCT07551947
- Record updated
- 27 April 2026
- Original description
This study investigates whether insulin resistance, a metabolic condition where the body's cells respond poorly to insulin, can predict the success of atrial fibrillation (AF) ablation using pulsed field ablation (PFA) technology.Read full original descriptionShow less
HOMA-PULSE: Assessment of Glucose Metabolism and Insulin Resistance as a Predictor of Pulsed Field Ablation Success in Atrial Fibrillation
This study investigates whether insulin resistance, a metabolic condition where the body's cells respond poorly to insulin, can predict the success of atrial fibrillation (AF) ablation using pulsed field ablation (PFA) technology.
Atrial fibrillation is the most common heart rhythm disorder, affecting 2-4% of adults. Catheter ablation is an effective treatment, but 20-40% of patients require a repeat procedure. Identifying patients at higher risk of ablation failure could improve treatment planning and outcomes.
Scientific evidence suggests that insulin resistance - which can exist for years before diabetes develops - may contribute to electrical and structural changes in the heart that promote AF. However, no prospective study has systematically examined whether insulin resistance measured by the HOMA-IR index predicts ablation outcomes, particularly with the newest pulsed field ablation technology.
HOMA-PULSE is a prospective observational study enrolling at least 120 non-diabetic patients undergoing their first AF ablation using pulsed field ablation at the Cardiocentrum, AGEL Hospital Trinec-Podlesi, Czech Republic.
On the day of ablation, fasting blood samples are collected as part of routine preoperative care. A portion of these samples is used to measure insulin resistance (HOMA-IR index, calculated from fasting glucose and insulin levels) along with additional biomarkers including GDF-15, hs-CRP, NT-proBNP, IL-6, and IL-1beta. Detailed procedural and clinical data are recorded.
Patients attend a single follow-up visit at 4-5 months post-ablation - a standard part of clinical care after AF ablation. The primary outcome is the clinical decision regarding need for repeat ablation (reablation), made by the treating physician blinded to the HOMA-IR result.
The study does not involve any additional procedures, visits, or interventions beyond standard clinical care. The only research-specific element is the additional laboratory analysis of biomarkers from blood samples that would be drawn regardless of study participation.
Additionally, intracardiac electrograms recorded during the ablation procedure will be analyzed using deep learning neural network models to extract electrophysiological features and evaluate whether insulin resistance has a detectable electrophysiological signature that can be captured by artificial intelligence.
If a significant association between insulin resistance and ablation outcomes is confirmed, this could lead to new strategies combining ablation with metabolic optimization to improve success rates.
Inclusion: Age >= 18 years; Undergoing first catheter ablation for atrial fibrillation using pulsed field ablation (PFA); No known diagnosis of diabetes mellitus; Signed written informed consent.
Exclusion: Previous atrial fibrillation ablation by any method; Known diabetes mellitus or active antidiabetic treatment; Severe renal insufficiency (eGFR < 30 mL/min); Pregnancy; Other severe comorbidities limiting follow-up; Inability to provide informed consent.