Finerenone After Catheter Ablation to Help Prevent Atrial Fibrillation Returning
Tests finerenone in adults after a first catheter ablation for atrial fibrillation.
Plain-language title generated from the registry record
Registry title: Finerenone After Catheter Ablation to Reduce Atrial Fibrillation Recurrence
Key facts
- Where
- Tainan, TaiwanSee the site
- Phase
- Phase 2
Could this be for you?
Answer for yourself. This is not a decision: only the study team can say whether you can take part.
- Are you between 18 and 80 years old?
Source: NCT07799519, who can take part
Where in Taiwan
- National Cheng Kung University HospitalTainan, TaiwanTaking people
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
- National Cheng-Kung University Hospital
- Trial code
- NCT07799519
- Record updated
- 2 September 2026
- Original description
Atrial fibrillation (AF) is a common heart rhythm disorder associated with stroke, heart failure, and increased mortality. Catheter ablation with pulmonary vein isolation (PVI) is an effective rhythm-control strategy, but 20-30% of patients experience AF recurrence within one year. Finerenone, a nonsteroidal mineralocorticoid receptor antagonist with anti-inflammatory, antifibrotic, and metabolic effects, was associated with a lower incidence of AF in prior large trials, and preclinical studies suggest it promotes "browning" of adipose tissue and improves epicardial adipose tissue (EAT) characteristics.Read full original descriptionShow less
Finerenone for Reducing Atrial Fibrillation Recurrence After Pulmonary Vein Isolation: A Randomized Pilot Trial With Mechanistic Assessment of Epicardial Adipose Tissue Remodeling and Brown Adipose Tissue Activation
Atrial fibrillation (AF) is a common heart rhythm disorder associated with stroke, heart failure, and increased mortality. Catheter ablation with pulmonary vein isolation (PVI) is an effective rhythm-control strategy, but 20-30% of patients experience AF recurrence within one year. Finerenone, a nonsteroidal mineralocorticoid receptor antagonist with anti-inflammatory, antifibrotic, and metabolic effects, was associated with a lower incidence of AF in prior large trials, and preclinical studies suggest it promotes "browning" of adipose tissue and improves epicardial adipose tissue (EAT) characteristics.
This single-center, randomized, investigator-blinded pilot trial will enroll 40 patients undergoing first-time catheter ablation for AF. After successful PVI, participants will be randomized 1:1 to receive finerenone or usual care for 12 months. The primary endpoint is AF recurrence (any atrial arrhythmia episode lasting 30 seconds or longer) after a 90-day blanking period, within 12 months post-ablation. Mechanistic endpoints include EAT remodeling assessed by cardiac computed tomography and echocardiography, and circulating uncoupling protein-1 (UCP1) levels as a biomarker of adipose tissue browning.
The investigators hypothesize that finerenone will lower AF recurrence after ablation, partly through modulation of EAT function.
Inclusion: Age 18-80 years; Atrial fibrillation scheduled for first-time catheter ablation (pulmonary vein isolation); Estimated glomerular filtration rate (eGFR) >=25 mL/min/1.73 m2; Serum potassium <=5.0 mmol/L.
Exclusion: History of prior catheter-based or surgical pulmonary vein isolation; Known hypersensitivity to the investigational drug; Contraindications to the investigational drug, such as concomitant use of strong CYP3A4 inducers (e.g., rifampicin, carbamazepine, phenytoin, phenobarbital); Severe liver disease (Child-Pugh class C); Active cancer or recent chemotherapy; Severe renal impairment (eGFR <25 mL/min/1.73 m2); Serum potassium >5.0 mmol/L; Current use of other mineralocorticoid receptor antagonists (MRAs); Women who are pregnant, breastfeeding, or planning to become pregnant during the study period.