Peri-procedural Hydration to Prevent Acute Kidney Injury After Pulsed Field Ablation for Atrial Fibrillation

Korábbi kezelés

• AF due to a reversible cause, such as hyperthyroidism or perioperative/cardiothoracic surgery-related AF.
• No oral anticoagulation for at least 3 weeks before ablation.
• Contraindication to anticoagulant therapy or iodinated contrast media.
• Myocardial infarction within 3 months before enrollment.
• Cardiac surgery within 3 months before enrollment.
• Need for renal replacement therapy (RRT) at enrollment or any history of prior RRT.
• Intravascular iodinated contrast administration within 7 days before enrollment.

Más betegség

• Significant valvular heart disease, including moderate or severe aortic stenosis, severe aortic regurgitation, moderate or severe mitral stenosis, or severe mitral regurgitation.
• New York Heart Association (NYHA) class III or IV congestive heart failure.
• Severe liver disease (Child-Pugh score \>7).
• History of kidney transplantation.
• Active systemic infection.

Laborértékek

• Left ventricular ejection fraction (LVEF) \<35%.
• Stage 4 or 5 chronic kidney disease (eGFR \<30 mL/min/1.73 m²).

Egyéb

• Participants meeting any of the following criteria will be excluded:
• Intracardiac thrombus.
• Hypertrophic cardiomyopathy.
• Known pregnancy or breastfeeding.
• Participation in another clinical trial that may affect the results of this study.
• Unwillingness or inability to comply with study procedures and follow-up, including participants considered by the investigator to be at substantial risk for poor adherence.

• Participants must meet all of the following criteria:
• Age ≥18 years.
• Symptomatic paroxysmal atrial fibrillation (AF) or persistent AF:
  • Paroxysmal AF: AF that terminates spontaneously or with intervention within 7 days of onset, and meets both of the following:
  • At least 2 symptomatic paroxysmal AF episodes within 6 months before enrollment;
  • At least 1 documented AF episode by electrocardiogram (ECG) or Holter monitoring within 12 months before enrollment.
  • Persistent AF: AF lasting \>7 days and ≤365 days, and meets both of the following:
  • At least 1 symptomatic persistent AF episode within 6 months before enrollment;
  • Persistent AF documented within 12 months before enrollment by either Holter monitoring or 2 ECGs obtained at least 7 days apart.
• Failure of antiarrhythmic drug (AAD) therapy, defined as inadequate efficacy and/or intolerance to at least 1 Class I or Class III AAD.
• Planned to undergo pulsed field ablation (PFA).
• Willing and able to provide written informed consent.
• Willing and able to comply with study procedures, including in-hospital assessments and 30-day and 90-day follow-up.