SMART-SF Radiofrequency Ablation Safety Study

The purpose of this study is to demonstrate the safety of the study device in the treatment
of drug refractory symptomatic paroxysmal atrial fibrillation (PAF) during standard
electrophysiology mapping and RF ablation procedures.

Inclusion Criteria:

- Symptomatic paroxysmal atrial fibrillation (AF) who have had at least one AF episode
electrocardiographically documented within one (1) year prior to enrollment and a
physician's note indicating recurrent, self-terminating AF. Electrocardiographic
documentation may include, but is not limited to, electrocardiogram (ECG),
transtelephonic monitor (TTM), Holter monitor (HM), or telemetry strip

- Failed at least one antiarrhythmic drug (AAD) (class I or III, or atrioventricular
(AV) nodal blocking agents such as beta blockers and calcium channel blockers) as
evidenced by recurrent symptomatic AF, or intolerable to the AAD

- Age 18 years or older

Exclusion Criteria:

- Atrial fibrillation secondary to electrolyte imbalance, thyroid disease, or reversible
or non-cardiac cause

- Previous surgical or catheter ablation for atrial fibrillation

- Amiodarone at any time during the past 3 months

- Any percutaneous coronary intervention (PCI), cardiac surgery, or valvular cardiac
surgical or percutaneous procedure (e.g., ventriculotomy, atriotomy, and valve repair
or replacement and presence of a prosthetic valve) within the past 2 months

- Any carotid stenting or endarterectomy

- Coronary artery bypass graft (CABG) surgery within the past 6 months

- AF episodes lasting >7 days

- Documented left atrial (LA) thrombus on imaging

- LA size >50 mm

- Left ventricular ejection fraction (LVEF) < 40%

- Contraindication to anticoagulation (heparin or warfarin)

- History of blood clotting or bleeding abnormalities

- MI within the past 2 months

- Documented thromboembolic event (including transient ischemic attack (TIA)) within the
past 12 months

- Rheumatic Heart Disease

- Uncontrolled heart failure or New York Heart Association (NYHA) function class III or
IV

- Awaiting cardiac transplantation or other cardiac surgery within the next 12 months

- Unstable angina

- Acute illness or active systemic infection or sepsis

- Diagnosed atrial myxoma

- Presence of implanted implantable cardioverter defibrillator (ICD)

- Significant pulmonary disease, (eg, restrictive pulmonary disease, constrictive or
chronic obstructive pulmonary disease) or any other disease or malfunction of the
lungs or respiratory system that produces chronic symptoms

- Significant congenital anomaly or medical problem that in the opinion of the
investigator would preclude enrollment in this study

- Women who are pregnant (as evidenced by pregnancy test if pre-menopausal)

- Enrollment in an investigational study evaluating another device, biologic, or drug

- Presence of intramural thrombus, tumor or other abnormality that precludes vascular
access, or manipulation of the catheter

- Presence of a condition that precludes vascular access

- Life expectancy or other disease processes likely to limit survival to less than 6
months