Prospective Elimination Of Distal Coronary Sinus-Left Atrial Connections for Atrial Fibrillation Ablation Trial

Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting millions of people
in the US and around the world. Over the last 20 years, catheter based AF ablation has been
widely adopted. However, long-term success rates fhave been reported to be as low as 50% and
20% for paroxysmal and persistent AF, respectively. To achieve permanent arrhythmia
suppression, repeated ablation procedures are often needed. Prior work indicates that distal
connections between coronary sinus musculature and the left atrium provide a substrate for
single or multiple reentry beats as a trigger for atrial fibrillation. In this prospective
randomized trial the investigators will define the efficacy of elimination of distal
connections between coronary sinus and left atrial musculature for suppression of recurrent
atrial arrhythmias. Patients will be randomly assigned to standard of care ablation
(pulmonary vein isolation and non pulmonary vein trigger ablations) alone, or standard of
care ablation augmented by distal coronary sinus to left atrial connection elimination.

Inclusion Criteria:

- Patients with paroxysmal or persistent atrial fibrillation; AND Undergoing first AF
ablation; AND Age ≥ 18 years.

Exclusion Criteria:

- Previous left atrial ablation; Women currently pregnant; Mental or physical inability
to take part in the study; Known terminally ill patients.