The purpose of this randomized, controlled trial is to investigate whether coronary computed tomography (CT) angiography prior to catheter ablation and derived treatment (medical anti-ischemic and multimodality treatment and/or mechanical revascularization) can improve clinical outcomes in patients with atrial fibrillation undergoing catheter ablation.
A sub-study will investigate the effect of different ablation strategies on clinical outcomes in patients with atrial fibrillation undergoing catheter ablation.
Age over 18 years.
Referral for catheter ablation treatment (excluding AV-junction ablation) for atrial fibrillation (both paroxysmal and persistent atrial fibrillation) at the Department of Cardiology at Gentofte Hospital. Both first ablation and re-ablation treatments are included.
The ability and willingness to provide written informed consent.
Known atherosclerotic cardiovascular disease (ASCVD).
Ongoing treatment with statins.
Contraindications for coronary CT angiography, e.g. contrast allergy
Recent coronary CT angiography including CAC-score without positive findings <3 years prior to screening.
Parallel
Analysis of coronary CT Angiography and CAC scoring at the time of catheter ablation
Diagnostic testAnalysis of coronary CT angiography and CAC scoring and initiation of relevant derived treatment at the time of catheter ablation.
Between-group difference in time to first recurrence of atrial tachyarrhythmia lasting >30 seconds between 91 days after ablation and end of follow-up.
Between-group difference in time to first documented occurrence of other arrhythmias after ablation
Between-group difference in AF burden as registered by the implantable cardiac monitor after ablation
Between-group difference in the number of participants hospitalized for angina pectoris or acute coronary syndrome after ablation
Between-group difference in the incidence of acute myocardial infarction after ablation
Between-group difference in the prevalence of coronary artery disease in patients with atrial fibrillation at baseline
Between group difference in the quality of life of participants as quantified by a validated self-administered questionnaire
The proportion of participants in the active arm that are started or intensified on the following medication following the coronary CT angiography: statins, antithrombotic or antidiabetic medication
Between-group differences in the proportion of patients that are started or intensified on the following medication within 1 year after the coronary CT angiography: statins, antithrombotic, antidiabetic, or antihypertensive medication.
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Tor Biering-Sørensen
Lead sponsor
Herlev and Gentofte Hospital
Sponsor institution
