Finerenone After Catheter Ablation to Reduce Atrial Fibrillation Recurrence

Sponsor
National Cheng-Kung University Hospital
Study ID
NCT07799519
Phase
PHASE2
Status
Recruiting
Apply to this trial

Conditions

  • Atrial Fibrillation (AF)

Eligibility Criteria

Sex
ALL
Age
18 Years - 80 Years
Healthy Volunteers
Not accepted

Interventions

  • Finerenone — DRUG
    Oral finerenone 10 mg or 20 mg once daily (dose per eGFR, with Week-4 up-titration where applicable based on serum potassium) for 12 months after catheter ablation.

Study Details

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.

Key Dates

First listed
Sep 2, 2026
Start date
Jun 9, 2026
Status verified
Aug 2026
Primary completion
Jun 30, 2028
Completion
Aug 31, 2028

Study Design

Enrollment
40 participants (estimated)
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT

Arms

  • Experimental: Finerenone
    Following successful pulmonary vein isolation, participants receive finerenone once daily for 12 months in addition to standard post-ablation care. Starting dose: 10 mg QD if eGFR 25-\<60 mL/min/1.73 m2, 20 mg QD if eGFR \>=60 mL/min/1.73 m2; up-titration to 20 mg QD at Week 4 where applicable if serum potassium \<=4.8 mmol/L.
  • No Intervention: Usual care
    Following successful pulmonary vein isolation, participants receive standard-of-care post-ablation management without finerenone.

Primary Outcome Measure

Atrial fibrillation recurrence after the blanking period [ Time Frame: From day 91 (end of the 90-day blanking period) to 12 months after ablation ]

Central Contacts

Related Studies