About this trial
SAFER-AF is an investigator-initiated, multicenter, open-label, parallel-group trial comparing catheter ablation versus usual care in patients with atrial fibrillation and intracerebral hemorrhage.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age ≥ 18 years
Between 14 Days and 12 Months After Spontaneous Intracerebral Hemorrhage
Able to Access Intracerebral Hemorrhage Imaging Data
ECG indicating the presence of atrial fibrillation
Disqualifiers
Atrial fibrillation secondary to clearly reversible causes (e.g., hyperthyroidism, hypokalemia, etc.)
Fully dependent (modified Rankin Scale [mRS] score > 4)
Uncontrolled hypertension (systolic blood pressure > 160 mmHg)
Presence of uncontrolled active bleeding
Trial design
Parallel
Treatments tested in this trial
Catheter Ablation
Procedure/SurgeryAll patients undergo pulsed field ablation, followed by low-dose rivaroxaban for 1 month. For patients with paroxysmal atrial fibrillation (AF), an ablation strategy based on bilateral pulmonary vein isolation (PVI) is adopted. For patients with persistent AF, PVI plus ethanol infusion of the vein of Marshall and linear ablation (mitral isthmus, cavotricuspid isthmus, and left atrial roof) strategy is recommended. Other additional ablation strategies are determined by the operator. Anticoagulation therapy is discontinued after 1 month if no AF is detected during patient monitoring.
Usual Care
DrugThe use of antithrombotic therapy is at the discretion of the treating physician.
Treatment groups
Trial outcomes
Primary outcomes
Composite of All-Cause Mortality, All-Cause Stroke, and Systemic Embolism
Secondary outcomes
Stroke and Systemic Embolism
Cardiovascular death
Ischemic Stroke
Intracerebral Hemorrhage
Sponsors and contacts
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