Non-pharmacological Prevention of Stroke in Patients With Non-valvular Atrial Fibrillation
- Conditions
- Atrial Fibrillation
- Registration Number
- NCT03867227
- Lead Sponsor
- National Research Center for Preventive Medicine
- Brief Summary
Left atrial appendage (LAA) occlude devices are used for over ten years. According to current data efficiency and safety of this approach at least comparable with pharmacological prevention of stroke in patients with non-valvular atrial fibrillation.
However, to date, LAA occluder implantation is not recommended as an alternative for conservative therapy and reserved for patients with contraindications for oral anticoagulants only. In the same time, long-term follow-up of patients enrolled in clinical trials and data from registries showed that LAA occlude device implantation as an alternative to oral anticoagulation could reduce drug load, decrease complexity and cost of treatment and thus improve patients' quality of life, and potentially may reduce the risk of death. The aim of our study is to investigate the risk of all-cause death, stroke, and bleedings in patients with LAA occluder implanted as an alternative to anticoagulant therapy.
Three hundred patients with atrial fibrillation will undergo LAA occluder implantation. For LAA occluder sizing transesophageal echocardiography (TEE), CT and LAA angiography will be performed. The follow-up period will be 36 months. The incidence of all-cause death, stroke, bleeding BARC≥2, device-related complications and QOL will be investigated.
The patients will be followed in the clinic at three and six months, and then at 12, 24 and 36 months, the telephone calls for getting information about endpoints events will be done. Additional in clinic visits will be scheduled if the late complications will be suspected.
TEE will be performed at three and six months to check for device leak, displacement and thrombosis.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 300
- Patient with paroxysmal/persistent/permanent atrial fibrillation
- CHA2DS2VASc score ≥2 for male and ≥3 for female
- Without contraindications to anticoagulation therapy
- LAA thrombosis
- mechanical prosthetic heart valve
- moderate or severe mitral valve stenosis
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Number of patients with Composite of death, stroke, clinically significant bleeding event (>_2 class according to BARC criteria), device leak, device displacement or device thrombosis with the first event for a given patient is taken into account 36 months a clinically significant bleeding event is \>_2 class according to Bleeding Academic Research Consortium (BARC) criteria bleeding
- Secondary Outcome Measures
Name Time Method device leak and displacement during first 6 months 6 months device leak detected by transesophageal echocardiography during first 6 months after implantation or device displacement during the same time period
the percent of patients in whom long -term anticoagulation therapy would add during follow-up 36 months number of patients who would require adding permanent anticoagulant therapy for any reason during follow-up
any adverse events during 7 days after LAA occluder implantation 7 days any adverse events related to the device implantation during the first 7 days after implantation
any bleed 36 months total number of patients who would have any bleeding event
bleeding BARC ≥2 36 months total number of patients who would have bleeding event with the grade BARC ≥2
device thrombosis during first 6 months 6 months device thrombosis detected by transesophageal echocardiography during first 6 months of follow-up
device dislocation 36 months number of patients who would have device dislocation
change in QOL SF 36 between baseline and final visit Assessed at baseline and 6-month follow-up visits change in quality of life (QOL) by Short Form (SF) 36 Health Survey between baseline and follow-up visits
SF 36 is a 36-item, patient-reported survey of patient health. SF-36 measures the subject's overall Health Related Quality of Life on 8 domains: physical functioning, role functioning, bodily pain, general health, vitality, social functioning, role emotional and mental health. 0-100 scale are using to access each domain. lower the score the more disability.
Trial Locations
- Locations (1)
. National Research Center for Preventive Medicine of the Ministry of Health
🇷🇺Moscow, Russian Federation