MedPath

Left Atrial Appendage Exclusion for Prophylactic Stroke Reduction Trial

Not Applicable
Recruiting
Conditions
Ischemic Stroke
Systemic Embolism
Interventions
Device: AtriClip LAA Exclusion System
Registration Number
NCT05478304
Lead Sponsor
AtriCure, Inc.
Brief Summary

This trial is a prospective, randomized, multicenter, multinational, blinded, superiority trial. The objective of this trial is to evaluate the effectiveness of left atrial appendage exclusion (LAAE) for the prevention of ischemic stroke or systemic arterial embolism in subjects undergoing cardiac surgery who have risk factors for atrial fibrillation and ischemic stroke.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
6500
Inclusion Criteria
  • Subjects ≥ 18 years of age

  • Documentation of any of the following clinical criteria:

    • CHA2DS2-VASc ≥ 4 with age ≥ 65
    • CHA2DS2-VASc ≥ 4 with significant left atrium enlargement or elevated NT-proBNP
    • CHA2DS2-VASc = 3 with age ≥ 75
    • CHA2DS2-VASc = 3 with significant left atrium enlargement or elevated NT-proBNP
    • CHA2DS2-VASc score = 2 with age ≥ 65 and significant left atrium enlargement or elevated NT-proBNP
Exclusion Criteria
  • Clinically significant atrial fibrillation or atrial flutter:

    • Anytime in the past and
    • Documented by an electrocardiographic recording and
    • Episode lasting 6 minutes or longer1*
  • Prior procedure involving opening the pericardium or entering the pericardial space

  • Prior LAA occlusion, exclusion, or removal (surgical or percutaneous)

  • Planned cardiac surgical procedure using non-sternotomy approaches

    o Partial sternotomies will be allowed.

  • Patients whose planned procedure is a heart transplant or implantation of any ventricular assist devices

  • Active endocarditis

  • Active systemic infection at the time of cardiac surgery requiring antibiotics, including known SARS-CoV2 infections regardless of symptoms

  • Known allergy to Nitinol or nickel sensitivity

  • Known medical condition with expected survival of less than 1 year

  • Other comorbidities that in the investigator's opinion make the subject unsuitable candidate to complete the protocol required visits.

  • Current enrollment in an investigation or trial or an investigational devices or investigational drug that would interfere with this trial.

  • Mental impairment or other psychiatric conditions which may not allow the patient to understand the nature, significance, and scope of the trial.

  • Pregnancy

  • Known severe symptomatic carotid disease

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
TreatmentAtriClip LAA Exclusion SystemLAAE using the AtriClip concomitant to and at the time of planned cardiac surgery
Primary Outcome Measures
NameTimeMethod
Primary Effectiveness EndpointCommon termination point (median follow-up for 5 years)

Time to the first occurrence of ischemic stroke or systemic arterial embolism as adjudicated by the Clinical Events Committee (CEC), or any procedure wherein the LAA was excluded, occluded, or amputated following the index procedure.

Primary Safety Endpoint30 days post index procedure

Occurrence of at least one of the following events assessed through 30 days post index procedure:

* Pericardial effusion requiring percutaneous or surgical treatment

* Major bleeding attributable to index surgical procedure

* Deep sternal wound infection

* Myocardial infarction

Secondary Outcome Measures
NameTimeMethod
Powered Secondary Effectiveness endpointCommon termination point (median follow-up for 5 years)

Time to the first occurrence of ischemic stroke or systemic arterial embolism

Trial Locations

Locations (126)

Heart Center Research / Huntsville Hospital

🇺🇸

Huntsville, Alabama, United States

HonorHealth Shea Scottsdale Healthcare

🇺🇸

Scottsdale, Arizona, United States

St. Bernard's Heart & Vascular

🇺🇸

Jonesboro, Arkansas, United States

CHI St. Vincent

🇺🇸

Little Rock, Arkansas, United States

Arkansas Heart Hospital

🇺🇸

Little Rock, Arkansas, United States

Memorial Care Long Beach Medical Center

🇺🇸

Long Beach, California, United States

Keck Medical Center of USC

🇺🇸

Los Angeles, California, United States

Hoag Memorial Hospital Presbyterian

🇺🇸

Newport Beach, California, United States

Sutter Sacramento Hospital

🇺🇸

Sacramento, California, United States

Stanford University

🇺🇸

Stanford, California, United States

University of Colorado

🇺🇸

Boulder, Colorado, United States

Hartford Hospital

🇺🇸

Hartford, Connecticut, United States

Christiana Care Health Services

🇺🇸

Newark, Delaware, United States

Medstar Washington Hospital Center

🇺🇸

Washington, District of Columbia, United States

HCA Florida JFK Hospital

🇺🇸

Atlantis, Florida, United States

HealthPark Medical Center

🇺🇸

Fort Myers, Florida, United States

University of Florida Hospital

🇺🇸

Gainesville, Florida, United States

Memorial Regional Hospital

🇺🇸

Hollywood, Florida, United States

Baptist Health Jacksonville

🇺🇸

Jacksonville, Florida, United States

Baptist Health South Florida

🇺🇸

Miami, Florida, United States

Advent South

🇺🇸

Orlando, Florida, United States

Orlando Regional Medical Center

🇺🇸

Orlando, Florida, United States

Sarasota Memorial Hospital

🇺🇸

Sarasota, Florida, United States

Tampa General Hospital

🇺🇸

Tampa, Florida, United States

Baycare Health System

🇺🇸

Tampa, Florida, United States

Emory University Hospital

🇺🇸

Atlanta, Georgia, United States

Piedmont Hospital

🇺🇸

Atlanta, Georgia, United States

Wellstar - Kennestone

🇺🇸

Marietta, Georgia, United States

St. Luke's Regional Medical Center

🇺🇸

Boise, Idaho, United States

Portneuf Medical Center

🇺🇸

Idaho Falls, Idaho, United States

Northwestern Memorial Hospital

🇺🇸

Chicago, Illinois, United States

Loyola University Medical Center

🇺🇸

Maywood, Illinois, United States

Memorial Hospital (SIU Medicine)

🇺🇸

Springfield, Illinois, United States

Ascension St. Vincent

🇺🇸

Carmel, Indiana, United States

Franciscan

🇺🇸

Indianapolis, Indiana, United States

Mercy Medical Center

🇺🇸

Coon Rapids, Minnesota, United States

University of Iowa Hospitals and Clinics

🇺🇸

Iowa City, Iowa, United States

St. Luke's Hospital

🇺🇸

Kansas City, Kansas, United States

Kansas University Medical Center

🇺🇸

Kansas City, Kansas, United States

Baptist Health

🇺🇸

Lexington, Kentucky, United States

University of Kentucky

🇺🇸

Lexington, Kentucky, United States

Norton Healthcare

🇺🇸

Louisville, Kentucky, United States

University of Louisville Health / Jewish Hospital

🇺🇸

Louisville, Kentucky, United States

Novant Presbyterian Hospital

🇺🇸

Louisville, Kentucky, United States

Our Lady of the Lake Hospital

🇺🇸

Baton Rouge, Louisiana, United States

Johns Hopkins Hospital

🇺🇸

Baltimore, Maryland, United States

Tufts Medical Center

🇺🇸

Boston, Massachusetts, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Brigham and Women's Hospital

🇺🇸

Boston, Massachusetts, United States

Beth Israel Deaconess Medical Center

🇺🇸

Boston, Massachusetts, United States

University of Michigan

🇺🇸

Ann Arbor, Michigan, United States

Corewell Health

🇺🇸

Grand Rapids, Michigan, United States

Corewell Health East

🇺🇸

Royal Oak, Michigan, United States

Munson Medical Center

🇺🇸

Traverse City, Michigan, United States

Trinity Health (formerly St. Joesph Mercy)

🇺🇸

Ypsilanti, Michigan, United States

Abbott Northwestern / Minneapolis Heart

🇺🇸

Minneapolis, Minnesota, United States

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

North Mississippi Medical Center

🇺🇸

Tupelo, Mississippi, United States

Midwest Heart and Vascular (HCA)

🇺🇸

Kansas City, Missouri, United States

St. Lukes Hospital

🇺🇸

Saint Louis, Missouri, United States

Washington University

🇺🇸

Saint Louis, Missouri, United States

Mercy Hospital St. Louis

🇺🇸

Saint Louis, Missouri, United States

Nebraska Methodist

🇺🇸

Omaha, Nebraska, United States

The Nebraska Medical Center

🇺🇸

Omaha, Nebraska, United States

Hackensack University Medical Center

🇺🇸

Hackensack, New Jersey, United States

Rutgers Robert Woods Johnson Medical School

🇺🇸

New Brunswick, New Jersey, United States

North Shore University Hospital (Northwell)

🇺🇸

Manhasset, New York, United States

St. Francis Hospital

🇺🇸

Roslyn, New York, United States

St. Joseph Hospital

🇺🇸

Syracuse, New York, United States

Atrium Health Carolinas Medical Center

🇺🇸

Charlotte, North Carolina, United States

Duke University

🇺🇸

Durham, North Carolina, United States

WakeMed Health & Hospitals

🇺🇸

Raleigh, North Carolina, United States

Wake Forest Baptist

🇺🇸

Winston-Salem, North Carolina, United States

TriHealth / Bethesda North Hospital

🇺🇸

Cincinnati, Ohio, United States

Christ Hospital / Lindner Research Center

🇺🇸

Cincinnati, Ohio, United States

University Hospitals of Cleveland

🇺🇸

Cleveland, Ohio, United States

Ohio State Medical Center

🇺🇸

Columbus, Ohio, United States

Riverside Methodist

🇺🇸

Columbus, Ohio, United States

The Toledo Hospital (Promedica)

🇺🇸

Toledo, Ohio, United States

Lehigh Valley Health Network

🇺🇸

Allentown, Pennsylvania, United States

UPMC Pinnacle

🇺🇸

Harrisburg, Pennsylvania, United States

Lancaster General Hospital

🇺🇸

Lancaster, Pennsylvania, United States

Allegheny General Hospital

🇺🇸

Pittsburgh, Pennsylvania, United States

UPMC Health System

🇺🇸

Pittsburgh, Pennsylvania, United States

Lankenau Hospital

🇺🇸

Wynnewood, Pennsylvania, United States

Medical University of South Carolina (MUSC)

🇺🇸

Charleston, South Carolina, United States

Sanford USD Medical Center

🇺🇸

Sioux Falls, South Dakota, United States

Jackson Madison County General

🇺🇸

Jackson, Tennessee, United States

Centennial Medical Center (TriStar)

🇺🇸

Nashville, Tennessee, United States

Ascension St. Thomas West

🇺🇸

Nashville, Tennessee, United States

UT Dell Medical School

🇺🇸

Austin, Texas, United States

HCA Medical City Dallas

🇺🇸

Dallas, Texas, United States

University of Texas Southwestern

🇺🇸

Dallas, Texas, United States

Houston Methodist Hospital

🇺🇸

Houston, Texas, United States

Baylor Heart Hospital - Plano

🇺🇸

Plano, Texas, United States

Trinity Mother Frances (CHRISTUS)

🇺🇸

Tyler, Texas, United States

University of Utah

🇺🇸

Salt Lake City, Utah, United States

Inova Fairfax Medical

🇺🇸

Falls Church, Virginia, United States

Sentara Hospitals & Sentara Medical Group

🇺🇸

Norfolk, Virginia, United States

Swedish Heart and Vascular Research

🇺🇸

Seattle, Washington, United States

West Virginia University

🇺🇸

Morgantown, West Virginia, United States

Columbia St. Mary's

🇺🇸

Milwaukee, Wisconsin, United States

Aspirus Hospital

🇺🇸

Wausau, Wisconsin, United States

University Hospitals UZ Leuven

🇧🇪

Leuven, Brabant, Belgium

Foothills Medical Centre

🇨🇦

Calgary, Alberta, Canada

University of Alberta Hospital

🇨🇦

Edmonton, Alberta, Canada

Royal Columbian Hospital

🇨🇦

New Westminster, British Columbia, Canada

New Brunswick Heart Centre

🇨🇦

Saint John, New Brunswick, Canada

Queen Elizabeth II - Nova Scotia Health

🇨🇦

Halifax, Nova Scotia, Canada

Hamilton General Hospital

🇨🇦

Hamilton, Ontario, Canada

Kingston General Hospital

🇨🇦

Kingston, Ontario, Canada

London Health Sciences Centre

🇨🇦

London, Ontario, Canada

Ottawa Heart Institute

🇨🇦

Ottawa, Ontario, Canada

St Michael's Hospital

🇨🇦

Toronto, Ontario, Canada

Toronto General Hospital

🇨🇦

Toronto, Ontario, Canada

Centre Hospitalier de l'Université de Montréal (CHUM)

🇨🇦

Montréal, Quebec, Canada

Montreal Heart Institute

🇨🇦

Montréal, Quebec, Canada

IUCPQ Hosptial Laval

🇨🇦

Québec, Canada

CKTCH Brno

🇨🇿

Brno, Czechia

Bad Rothefelde Schüchtermann-Klinik

🇩🇪

Bad Rothenfelde, Lower Saxony, Germany

Hospital Clinic Barcelona

🇪🇸

Barcelona, Spain

Hospital Clinico San Carlos

🇪🇸

Madrid, Spain

Northern General Hospital

🇬🇧

Sheffield, Great Britain, United Kingdom

The James Cook University Hospital

🇬🇧

Middlesbrough, North Yorkshire, United Kingdom

The Royal Wolverhampton NHS Trust

🇬🇧

Wolverhampton, West Midlands, United Kingdom

Royal Papworth Hospital

🇬🇧

Cambridge, United Kingdom

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