Intracardiac Versus Transesophageal Echocardiographic Guidance for Left Atrial Appendage Occlusion
- Conditions
- Left Atrial Appendage Closure
- Interventions
- Other: Intracardiac Echocardiography
- Registration Number
- NCT06348394
- Lead Sponsor
- Baylor Research Institute
- Brief Summary
This single-center, prospective, randomized study will evaluate the safety and feasibility of Intracardiac echocardiography (ICE)-guided Left atrial appendage closure (LAAC) when compared to the traditional Transesophageal echocardiography (TEE) approach.
- Detailed Description
The primary objective of this study is to assess the efficacy and safety of using Intracardiac echocardiography (ICE) to guide implantation of percutaneous left atrial appendage closure (LAAC) devices.
Primary endpoints include procedural success following implantation of the left atrial appendage occlusion (LAAO) device. Procedural success specifies that the device should be implanted in the correct position without device related complications and no peri-device leaks \>5 mm on color doppler.
Secondary end points include periprocedural complications (such as pericardial effusion/tamponade, stroke, death, vascular complications, and device embolization), procedural characteristics (total duration, fluoroscopy time, contrast volume, Length of hospital stay), cost of hospitalization, in-hospital patient satisfaction, and clinical alterations at 45-day follow-up.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 444
- Patients diagnosed for non-valvular atrial fibrillation with elevated CHADSVASC and HASBLED scores, meeting commercial LAAO criteria indications, who underwent appropriate pre-procedural imaging with Computed tomography or transesophageal echocardiography.
- Patients with increased risk of stroke with elevated CHA2DS2-VASc score.
- Patients who cannot be on oral anticoagulants or can't tolerate these medications.
- Patient should be able to comply with the protocol.
- Provide written informed consent before study participation.
- Ages 18 and above
Exclusion Criteria
- Presence of an intracardiac thrombus on the preprocedural TEE or CT.
- History of previously implanted device for atrial septal defect or patent foramen ovale.
- Severe left ventricle dysfunction- Left ventricular ejection fraction (LVEF < 40%) or greater than moderate valvular heart disease.
- Enrollment in another study that competes or interferes with this study.
- Poor clinical condition like cardiogenic shock, which prohibits pre- and post-procedural function tests.
- Subject with planned complex PCI or procedure necessitating multiple intervention.
- Any other condition or co-morbidity which, in the opinion of the investigator or operator, may pose a significant hazard to the subject if he or she is enrolled in the study.
- Pregnant or breastfeeding women or planning pregnancy during the course of the investigation are excluded due to the risks involved in the procedure
- Children below 18 years, prisoners and patients who are unable to provide consent are excluded.
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intracardiac echocardiography Left atrial appendage closure. Intracardiac Echocardiography Intra cardiac echocardiography will be performed prior to left atrial appendage closure. Traditional transesophageal echocardiography guided Left atrial appendage closure Intracardiac Echocardiography Transesophageal Echocardiography will be performed under general anesthesia.
- Primary Outcome Measures
Name Time Method Procedural success following implantation of the left atrial appendage occlusion (LAAO) device. Intra op Procedural success specifies that the device should be implanted in the correct position measured as:
Peri-device leaks greater than 5 milliliters on color doppler (Yes/No)
- Secondary Outcome Measures
Name Time Method Periprocedural complications 45 days after the procedure Death measured as (Yes/No)
Patient satisfaction 45 days after the procedure Patient satisfaction will be assessed in-hospital by a questionnaire addressing anesthesia-related discomfort.
Procedural characteristics 45 days after the procedure Length of hospital stay measured as number of days.
Trial Locations
- Locations (1)
Baylor Scott and White Heart Hospital
🇺🇸Plano, Texas, United States