Comprehensive LEFt Atrial Appendage Occlusion With Rhythm Restoration (CLEAR)

The objective of this clinical investigation is to evaluate the feasibility, safety, and effectiveness of a concomitant procedure involving the Volt PFA System and Amulet 2 device in patients indicated for both AF ablation and percutaneous LAAO.

Study Overview

• Status: Recruiting
• Conditions: Persistent Atrial Fibrillation; Atrial Fibrillation (AF); Paroxysmal AF
• Intervention / Treatment: Procedure: PVI Ablation; Device: Left Atrial Appendage Occluder Implant

Detailed Description

This clinical investigation is intended to evaluate the safety and feasibility of Abbott's Volt™ Pulsed Field Ablation (PFA) System (Volt PFA System) and Amulet™ 2 Left Atrial Appendage (LAA) occluder device (Amulet 2 device) in patients with non-valvular atrial fibrillation who are indicated for both atrial fibrillation (AF) ablation and LAA occlusion (LAAO)

• Study Type: Interventional
• Enrollment (Estimated): 240
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Abeer Madbouly, Ph. D; Phone Number: 651-497-5099; Email: abeer.madbouly@abbott.com

Study Locations

• Belgium
  • B CAP R
    • Brussels, B CAP R, Belgium, 1090
      • Not yet recruiting
      • Uz Brussel
• Czechia
  • Czech Republic
    • Prague, Czech Republic, Czechia, 1500
      • Recruiting
      • Motol and Homolka University Hospital
• Denmark
  • Copenha
    • Copenhagen, Copenha, Denmark, 2100
      • Not yet recruiting
      • Rigshospitalet
• Germany
  • Hesse
    • Frankfurt am Main, Hesse, Germany, 60389
      • Not yet recruiting
      • Cardioangiologisches Centrum am Bethanien Krankenhaus
  • Schlesw
    • Lübeck, Schlesw, Germany, 23538
      • Not yet recruiting
      • Universitätsklinikum Schleswig-Holstein - Campus Lübeck
  • State of Berlin
    • Berlin, State of Berlin, Germany, 13353
      • Not yet recruiting
      • Deutsches Herzzentrum der Charite
• Ireland
  • Dublin
    • Dublin, Dublin, Ireland, Dublin 7
      • Not yet recruiting
      • Mater Private Hospital
• Italy
  • Italy
    • Milan, Italy, Italy, 20138
      • Recruiting
      • Centro Cardiologico Monzino
  • Lombard
    • Milan, Lombard, Italy, 20162
      • Not yet recruiting
      • ASST Grande Ospedale Metropolitano
• Lithuania
  • Dzukija
    • Vilnius, Dzukija, Lithuania, 08406
      • Not yet recruiting
      • Vilnius University Hospital Santaros Klinikos
• Poland
  • Silesian Voivodeship
    • Zabrze, Silesian Voivodeship, Poland, 41-800
      • Not yet recruiting
      • Slaskie Centrum Chorob Serca
• Spain
  • Catalon
    • Barcelona, Catalon, Spain, 08025
      • Not yet recruiting
      • Hospital de la Santa Creu i Sant Pau
  • Navarre
    • Pamplona, Navarre, Spain, 31008
      • Not yet recruiting
      • Clinica Universidad de Navarra

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Subject must provide written informed consent prior to any clinical investigation-related procedure.
• 18 years of age or older, or the age of legal consent
• CHA2DS2-VASc score of ≥ 3 for women and ≥ 2 for men
• Able to stop anticoagulation by 90 days post index procedure
• Able to adhere to the protocol defined post-concomitant procedure pharmacologic regimen of OAC for at least 60 days followed by SAPT
• Plans to undergo a catheter ablation procedure including PVI due to symptomatic, recurrent, drug-refractory PAF or PersAF
• Documented symptomatic PAF or PersAF. Documentation requirements are as follows:

Paroxysmal:

• Physician's note indicating recurrent self-terminating AF with ≥ 2 episodes of PAF within the 12 months prior to enrollment AND
• One electrocardiographically documented PAF episode within 12 months prior to enrollment.

Persistent: Continuous AF sustained beyond 7 days and less than 1 year that is documented by

• Physician's note, AND either
• 24-hour Holter within 180 days prior to enrollment, showing continuous AF, OR

• Two electrocardiograms (from any form of rhythm monitoring) showing continuous AF:

  • That are taken at least 7 days apart but less than 12 months apart
  • If electrograms are more than 12 months apart, there must be one or more Sinus Rhythm recordings in between or within 12 months prior to consent/enrollment
  • The most recent electrocardiogram must be within 180 days of enrollment.

NOTE: Documented evidence of the AF episode must either be continuous AF on a 12-lead ECG or include at least 30 seconds of continuous AF from another ECG device.

Exclusion Criteria:

• Known contraindication or allergy to NOACs or aspirin, preventing use of the drugs post-procedure
• Required to take P2Y12 platelet inhibitor after the study procedure (e.g., due to percutaneous coronary intervention)
• Patients with heart prosthetic valves
• Patient implanted with an inferior vena cava filter
• Patients with left ventricular ejection fraction ≤30%
• Patients with NYHA Class IV heart failure
• Patients who have undergone any invasive intervention or surgery within 30 days prior to the index procedure (diagnostic catheterization is not within scope, however, percutaneous coronary intervention is within scope)
• Patients who have experienced stroke or transient ischemic attack within 90 days prior to study procedure
• Patients who have had previous attempt at LAA surgical or epicardial intervention (e.g., stapling, suturing, ligation, epicardial LAA management device)
• Patients previously diagnosed long-standing persistent atrial fibrillation (Continuous AF greater than 1 year in duration)
• Patients with arrhythmia due to reversible causes including thyroid disorders, acute alcohol intoxication, electrolyte imbalance, severe untreated sleep apnea, and other major surgical procedures within 90 days prior to the study procedure
• Patients unable to receive heparin or an acceptable alternative to achieve adequate intra-procedural anticoagulation
• Patients with a stent, constriction, or stenosis in a pulmonary vein
• Patients with severe mitral regurgitation (regurgitant volume ≥ 60 mL/beat, regurgitant fraction ≥ 50%, and/or effective regurgitant orifice area ≥ 0.40cm2)
• Patients with severe renal failure (estimated glomerular filtration rate <30 ml/min/1.73m2) or on chronic dialysis
• Patients with severe pulmonary disease (e.g., restrictive pulmonary disease, constrictive or chronic obstructive pulmonary disease) or any other disease or malfunction of the lungs or respiratory system that produces severe chronic symptoms
• Patients with hypertrophic cardiomyopathy (maximal LV wall thickness ≥ 15 mm in the absence of abnormal loading conditions such as hypertension or aortic stenosis)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Treatment; Concomitant procedure utilizing the Volt PFA System and Amulet 2 device in patients indicated for both AF ablation and percutaneous LAAO implant.	Procedure: PVI Ablation; PVI Ablation with Pulsed Field Ablation; Device: Left Atrial Appendage Occluder Implant; Left atrial appendage occluder implant

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
LAA occlusion success determined by peri-device flow ≤5mm	The primary effectiveness outcome is LAA occlusion defined as no peri-device flow or peri-device flow ≤5mm based on Doppler color flow TEE/TOE at the 3-month follow-up visit as assessed by an independent core laboratory	From treatment through 3-month follow-up vists
Occurrence of specific adverse events between time of implant and 7 days post-procedure or hospital discharge, whichever was later	The primary safety outcome is defined as occurrence of one of the following between the time of implant and ≤7 days post-procedure or hospital discharge, whichever was later: death, ischemic stroke, systemic embolism, or device/procedure related complications requiring open cardiac surgery or major endovascular intervention; Includes pseudoaneurysm repair or AV fistula repair; Excludes percutaneous drainage of PE, snaring of embolized devices, thrombin injection or nonsurgical treatment of access site complications	From implant of LAAO through ≤7 days post-procedure or hospital discharge, whichever is later

Collaborators and Investigators

• Sponsor: Abbott Medical Devices

Study record dates

Study Major Dates

• Study Start (Actual): March 31, 2026
• Primary Completion (Estimated): May 31, 2027
• Study Completion (Estimated): February 28, 2028

Study Registration Dates

• First Submitted: April 6, 2026
• First Submitted That Met QC Criteria: April 6, 2026
• First Posted (Actual): April 13, 2026

Study Record Updates

• Last Update Posted (Actual): May 27, 2026
• Last Update Submitted That Met QC Criteria: May 22, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Atrial Fibrillation; Left Atrial Appendage; Persistent Atrial Fibrillation; Paroxysmal Atrial Fibrillation
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Pathologic Processes; Heart Diseases; Arrhythmias, Cardiac; Pathological Conditions, Signs and Symptoms; Atrial Fibrillation
• Other Study ID Numbers: ABT-CIP-10617

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: Yes
• product manufactured in and exported from the U.S.: Yes