Opakovaná ablace přetrvávající fibrilace síní, včetně katetrizační ablace mitrálního isthmu, se systémem pulzní ablace pole FARAPULSE (ReMATCH)
Studie ReMATCH je prospektivní, jednoramenná, otevřená, multicentrická studie využívající systém FARAPULSE PFA, včetně katétrů FARAWAVE a FARAPOINT PFA
The ReMATCH Study is a prospective, single arm, open label, multi-center, study utilizing the FARAPULSE PFA System, including the FARAWAVE and FARAPOINT PFA Catheters.
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Detailní popis
The goal of this study is to evaluate the safety and effectiveness of using the FARAWAVE™ and FARAPOINT™ pulsed field ablation (PFA) catheters for re-treatment of persistent atrial fibrillation (PersAF) after a failed initial procedure.
Typ studie
Typ studie
Zápis (Odhadovaný)
Zápis
Fáze
Fáze
- Nelze použít
Kontakty a umístění
Studijní místa
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Melbourne, Austrálie
- The Alfred Hospital
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New South Wales
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New Lambton Heights, New South Wales, Austrálie, 606-8507
- John Hunter Hospital
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Westmead, New South Wales, Austrálie, 2145
- Westmead Hospital
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Queensland
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Brisbane, Queensland, Austrálie, 4001
- St. Andrew's War Memorial Hospital
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Victoria
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Clayton, Victoria, Austrálie, 3168
- Victorian Heart Hospital
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Parkville, Victoria, Austrálie, 3050
- The Royal Melbourne Hospital
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Alabama
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Mobile, Alabama, Spojené státy, 36607
- Mobile Infirmary Medical Center
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Arkansas
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Jonesboro, Arkansas, Spojené státy, 72401
- Arrhythmia Research Group-Research Facility
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California
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Los Angeles, California, Spojené státy, 90033
- University of Southern California Hospital
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Oxnard, California, Spojené státy, 93030
- St. John's Regional Medical Center
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Stanford, California, Spojené státy, 94305
- Stanford University Medical Center
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Colorado
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Littleton, Colorado, Spojené státy, 80120
- South Denver Cardiology Associates, PC
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Florida
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Miami, Florida, Spojené státy, 33133
- HCA Florida Mercy Hospital
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Naples, Florida, Spojené státy, 34102
- Naples Comprehensive Health
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Orlando, Florida, Spojené státy, 32803
- AdventHealth Orlando-Hospital
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Tampa, Florida, Spojené státy, 33606
- Tampa General Hospital
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Tampa, Florida, Spojené státy, 33613
- AdventHealth Tampa-Hospital
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Georgia
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Atlanta, Georgia, Spojené státy, 30322
- Emory University Hospital
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Macon, Georgia, Spojené státy, 32201
- Atrium Health Navicent The Medical Center
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Savannah, Georgia, Spojené státy, 31404
- Memorial Health University Medical Center
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Idaho
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Boise, Idaho, Spojené státy, 83712
- St. Luke's Boise Medical Center
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Illinois
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Oak Lawn, Illinois, Spojené státy, 60453
- Advocate Christ Medical Center-Hospital
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Maryland
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Baltimore, Maryland, Spojené státy, 21287
- Johns Hopkins Hospital
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Massachusetts
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Boston, Massachusetts, Spojené státy, 02114
- Massachusetts General Hospital
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Fall River, Massachusetts, Spojené státy, 02720
- Southcoast Physicians Group
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Michigan
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Royal Oak, Michigan, Spojené státy, 48073
- William Beaumont Hospital-Hospital
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New Hampshire
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Lebanon, New Hampshire, Spojené státy, 03756
- Dartmouth Hitchcock Medical Center
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New Jersey
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Marlton, New Jersey, Spojené státy, 08053
- Virtua Health Inc.
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New Mexico
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Albuquerque, New Mexico, Spojené státy, 87102
- Lovelace Medical Center
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New York
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Manhasset, New York, Spojené státy, 11030
- Northwell Health
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New York, New York, Spojené státy, 10065
- Weill Cornell Medical University
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Ohio
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Cincinnati, Ohio, Spojené státy, 45242
- Bethesda North Hospital
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Columbus, Ohio, Spojené státy, 43210
- Ohio State University Medical Center
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Oklahoma
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Tulsa, Oklahoma, Spojené státy, 74104
- Oklahoma Heart Institute
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South Carolina
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Charleston, South Carolina, Spojené státy, 29406
- Trident Medical Center
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Texas
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Austin, Texas, Spojené státy, 78705
- Texas Cardiac Arrhythmia Research
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Tyler, Texas, Spojené státy, 75701
- Christus Trinity Mother Frances Health System
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Utah
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Salt Lake City, Utah, Spojené státy, 84124
- St. Mark's Hospital
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Virginia
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Norfolk, Virginia, Spojené státy, 23507
- Sentara Norfolk General Hospital
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Taipei, Tchaj-wan
- National Taiwan University Hospital
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Taipei, Tchaj-wan
- Taipei Veterans General Hospital
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Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
- ≥ 18 years of age, or older if required by local law
- Single previous endocardial AF ablation procedure for PAF or PersAF that minimally included pulmonary vein isolation
- Documented (physician's note) diagnosis of PersAF either prior to the subject's Index Procedure OR development of PersAF after the Index Procedure.
- Documented evidence of symptomatic AF recurrence at least 60 days after the subject's Index Procedure, captured by any regulatory cleared rhythm monitoring device.
OR
- If diagnosed with PersAF prior to the Index Procedure, documented recurrence of symptomatic AF or atypical AFL at least 60 days after the Index Procedure, captured by any regulatory cleared rhythm monitoring device.
- Willing and capable of providing informed consent
- Willing and capable of participating in all follow-up assessments and testing associated with this clinical investigation at an approved clinical investigational center
Exclusion Criteria:
-
Atrial exclusions - Any of the following atrial conditions:
a. Left atrial anteroposterior diameter ≥ 5.5 cm, or if LA diameter not available, non-indexed volume >100 ml (physician note or imaging) b. Current atrial myxoma c. Any PV abnormality, stenosis, or stenting (common and middle PVs are admissible) d. Current left atrial thrombus
-
Cardiovascular exclusions - Any of the following CV conditions:
-
History of sustained ventricular tachycardia or any ventricular fibrillation
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AF that is secondary to electrolyte imbalance, thyroid disease, alcohol, or other reversible / non-cardiac causes
-
Current or anticipated implantable cardioverter defibrillator, cardiac resynchronization therapy devices, or implantable loop recorders, other than LUX-Dx. Patients with a pacemaker are permitted; however, pacemaker-dependent patients are excluded.
Prior interatrial baffle, atrial septal patch, atrial septal defect closure device, patent foramen ovale occluder Left atrial appendage closure devices are excluded, with the exception of WATCHMAN. WATCHMAN is excluded if implanted within 90 days of enrollment
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Presence of any of the following:
• Any prosthetic heart valve, ring or repair
• Moderate to severe mitral valve stenosis
• More than moderate mitral regurgitation (>3+)
- Moderate to severe aortic stenosis
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Hypertrophic cardiomyopathy
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Any IVC filter, known inability to obtain vascular access or other contraindication to femoral access
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Awaiting cardiac transplantation or other cardiac surgery within the next 12 months
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Severe right ventricular dysfunction with documented echocardiography and/or hemodynamic data.
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Any of the following conditions at baseline:
- Heart failure associated with NYHA Class III or IV
- Documented LVEF < 40% as documented within the previous 12 months
- Uncontrolled hypertension (SBP > 160 mmHg or DBP > 95 mmHg on two (2) BP measurements at baseline assessment not attributable to white coat syndrome per Investigator opinion
- Body Mass Index (BMI) >45.0
- CHA2DS2-VASc score ≥5
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Any of the following events within 90 Days of the Consent Date:
- Coronary disease: Myocardial infarction (MI), unstable or Prinzmetal angina or coronary intervention within 90 days of consent or any documented history of severe non-revascularize coronary disease
- Cardiac surgery: Any cardiac surgery
- Heart failure hospitalization: Heart failure hospitalization
- Pericardium: Pericarditis or symptomatic pericardial effusion
- GI bleeding: Gastrointestinal bleeding
- Neurovascular event: Stroke, TIA, or intracranial bleeding
- Thromboembolism: Any active non-neurologic thrombus and/or thromboembolic event
- Carotid intervention: Carotid stenting or endarterectomy
- Diabetes: Uncontrolled diabetes mellitus or a recorded HgbA1c > 8.0%
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Any of the following congenital conditions:
- Congenital heart disease: Congenital heart disease with any clinically significant residual anatomic or conduction abnormality
- Methemoglobinemia: History of known congenital methemoglobinemia
- G6PD deficiency: History of known G6PD deficiency
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Any of the following conditions:
- Transplantation: Solid organ or hematologic transplant, or currently being evaluated for a transplant
- Diaphragmatic abnormality: Any prior history or current evidence of hemi-diaphragmatic paralysis or paresis.
Pulmonary: Severe lung disease, severe pulmonary hypertension, or any lung disease involving abnormal blood gases or requiring supplemental oxygen d. Renal: Renal insufficiency if an estimated glomerular filtration rate (eGFR) is < 30 mL / min / 1.73 m2, or with any history of renal dialysis or renal transplant e. Malignancy: Active malignancy (other than squamous cell carcinoma) f. Gastrointestinal: Clinically significant gastrointestinal problems involving the esophagus or stomach including severe or erosive esophagitis, uncontrolled gastric reflux, gastroparesis, esophageal candidiasis or active gastroduodenal ulceration g. Infections: Active systemic infection h. Required use of phosphodiesterase inhibitors within 24 hours of the ablation procedure i. Nitroglycerin intolerance: Known allergic drug reaction to nitroglycerin (excluding hypotension) j. Hematologic condition: Known coagulopathy or bleeding disorder (e.g. von Willebrand disease, hemophilia) k. Contraindication to anticoagulation: Contraindication to, or unwillingness to use, systemic anticoagulation, or acceptable alternatives, pre-, intra- and post-procedure to achieve adequate anticoagulation.
l. Pregnancy: Women of childbearing potential who are pregnant, lactating, not using medical birth control or who are planning to become pregnant during the anticipated study period m. General health conditions: Health conditions that, in the investigator's medical opinion, would prevent participation in the study, interfere with assessment or therapy, significantly raise the risk of study participation, or modify outcome data or its interpretation.
n. LUX-Dx ICM intolerance: Unwillingness to receive, or unable to tolerate, a subcutaneous, chronically inserted LUX-Dx ICM device o. Participation in another trial: Subjects who are currently enrolled in another investigational study or registry that would directly interfere with the current study, except when the subject is participating in a mandatory governmental registry, or a purely observational registry with no associated treatments; each instance must be brought to the attention of the Sponsor to determine eligibility.
p. Life expectancy: Predicted life expectancy less than one (1) year
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: N/A
- Intervenční model: Přiřazení jedné skupiny
- Maskování: Žádné (otevřený štítek)
Počet zbraní
Zbraně a zásahy
Skupina účastníků / ArmSkupina účastníků / Arm |
Intervence / LéčbaIntervence / Léčba |
|---|---|
|
Jiný: Single Arm Prospective
Repeat Ablation of Persistent Atrial Fibrillation, including Mitral Isthmus Catheter Ablation, with the FARAPULSE Pulsed Field Ablation System. |
The FARAPULSE™ Pulsed Field Ablation System is indicated for the treatment of symptomatic atrial fibrillation. The FARAWAVE Catheter is indicated for the isolation of pulmonary veins and posterior wall in the treatment of drug-refractory, recurrent, symptomatic paroxysmal and persistent atrial fibrillation. The FARAWAVE Catheter is also indicated for the for the isolation of pulmonary veins and posterior wall in the treatment of persistent atrial fibrillation as an alternative to anti-arrhythmic drug (AAD) therapy as an initial rhythm control strategy. The FARAPOINT™ PFA Catheter is indicated for use as an adjunctive device for 1) the creation of an ablation line between the inferior vena cava and the tricuspid valve and/or 2) Mitral Isthmus, when the FARAWAVE Catheter is used in the endocardial treatment of persistent atrial fibrillation (episode duration no greater than 12 months). |
Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Primary safety endpoint rate
Časové okno: 60 days
|
The primary safety endpoint (PSE) is the proportion of Treatment subjects with one or more device or procedure-related Composite Serious Adverse Events (CSAEs) following the Repeat Ablation Procedure. |
60 days
|
|
The primary effectiveness endpoint is the proportion of Treatment subjects with Acute Procedural Success.
Časové okno: 24 hours
|
The proportion of Treatment Subjects with confirmed electrical block across all anatomical locations ablated with the investigational system only (Acute Procedural Success). |
24 hours
|
Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Vyšetřovatelé
Vyšetřovatelé
- Vrchní vyšetřovatel: Moussa Mansour,, MD, Massachusetts General Hospital
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Začátek studia
Primární dokončení (Odhadovaný)
Primární dokončení
Dokončení studie (Odhadovaný)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
Další identifikační čísla studie
- PF313
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
produkt vyrobený a vyvážený z USA
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