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Dual Epicardial Endocardial Persistent Atrial Fibrillation(AF) Study (Staged DEEP) (Staged DEEP)

7. april 2017 oppdatert av: AtriCure, Inc.

Feasibility Trial of a Staged Epicardial & Endocardial Approach for Treatment of Patients With Persistent or Long Standing Persistent Atrial Fibrillation With Radiofrequency Ablation

The purpose of this study is to assess the safety and technical feasibility of treating subjects with Persistent Atrial Fibrillation or Longstanding Persistent Atrial Fibrillation in a minimally invasive thoracoscopic ablation procedure utilizing the AtriCure Bipolar System, with mapping and additional lesion creation/ gap closure (as needed) provided by currently approved catheter technology, when the epicardial and endocardial phases are performed in a staged manner within 1-10 days apart, during the same hospitalization.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

The purpose of this clinical investigation is to evaluate how safe a less invasive cardiac surgery using the AtriCure Bipolar System in conjunction with a catheter ablation procedure performed approximately 1-10 days after, in treating atrial fibrillation, and how effective is this staged procedure. The AtriCure Bipolar System will be used to perform the less invasive cardiac surgery and a standard electrophysiology catheter, currently available, will be used to perform the catheter ablation procedure. This surgical procedure is considered less invasive because it is done through tiny surgical punctures on the sides of the chest near the ribs instead of one large surgical incision of the breast bone to completely open the chest and access the heart, and it also avoids the need for the heart-lung bypass machine.

Studietype

Intervensjonell

Registrering (Faktiske)

30

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Belgia
      • Brussel, Belgia
        • Universitair Ziekenhuis Brussel
  • Forente stater
    • California
      • Stanford, California, Forente stater, 94305
        • Stanford University Medical Center
    • Colorado
      • Colorado Springs, Colorado, Forente stater, 80907
        • Colorado Springs Cardiology/Colorado Cardiac Alliance
    • Tennessee
      • Nashville, Tennessee, Forente stater, 37232
        • Vanderbilt Heart Institute
    • Virginia
      • Norfolk, Virginia, Forente stater, 23507
        • Sentara Norfolk Hospital
  • Nederland
      • Amsterdam, Nederland
        • Academic Medical Center

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Age > 18 year
  • Patients with symptomatic persistent or longstanding persistent AF refractory to a minimum of one Class I or III antiarrhythmic drug (AAD).
  • Patients with failed catheter ablation attempts are eligible if the patients are symptomatic with persistent or longstanding persistent AF. (catheter ablation procedure must be more than 3 months prior to index procedure)
  • Life expectancy of at least two years
  • Patient will and able to provide informed consent
  • Patient is willing and able to attend the scheduled follow-up visits

Exclusion Criteria:

  • Prior Cardiothoracic Surgery
  • Patient has NYHA (New York Heart Association) Class IV heart failure
  • Evidence of underlying structural heart disease requiring surgical treatment
  • Surgical procedure within the 30 days prior to the index procedure
  • Ejection fraction < 30%
  • Measured left atrial diameter > 6.0 cm
  • Renal Failure
  • Stroke within previous 6 months
  • Known carotid artery stenosis greater than 80%
  • Evidence of significant active infection or endocarditis
  • Pregnant woman or women desiring to become pregnant in the next 24 months
  • Presence of thrombus in the left atrium determined by echocardiography
  • History of blood dyscrasia
  • Contraindication to anticoagulation, based on Investigator's opinion
  • Mural thrombus or tumor
  • Moderate to Severe COPD

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: AtriCure Bipolar System combined with a catheter ablation
Minimally invasive procedure using the AtriCure Bipolar System plus a catheter ablation performed approximately 1-10 days apart
Enhet: Ablation procedure staged catheter ablation
AtriCure Bipolar System used in conjunction with a catheter ablation procedure performed 1-10 days apart

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Number of Patients With Pre-specified Safety Endpoints Occurring in the First 30 Days Post-index Procedure or Hospital Discharge, Whichever is Longer.
Tidsramme: 30 days post-index procedure or hospital discharge
Pre-specified events include: Death; Myocardial Infarction; Stroke or TIA; Excess bleeding; Pulmonary vein stenosis; atrio-esophagael fistula; phrenic nerve paralysis; Pericardial effusion; Embolisms.
30 days post-index procedure or hospital discharge
Number of Subjects With Absence of Atrial Fibrillation
Tidsramme: 12 month follow-up
Absence of atrial fibrillation (AF) at twelve month follow-up based on continuous 14 day ECG monitoring, while off all Class I and III antiarrhythmic therapy.
12 month follow-up

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Number Subjects With Serious Device or Procedure Related Adverse Event Rate
Tidsramme: 12 month follow-up
12 month follow-up
Number of Subjects With Acute Procedure Success
Tidsramme: Day 0

Defined as subject meeting all of the following criteria upon completion of the index-EP procedure

  1. Isolation/block of all pulmonary veins (e.g. 4 of 4 veins);
  2. Bi-directional cavotricuspid isthmus block;
  3. Isolation of Box (i.e. no capture outside ablation lines connecting roof and floor lines between right-and-left pulmonary vein isolation lines);
  4. Superior Vena Cava (SVC) isolation, if encircling SVC lesion performed.
Day 0
Number of Subject Without Atrial Fibrillation
Tidsramme: 6 and 12 month follow-up
AF free with or without the need of antiarrhythmic drugs
6 and 12 month follow-up
Number of Subjects With Reinterventions
Tidsramme: 12 month follow-up
12 month follow-up
Number of Subjects With Direct Current (DC) Cardioversion
Tidsramme: 12 month follow-up
12 month follow-up
Change in AF Based on AF Symptoms Checklist Frequency and Severity Scores
Tidsramme: 12 month follow-up

Change in Atrial Fibrillation Symptom Checklist Frequency and Severity Scores. This is reported as change from Baseline.

  1. This scale has 16 items to assess frequency of occurrence on a scale: Never; Rarely; Sometimes; Often; Always. These rating correspond to numerical values of: 1, 2, 3, 4, and 5, respectively. AF Frequency range from 0 to 80 . Higher scores indicating greater symptomatology.
  2. The same items are also used to assess severity on a scale: Mild; Moderate; Severe. Corresponding to 1, 2, and 3, respectively. AF Severity score range from 0 to 48. Higher scores indicating greater symptomatology.
  3. Negative change from baseline compared to 12-months represents an improvement in AF symptomatology .
12 month follow-up

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

AtriCure, Inc.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. august 2012

Primær fullføring (Faktiske)

1. desember 2015

Studiet fullført (Faktiske)

1. desember 2015

Datoer for studieregistrering

Først innsendt

11. juli 2012

Først innsendt som oppfylte QC-kriteriene

6. august 2012

Først lagt ut (Anslag)

9. august 2012

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

17. mai 2017

Siste oppdatering sendt inn som oppfylte QC-kriteriene

7. april 2017

Sist bekreftet

1. april 2017

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • CP2012-1

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