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Multi-electrode Radiofrequency Balloon Catheter Use for the Isolation of the Pulmonary Veins. (SHINE)

1 de dezembro de 2020 atualizado por: Biosense Webster, Inc.
This clinical investigation is a prospective, multicenter, single arm clinical evaluation utilizing the multi-electrode radiofrequency balloon catheter and the multi-electrode circular diagnostic catheter.

Visão geral do estudo

Status

Concluído

Intervenção / Tratamento

Descrição detalhada

The objective of this clinical investigation is to assess the safety and acute effectiveness of the multi-electrode radiofrequency balloon catheter and multi-electrode circular diagnostic catheter when used for the isolation of the pulmonary veins in the treatment of Paroxysmal Atrial Fibrillation (PAF).

Tipo de estudo

Intervencional

Inscrição (Real)

98

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

      • Bari, Itália
        • Ospedale "F. Miulli"
      • Milan, Itália
        • Centro Cardiologico Monzino
      • Liverpool, Reino Unido
        • Liverpool Heart and Chest Hospital
      • London, Reino Unido
        • Bart's Health NHS Trust
      • Prague, Tcheca
        • Na Homolce Hospital

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos a 75 anos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

Inclusion Criteria:

  1. Diagnosed with Symptomatic Paroxysmal AF.
  2. Selected for atrial fibrillation (AF) ablation procedure for pulmonary vein isolation.
  3. Able and willing to comply with uninterrupted per-protocol anticoagulation requirements
  4. Age 18-75 years.
  5. Able and willing to comply with all pre-, post- and follow-up testing and requirements.
  6. Signed Patient Informed Consent Form.

Exclusion Criteria:

  1. AF secondary to electrolyte imbalance, thyroid disease, or reversible or non-cardiac cause.
  2. Previous surgical or catheter ablation for AF.
  3. Anticipated to receive ablation outside the PV ostia and Cavo-triscuspid-isthmus (CTI) region
  4. Previously diagnosed with persistent, longstanding AF and/or continuous AF > 7 days, or > 48 hrs terminated by cardioversion.
  5. Any percutaneous coronary intervention (PCI) within the past 2 months.
  6. Valve repair or replacement and presence of a prosthetic valve.
  7. Any carotid stenting or endarterectomy.
  8. Coronary artery bypass grafting (CABG), cardiac surgery (e.g. ventriculotomy, atriotomy), or valvular cardiac surgical or percutaneous procedure within the past 6 months.
  9. Documented left atrium (LA) thrombus on baseline/pre-procedure imaging.
  10. LA antero posterior diameter > 50 mm
  11. Any PV with a diameter ≥ 26 mm
  12. Left Ventricular Ejection Fraction (LVEF) < 40%.
  13. Contraindication to anticoagulation (e.g. heparin).
  14. History of blood clotting or bleeding abnormalities.
  15. Myocardial infarction within the past 2 months.
  16. Documented thromboembolic event [including transient ischemic attack(TIA)] within the past 12 months.
  17. Rheumatic Heart Disease.
  18. Uncontrolled heart failure or New York Heart Association (NYHA) function class III or IV.
  19. Awaiting cardiac transplantation or other cardiac surgery within the next 12 months.
  20. Unstable angina.
  21. Acute illness or active systemic infection or sepsis.
  22. Diagnosed atrial myxoma or interatrial baffle or patch.
  23. Presence of implanted pacemaker or implantable cardioverter defibrillator (ICD).
  24. Significant 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 chronic symptoms.
  25. Significant congenital anomaly or medical problem that, in the opinion of the investigator, would preclude enrollment in this study.
  26. Women who are pregnant (as evidenced by pregnancy test if pre-menopausal), lactating, or who are of child bearing age and plan on becoming pregnant during the course of the clinical investigation.
  27. Enrollment in an investigational study evaluating another device, biologic, or drug.
  28. Has known pulmonary vein stenosis.
  29. Presence of intramural thrombus, tumor or other abnormality that precludes vascular access, or manipulation of the catheter.
  30. Presence of an Inferior Vena Cava (IVC) filter
  31. Presence of a condition that precludes vascular access.
  32. Life expectancy or other disease processes likely to limit survival to less than 12 months.
  33. Presenting contra-indication for the devices (e.g. transthoracic echocardiography (TTE), CT, etc.) used in the study, as indicated in the respective instructions for use.
  34. Categorized as a vulnerable population and requires special treatment with respect to safeguards of well-being

    Additional exclusion criteria for Neurological Assessment Evaluable (NAE) subjects:

  35. Contraindication to use of contrast agents for MRI such as advanced renal disease, etc. (at PI discretion)
  36. Presence of iron-containing metal fragments in the body
  37. Unresolved pre-existing neurological deficit.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: N / D
  • Modelo Intervencional: Atribuição de grupo único
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Intervention
Ablation with Multi-electrode Radiofrequency (RF) Balloon Catheter
RF ablation using multi-electrode radiofrequency balloon catheter and multi-electrode circular diagnostic catheter

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Number of Participants With Early Onset Primary Adverse Events (PAEs): Death, Atrio-esophageal Fistula and Pulmonary Vein Stenosis
Prazo: Up to 90 days (post initial mapping and ablation procedure)
A Primary AEs is an event which occurred within 90 days following initial ablation procedure. Primary AEs included: Death, atrio-esophageal fistula, and pulmonary vein stenosis.
Up to 90 days (post initial mapping and ablation procedure)
Number of Participants With Early Onset PAEs: Myocardial Infraction, Cardiac Tamponade/Perforation, Thromboembolism, Stroke/Cerebrovascular Accident, Transient Ischemic Attack, Phrenic Nerve Paralysis, and Major Vascular Access Complication/Bleeding
Prazo: Up to 7 days (post initial mapping and ablation procedure)
A Primary AEs is an event which occurred within the first week (7 days of the initial mapping and ablation procedure) which included myocardial infraction (MI), cardiac tamponade (CT)/perforation, thromboembolism, stroke/cerebrovascular accident (CVA), Transient ischemic attack (TIA), phrenic nerve paralysis (PNP), and major vascular access complication (MVAC)/bleeding following initial ablation procedure.
Up to 7 days (post initial mapping and ablation procedure)
Percentage of Participants With Acute Procedural Success
Prazo: Day 1
Acute procedural success is defined as confirmation of entrance block in treated pulmonary veins (PV) after adenosine and/or isoproterenol challenge (with or without the use of a focal catheter).
Day 1

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Number of Participants With Individual PAE From Primary Composite
Prazo: Up to 7 days for MI, CT/perforation, thromboembolism, stroke/CVA, TIA, PNP and MVAC (initial mapping and ablation procedure) and up to 90 days for death, AE fistula, and PVST (post procedure)
A Primary AEs is an event which occurred within the first week (7 days of the initial mapping and ablation procedure) which included death, atrio-esophageal fistula (AE fistula) and pulmonary vein stenosis (PVST); and up to 90 days post procedure which included myocardial infraction (MI), cardiac tamponade (CT)/perforation, thromboembolism, stroke/cerebrovascular accident (CVA), Transient ischemic attack (TIA), phrenic nerve paralysis (PNP), and major vascular access complication (MVAC)/bleeding following initial ablation procedure.
Up to 7 days for MI, CT/perforation, thromboembolism, stroke/CVA, TIA, PNP and MVAC (initial mapping and ablation procedure) and up to 90 days for death, AE fistula, and PVST (post procedure)
Number of Participants With Serious Adverse Device Effects (SADEs)
Prazo: Up to 405 Days
An adverse device effect is an adverse event related to the to the device and or the procedure of the investigational medical device. SADE is an adverse device effect that has resulted in any of the consequences characteristic of an SAE.
Up to 405 Days
Number of Participants With Serious Non-primary Adverse Events Within 7 Days (Early Onset), 8-30 Days (Peri-procedural) and Greater Than or Equal to (>=) 31 Days (Late Onset) of Initial Ablation Procedure
Prazo: Within 7 Days (Early Onset), 8-30 Days (Peri-procedural) and >=31 Days (Late Onset) of Initial Ablation Procedure (Up to 405 Days)
Serious non-primary adverse event was defined as SAE that are not primary adverse events. Primary AEs included: Death, atrio-esophageal fistula, and pulmonary vein stenosis.
Within 7 Days (Early Onset), 8-30 Days (Peri-procedural) and >=31 Days (Late Onset) of Initial Ablation Procedure (Up to 405 Days)
Number of Participants With Non-serious Adverse Events
Prazo: Up to 405 Days
An AE is any untoward medical occurrence in participants whether or not related to the investigational medical device.
Up to 405 Days
Number of Participants With Pre-and Post-ablation Asymptomatic and Symptomatic Cerebral Emboli
Prazo: Pre-procedure, at Discharge, 1 Month and at unscheduled visit (Up to 405 Days)
Number of participants with pre-and post-ablation asymptomatic and symptomatic cerebral emboli was reported.
Pre-procedure, at Discharge, 1 Month and at unscheduled visit (Up to 405 Days)
Number of Participants With Symptomatic and Asymptomatic Cerebral Emboli
Prazo: Up to 405 Days
Number of participants with symptomatic and asymptomatic cerebral emboli was reported
Up to 405 Days
Number of Participants With New or Worsening Neurologic Deficits
Prazo: Pre-procedure, discharge, 1 Month, 3 Month and 6 Month
Number of participants with new or worsening neurologic deficits was reported.
Pre-procedure, discharge, 1 Month, 3 Month and 6 Month
Number of Participants With NIHSS Scores
Prazo: Pre-procedure and at discharge (Up to 405 Days)
The National Institutes of Health Stroke Scale, or NIH Stroke Scale (NIHSS) is a tool used to objectively quantify the impairment caused by a stroke. The NIHSS is composed of 11 items, each of which scores a specific ability between 0 and 4. For each item, a score of 0 typically indicates normal function in that specific ability, while a higher score is indicative of some level of impairment. The individual scores from each item are summed to calculate a patient's total NIHSS score. The patient's total NIHSS score ranges from 0 (minimum) - 42 (maximum). Score 0 (no stroke symptoms); 1 - 4 (Minor stroke); 5-15 (Moderate stroke); 16-20 (Moderate to severe stroke); and 21-42 (Severe stroke).
Pre-procedure and at discharge (Up to 405 Days)
Number of Participants With MoCA Scores
Prazo: Up to 405 Days
Montreal Cognitive Assessment (MoCA) is used for detecting cognitive impairment, the scores range from 0 to 30. A score of 26 or higher is considered normal, patients with mild cognitive impairment (MCI) were scored an average of 22 and patients with significant cognitive impairment (SCI) were scored an average of 16.
Up to 405 Days
Number of Participants With Hospitalization for Cardiovascular Events
Prazo: Within 7 Days (Early Onset), 8-30 Days (Peri-procedural) and >=31 Days (Late Onset) of Initial Ablation Procedure (Up to 405 Days)
Hospitalization was defined as prolonged stay greater than or equal to (>=) 2 nights post index procedure or in-patient stay not concurrent with index procedure >= 1 calendar day. Hospitalization included cardiovascular events due to any cause post index procedure, regardless of protocol-defined serious/non-serious adverse events (AEs) or not. Hence this data was not contributed in serious Adverse events until met the AE definition.
Within 7 Days (Early Onset), 8-30 Days (Peri-procedural) and >=31 Days (Late Onset) of Initial Ablation Procedure (Up to 405 Days)
Percentage of Participants With PVI Touch-up by Balloon and/or Focal Catheter Among All Targeted Veins and by Participants
Prazo: Up to 405 Days
Percentage of participants with PVI touch-up by balloon and/or focal catheter among all targeted veins and by participants was reported. Most of the participants were ablated by Balloon catheter only while one participant was ablated with both Balloon and Focal catheters.
Up to 405 Days
Percentage of Participants With Use of Focal Catheter Ablation for Non-PV Triggers
Prazo: Up to 405 Days
Percentage of participants with use of focal catheter ablation for non-PV triggers was reported.
Up to 405 Days
Percentage of Participants With Freedom From Documented Atrial Fibrillation (AF), Atrial Tachycardia (AT), or Atypical (Left Side) Atrial Flutter (AFL) Episodes or Documented Symptomatic AF/AT/AFL
Prazo: Up to 6 Months
Percentage of participants with six-month arrythmia recurrence [defined as freedom from documented symptomatic or asymptomatic atrial fibrillation (AF), atrial tachycardia (AT), or atypical (left side) atrial flutter (AFL) episodes (episodes >30 seconds on arrhythmia monitoring device from Day 91 to 180 post the index procedure)] was reported.
Up to 6 Months
Percentage of Participants With Freedom From Documented, AF, AT, or Atypical (Left Side) AFL Episodes or Documented Symptomatic AF/AT/AFL
Prazo: Up to 12 Months
Twelve-month Arrythmia recurrence is defined as a documented symptomatic or asymptomatic episode >30 seconds on an arrhythmia monitoring device between day 91 to 365 post the index procedure.
Up to 12 Months

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Publicações e links úteis

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Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

28 de fevereiro de 2018

Conclusão Primária (Real)

1 de fevereiro de 2019

Conclusão do estudo (Real)

17 de outubro de 2019

Datas de inscrição no estudo

Enviado pela primeira vez

13 de fevereiro de 2018

Enviado pela primeira vez que atendeu aos critérios de CQ

13 de fevereiro de 2018

Primeira postagem (Real)

19 de fevereiro de 2018

Atualizações de registro de estudo

Última Atualização Postada (Real)

22 de dezembro de 2020

Última atualização enviada que atendeu aos critérios de controle de qualidade

1 de dezembro de 2020

Última verificação

1 de novembro de 2020

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • BWI_2017_01

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Sim

produto fabricado e exportado dos EUA

Sim

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

Ensaios clínicos em Fibrilação Atrial Paroxística

Ensaios clínicos em Radiofrequency Ablation

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