Non-Valvular Atrial Fibrillation
Conditions
Keywords
Non-Valvular Atrial Fibrillation, NVAF, Amplatzer Amulet
Brief summary
The purpose of this study is to prospectively evaluate the safety and effectiveness of the Amplatzer Amulet LAA occluder in a Chinese patient population indicated for use of this device.
Detailed description
Atrial fibrillation (AF) is the most common sustained heart rhythm disorder. During AF, chaotic electrical activity results in rapid, uncoordinated, and insufficient contractions of the atrial chambers. Stagnation of blood flow in the left atrium (LA) can lead to hypercoagulability. The left atrial appendage (LAA), given its location and complex shape is often the primary site of stasis and thus increases the risk for thrombus formation. Approximately 90% of all thrombi in patients with non-valvular AF (NVAF) forming in the LA originate in the LAA. Patients with NVAF are at an increased risk of systemic embolism and stoke due to the potential for clot forming in the LAA. OAC is the recommended first-line therapy for NVAF at increased risk of stroke, however, many patients have relative or absolute contraindications to taking OACs. LAAO offers a non-pharmacological option for stroke risk reduction in these patients unable to take OAC. The Amulet occluder is Abbott's second-generation LAA occlusion device. It received CE Mark in 2013, and FDA approval in August 2021. Observational studies performed in multiple geographies show that the Amulet occluder can be safely implanted with good procedural outcomes and reduce the risk of stroke as compared to a predicted rate without the need for anticoagulation in most patients. This led to the National Medical Products Administration (NMPA) approval of the Amulet occluder in 2020. The purpose of this study is to prospectively evaluate the safety and effectiveness of the Amplatzer Amulet LAA occluder in a Chinese patient population indicated for use of this device.
Interventions
DEVICELeft Atrial Appendage (LAA) closure procedure with Amplatzer Amulet LAA occluder
Subject will receive the Left Atrial Appendage (LAA) closure procedure with Amplatzer Amulet LAA occluder.
Sponsors
Abbott Medical Devices
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Documented non-valvular atrial fibrillation and contraindicated for long-term oral anticoagulation, or in those who are taking oral warfarin but still develop stroke or relevant events 2. Meets the current device indications and per physician discretion for Amulet implant 3. Able to provide written Informed Consent prior to any study related procedures 4. 18 years of age or older at the time of enrolment
Exclusion criteria
1. With the presence of intracardiac thrombus 2. With active endocarditis or other infections producing bacteremia 3. Patients whose low risk of stroke (CHA2DS2-VASC score is 0 or 1) or bleeding (HAS-BLED score \< 3) 4. Where placement of the device would interfere with any intracardiac or intravascular structures 5. Has a life expectancy of less than 2 years due to any condition 6. Currently participating or planning on participating during the follow up period of this study in a clinical study that includes an active treatment arm or a concurrent clinical study which may confound the results of this trial
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Primary Short-Term Safety Endpoint: Occurrence of Major Adverse Events | 7 days | The primary short-term safety endpoint is the occurrence of one or more of the following major adverse events within 7 days after the procedure: all-cause mortality, procedure or device-related complications requiring open cardiac surgery or major endovascular intervention, ischemic or hemorrhagic stroke, or systemic embolism. |
| Primary Long-Term Safety Endpoint: Occurrence of Device Embolization, Device Erosion, Significant Device Interference With Surrounding Structure, Device Thrombus, Device Fracture, Device Related Infections, Device Breakage, or Device Related Allergy | 2 years | The primary long-term safety endpoint is the occurrence of device embolization, device erosion, clinically significant device interference with surrounding structure, device thrombus, device fracture, device related infections (endocarditis and pericarditis), device breakage, or device related allergy through 2 years. The protocol-defined time frame for endpoint assessment was 2 years. However, the study was prematurely terminated at 1 year and 11 months after study initiation. As a result, the endpoint analysis was conducted using all available data collected up to the point of study termination, but was shorter than the planned observation period. |
| Primary Effectiveness Endpoint: Composite of Ischemic Stroke or Systemic Embolism | 2 years | The primary effectiveness endpoint is a composite of ischemic stroke or systemic embolism through 2 years. The protocol-defined time frame for endpoint assessment was 2 years. However, the study was prematurely terminated at 1 year and 11 months after study initiation. As a result, the endpoint analysis was conducted using all available data collected up to the point of study termination, but was shorter than the planned observation period. |
Countries
China
Contacts
PRINCIPAL_INVESTIGATORZhihui ZHANG
The Third Xiangya Hospital of Central South University
Participant flow
Recruitment details
A total of 50 subjects were enrolled across five investigational sites in China between January 30, 2024, and January 10, 2025.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Continuous | 68.7 Year STANDARD_DEVIATION 9.5 |
| Primary reason for seeking an alternative or unable to take long-term warfarin/other anticoagulant High bleeding risk | 42 Participants |
| Primary reason for seeking an alternative or unable to take long-term warfarin/other anticoagulant History of major or minor bleeding | 2 Participants |
| Primary reason for seeking an alternative or unable to take long-term warfarin/other anticoagulant Prior stroke on anticoagulant | 5 Participants |
| Primary reason for seeking an alternative or unable to take long-term warfarin/other anticoagulant Subject's preference/lifestyle | 1 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 50 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 0 Participants |
| Sex: Female, Male Female | 18 Participants |
| Sex: Female, Male Male | 32 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 1 / 50 |
| other Total, other adverse events | 8 / 50 |
| serious Total, serious adverse events | 10 / 50 |
Outcome results
None listed