Pivotal Study Of A Dual Epicardial & Endocardial Procedure (DEEP) Approach

NCT ID: NCT02393885

Last Updated: 2024-12-19

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-02-28

Study Completion Date

2024-04-17

Brief Summary

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The objective of this study is to establish the safety and effectiveness of a dual epicardial and endocardial ablation procedure for patients presenting with Persistent Atrial Fibrillation or Longstanding Persistent Atrial Fibrillation

Detailed Description

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The objective of this study is to establish the safety and effectiveness of a dual epicardial and endocardial ablation procedure for patients presenting with Persistent Atrial Fibrillation or Longstanding Persistent Atrial Fibrillation utilizing the AtriCure Bipolar System and AtriClip® PRO LAA Exclusion System in an endoscopic or open ablation procedure, followed by an endocardial mapping and ablation procedure utilizing commercially available RF based, irrigated, power controlled, ablation catheters for endocardial lesions. The endocardial procedure will be staged to occur after 90 days post epicardial surgical procedure.

Conditions

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Atrial Fibrillation Persistent or Longstanding Persistent Atrial Fibrillation

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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AtriCure Bipolar System and AtriClip® PRO LAA Exclusion System

AtriCure Bipolar System and AtriClip® PRO LAA Exclusion System at day 1 of surgical procedure followed by endocardial catheter ablation procedure to occur at approximately 90 days after day 1 of surgical procedure.

Group Type EXPERIMENTAL

AtriCure Bipolar System and AtriClip® PRO LAA Exclusion System, Endocardial Ablation

Intervention Type DEVICE

Interventions

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AtriCure Bipolar System and AtriClip® PRO LAA Exclusion System, Endocardial Ablation

Intervention Type DEVICE

Other Intervention Names

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Irrigated Endocardial Catheters

Eligibility Criteria

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Inclusion Criteria

1\. Symptomatic Persistent Atrial Fibrillation or Longstanding Persistent Atrial Fibrillation refractory to a minimum of one Class I or Class III AADs.

Exclusion Criteria

1. AF \>10 years.
2. Refractory hypertension, defined as systolic (\>150 mm Hg) or diastolic (\> 90 mm Hg) blood pressure that remains uncontrolled despite sustained therapy
3. History of pulmonary hypertension
4. Pulmonary vein stenosis in one or more of the pulmonary veins
5. EP catheter ablation procedure to treat atrial fibrillation within 3 months
6. Undergone prior cardiothoracic surgery, previous thorax trauma which resulted in a pneumothorax or hemothorax.
7. Sleep apnea, home oxygen therapy, moderate to severe COPD, (FEV1/FVC \< 70% predicted) or patient is considered intolerant to single lung ventilation.
8. NYHA Class IV heart failure.
9. Uncorrected, reversible cause(s) of atrial fibrillation, or is currently being treated for arrhythmias other than atrial fibrillation (AF) or atrial flutter.
10. Documented history of previous catheter ablation with perforation, history of pericarditis, pericardial effusion, or tamponade.
11. Structural heart disease requiring surgical treatment (i.e. valve disease requiring repair or replacement within 12 months following surgical ablation procedure).
12. CAD requiring intervention (either surgical, i.e. CABG, or catheter).
13. Ejection fraction \< 30%
14. Measured left atrial diameter \> 5.5 cm
15. Stroke/cerebrovascular accident (CVA) within previous six months, carotid artery stenosis greater than 80%.
16. BMI is \>40
17. Thrombus in the left atrium or the left atrial appendage, determined by echocardiography (either at baseline TTE (or equivalent diagnostic test) or intraoperative TEE).
18. Blood dyscrasia or clotting disorder (i.e. Idiopathic Thrombocytopenic Purpura \[ITP\] or Thrombotic Thrombocytopenic Purpura \[TTP\]).
19. Contraindication to anticoagulation that in the opinion of the investigator poses undue risk to the patient from participating in the endocardial EP procedure.
20. Documented thromboembolism within the previous six months prior to signing informed consent.
21. Has the following atrial myxoma, mural thrombus or mural tumor.
22. A condition or congenital anomaly which prevents required surgical or catheter access.
23. A co-morbid condition that, in the opinion of the investigator, poses undue risk of general anesthesia or port access cardiac surgery.
24. Currently abusing drugs or alcohol.
25. Currently or has participated in a clinical study in the last 3 months prior to signing informed consent.
26. A psychological disorder that could interfere with provision of informed consent, completion of tests, therapy, or follow-up.
27. A condition that, in the opinion of the investigator, may jeopardize the patient's well-being and/or the soundness of this clinical study.
28. Pre-existing esophageal condition that required (or requires) endoscopic therapy or surgical treatment.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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AtriCure, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kenneth Ellenbogen, MD

Role: PRINCIPAL_INVESTIGATOR

VCU

Vigneshwar Kasirajan, MD

Role: PRINCIPAL_INVESTIGATOR

VCU

Ali Khoynezhad, MD

Role: PRINCIPAL_INVESTIGATOR

MemorialCare Long Beach Medical Ctr

Locations

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Long Beach Memorial Medical Center

Long Beach, California, United States

Site Status

Cedars-Sinai Heart Institute

Los Angeles, California, United States

Site Status

Alta Bates Sutter Medical Center, East Bay Hospital

Oakland, California, United States

Site Status

St. Helena Hospital, Adventist Heart Institute

St. Helena, California, United States

Site Status

Stanford University Department of CV medicine

Stanford, California, United States

Site Status

Shands at the University of Florida

Gainesville, Florida, United States

Site Status

Orlando Heart Institute

Orlando, Florida, United States

Site Status

Sarasota Memorial Hospital

Sarasota, Florida, United States

Site Status

Saint Alphonsus Regional Medical Center

Boise, Idaho, United States

Site Status

The Christ Hospital

Cincinnati, Ohio, United States

Site Status

Tri Health Hosptial - Good Samaritan and Bethesda North Hospitals

Cincinnati, Ohio, United States

Site Status

Pinnacle Health

Harrisburg, Pennsylvania, United States

Site Status

Sentara Cardiovascular Research Institute

Norfolk, Virginia, United States

Site Status

Virginia Commonwealth University

Richmond, Virginia, United States

Site Status

Aspirus Research Institute

Wausau, Wisconsin, United States

Site Status

Universitair Ziekenhuis Brussel (UZ Brussels)

Brussels, , Belgium

Site Status

Academic Medical Center (AMC)

Amsterdam, , Netherlands

Site Status

Countries

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United States Belgium Netherlands

References

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Ellenbogen KA, Khoynezhad A, La Meir M, de Asmundis C, Koneru JN, Johnkoski J, Rist K, Mumtaz M, Link MG, de Groot JR, Driessen AHG, Lee MY, Hoff SJ, Bello D, Dunnington G, Eisenberg S, Vloka M, Taylor BJ, Jones SD, Philpott JM, Beaver TM, Miles WM, Khan JH, Kang S, Gandhi GD, Okum EJ, Badhwar N, Baykaner T, Lee AM, Vesco PA, Smith JM, Gaynor S, Frazier K, Lee RJ, Kasirajan V. Dual Epicardial and Endocardial Procedure (DEEP) for Persistent or Longstanding Persistent Atrial Fibrillation. Circ Arrhythm Electrophysiol. 2025 Oct;18(10):e013692. doi: 10.1161/CIRCEP.125.013692. Epub 2025 Sep 30.

Reference Type DERIVED
PMID: 41025224 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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CP2014-1

Identifier Type: -

Identifier Source: org_study_id