AtriClip® Left Atrial Appendage Exclusion Concomitant to Structural Heart Procedures (ATLAS)

NCT ID: NCT02701062

Last Updated: 2021-11-24

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

562 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-02-29

Study Completion Date

2019-06-01

Brief Summary

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Patients without a documented history of Atrial Fibrillation (AF) and will undergo a valve or Coronary Artery Bypass Graft (CABG) procedure with direct visual access to the Left Atrial Appendage (LAA) will be eligible to participate. Patients enrolled will be randomized 2:1 (2 with AtriClip to 1 without AtriClip. Subjects who develop Post-operative Atrial Fibrillation (POAF) and receive the AtriClip will be followed for 365 days post index procedure.

Detailed Description

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Patients without a documented history of AF but who present with a CHA2DS2- VASc (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke or transient ischemic attack (TIA), vascular disease, age 65 to 74 years, sex category) of =\> 2 and HASBLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) of =\> 2 and will undergo a valve or CABG (structural heart) procedure with direct visual access to the LAA will be eligible to participate based upon the inclusion and exclusion criteria defined in this protocol. Up to 2000 patients will enroll at up to 40 sites and will be randomized 2:1 (2 with AtriClip to 1 without AtriClip. Subjects who not develop Post-operative Atrial Fibrillation (POAF) will be followed for 30 days for safety. Subjects who develop POAF and receive the AtriClip will be followed for 365 days post index procedure.

Conditions

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Post-Operative Atrial Fibrillation

Keywords

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Left Atrial Appendage Anticoagulation CHA2DS2- VASc HASBLED

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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LAA Exclusion with AtriClip®

LAA Exclusion with AtriClip®: AtriClip® is used per label and is not experimental.

Group Type OTHER

AtriClip® Gillinov-Cosgrove™ LAA Exclusion Systems

Intervention Type DEVICE

Medical Management

Medical Management: Standard of Care Oral Anticoagulation Therapy at the discretion of the Investigator.

Group Type ACTIVE_COMPARATOR

Anticoagulation Therapy

Intervention Type DRUG

Anticoagulation Therapy- Standard of Care at the discretion of the Investigator.

Interventions

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AtriClip® Gillinov-Cosgrove™ LAA Exclusion Systems

Intervention Type DEVICE

Anticoagulation Therapy

Anticoagulation Therapy- Standard of Care at the discretion of the Investigator.

Intervention Type DRUG

Other Intervention Names

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AtriClip FLEX (ACH2) AtriClip Long (LAA) AtriClip Standard (ACH1) Warfarin/Coumadin New oral anticoagulants (NOACs): dabigatran, rivaroxaban, apixaban

Eligibility Criteria

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Inclusion Criteria

Patients satisfying the following criteria will be considered the screening population and will be eligible for participation:

* Age \> 18 years male or female.
* Scheduled for any non-mechanical valve and/or CABG (structural heart) procedure where direct access to the LAA is expected.
* No documented preoperative AF.
* CHA2DS2-VASc score of =\> 2.
* HASBLED score of =\> 2.
* Acceptable surgical candidate, including use of general anesthesia.
* Willing and able to provide written informed consent.

Exclusion Criteria

Patients satisfying the following criteria will not be eligible for participation:

* Redo cardiac surgery.
* Mechanical heart valve or other anticipated or current requirement for anticoagulation therapy during the post-operative (30 day) period.
* Hypercoagulability conditions that may confound the study.
* Ejection Fraction \< 30.
* Left Atrium \> 6 cm.
* Severe Diastolic Dysfunction.
* Requires anticoagulation therapy.
* Patient had a stroke/cerebrovascular accident (CVA) within previous 30 days prior to signing informed consent.


* Presence of thrombus in the left atrium or LAA.
* LAA tissue is deemed friable or has significant adhesions (as evaluated by the surgeon) near or on the LAA making AtriClip placement overly risky.
* Left atrial appendage is outside the range of manufacturer's recommendations - width \< 29mm or \> 50mm.
* Direct visualization access is not available for AtriClip placement.
Minimum Eligible Age

18 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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Sydney Gaynor, MD

Role: STUDY_CHAIR

AtriCure, Inc.

Locations

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Sharp Memorial Hospital

San Diego, California, United States

Site Status

Stanford University

Stanford, California, United States

Site Status

Orlando Health Heart Institute

Orlando, Florida, United States

Site Status

Emory St Joseph Hospital

Atlanta, Georgia, United States

Site Status

St Francis Heart Hospital

Indianapolis, Indiana, United States

Site Status

St. Vincent Heart Center, Inc.

Indianapolis, Indiana, United States

Site Status

University of Kansas Hospital

Kansas City, Kansas, United States

Site Status

University of Maryland

Baltimore, Maryland, United States

Site Status

United Heart & Vascular Clinic

Saint Paul, Minnesota, United States

Site Status

Cardiology Associates Research

Tupelo, Mississippi, United States

Site Status

NYU Langone Medical Center

New York, New York, United States

Site Status

Mount Sinai -St. Luke's

New York, New York, United States

Site Status

Icahn School of Medicine at Mount Sinai

New York, New York, United States

Site Status

The Christ Hospital -Linder Research Center

Cincinnati, Ohio, United States

Site Status

Tri-Health

Cincinnati, Ohio, United States

Site Status

Oregon Health and Science University

Portland, Oregon, United States

Site Status

PinnacleHealth Hospitals

Harrisburg, Pennsylvania, United States

Site Status

Wellmont CVA Heart Institute

Kingsport, Tennessee, United States

Site Status

Cardiovascular Surgery Clinic

Memphis, Tennessee, United States

Site Status

Valley Health System

Winchester, Virginia, United States

Site Status

Swedish Medical Center/Cherry Hill Campus

Seattle, Washington, United States

Site Status

Aspirus Wausau Hospital

Wausau, Wisconsin, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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CP2015-2

Identifier Type: -

Identifier Source: org_study_id