WAveCrest Vs. Watchman TranssEptal LAA Closure to REduce AF-Mediated STroke 2

NCT ID: NCT03302494

Last Updated: 2025-03-12

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

248 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-12-27

Study Completion Date

2023-12-21

Brief Summary

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The WAVECREST 2 trial is a prospective, multicenter, randomized, active controlled, clinical trial to evaluate the safety and effectiveness of the Coherex WaveCrest Left Atrial Appendage (LAA) Occlusion System.

Detailed Description

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The WAVECREST 2 trial is a prospective, multicenter, randomized, active controlled, clinical trial to evaluate the safety and effectiveness of the Coherex WaveCrest Left Atrial Appendage (LAA) Occlusion System. Subjects will be randomized in a 1:1 ratio to the Treatment Arm (Coherex WaveCrest LAA occlusion system) or the Control Arm (Boston Scientific's Watchman LAA occlusion system). The trial is designed to demonstrate that safety and effectiveness of the WaveCrest device are non-inferior to the Watchman device.

Conditions

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Stroke

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors
If the subject is suspected of having a stroke since their most recent follow-up, a Neurologist blinded to subject's randomization and implanted device must evaluate the subject or otherwise provide rationale for why an in-person neurology visit and exam are unnecessary. Neurology or blinded trial personnel should also administer mRS \& NIHSS if there is suspicion of stroke A Clinical Events Committee, also blinded to subject's randomization, will adjudicate primary safety and effectiveness.

Study Groups

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WaveCrest

WaveCrest left atrial appendage occluder

Group Type EXPERIMENTAL

Coherex WaveCrest® Left Atrial Appendage Occlusion System

Intervention Type DEVICE

Percutaneous left atrial appendage closure

Watchman (control)

Watchman left atrial appendage closure device

Group Type ACTIVE_COMPARATOR

Watchman® LAA Closure Device

Intervention Type DEVICE

Percutaeous left atrial appendage closure

Interventions

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Coherex WaveCrest® Left Atrial Appendage Occlusion System

Percutaneous left atrial appendage closure

Intervention Type DEVICE

Watchman® LAA Closure Device

Percutaeous left atrial appendage closure

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Documented evidence of paroxysmal, persistent, or permanent non-valvular atrial fibrillation
2. At least 18 years of age
3. Calculated CHADS2 score ≥ 2 or CHA2DS2-VASc score ≥ 3
4. Indication for warfarin therapy with an appropriate rationale to seek a non-pharmacologic alternative to chronic oral anticoagulation
5. Willing and able to comply with post-implant anticoagulation and antiplatelet regimen
6. Willing to participate in the required follow-up visits and tests
7. Subject has been informed of the nature of the trial, agrees to its provisions and has provided written informed consent as approved by the IRB/EC at the site

Exclusion Criteria

1. Atrial fibrillation (AF) due to a reversible cause (e.g. thyrotoxicosis or postoperative)
2. Known contraindication and/or allergy to warfarin, nickel, aspirin, intravenous contrast or P2Y12 inhibitors (clopidogrel, ticagrelor, and prasugrel), which cannot be adequately pre-medicated or desensitized
3. Conditions other than AF requiring long-term anticoagulation therapy
4. Contraindications for percutaneous catheterization procedures
5. Prior surgical LAA occlusion/exclusion or implanted with LAA occlusion device, or any prior attempt of such procedures
6. Prior percutaneous or surgical closure of a patent foramen ovale or atrial septal defect
7. Inability or unwillingness to take oral anticoagulation for 45 days post-procedure
8. New York Heart Association (NYHA) Class IV heart failure
9. Prior cardiac transplant, history of mitral valve replacement or transcatheter mitral valve intervention, or any mechanical valve implant
10. History of symptomatic carotid, intervertebral, or intracranial artery occlusion or stenosis without revascularization with the exception of known occlusion without symptoms \> 6 months
11. Modified Rankin Scale (mRS) score ≥ 4
12. Chronic resting heart rate ≥ 110 bpm
13. Congenital cardiac anomalies requiring cardiac surgery or interventional repair
14. Stroke or transient ischemic attack (confirmed by Neurologist) within 60 days prior to enrollment
15. Myocardial infarction within 60 days prior to enrollment
16. Sepsis or any infection requiring oral antibiotic therapy within 14 days or intravenous antibiotic therapy within 30 days prior to enrollment
17. Surgical or interventional cardiovascular and non-cardiovascular procedure including cardioversion within 30 days prior to enrollment or AF ablation within 60 days prior to enrollment or any planned general surgery or interventional procedure within 90 days after enrollment or any planned cardiac surgery.
18. On renal replacement therapy, serum creatinine \> 3.0 mg/dl (265 μmol/L) or calculated creatinine clearance \< 25 ml/minute
19. Thrombocytopenia (\<60,000 platelets/mm3), leucopenia (white blood cell count \< 3,000 cells/mm³), or anemia (hemoglobin concentration \< 10 grams/deciliter) based on blood work done within 30 days prior to enrollment
20. Any medical disorder or psychiatric illness that would interfere with successful completion of the trial
21. Currently participating in an investigational drug trial or another device trial that has not completed the primary endpoint (trials requiring extended follow-up for products that are commercially available are not considered investigational trials). Concurrent enrollment in the ACC LAAO Registry is permitted.
22. Subject belongs to a vulnerable population (see definition in Appendix I: Acronyms and Definitions)
23. Any condition that would reduce life expectancy to less than 2 years
24. Women of childbearing potential who are, or plan to become pregnant during the time of the trial (method of assessment per physician discretion)


1. Left ventricular ejection fraction \< 30%
2. Mitral valve stenosis defined as valve area \< 1.5cm2, mean gradient \> 6mmHg, or any valve deformity consistent with rheumatic valvular disease
3. Aortic valve stenosis defined as valve area ≤1.0cm2 or mean gradient \>30mmHg
4. Circumferential pericardial effusion \> 10mm or symptomatic pericardial effusion
5. Evidence of intracardiac thrombus
6. Cardiac tumor or myxoma
7. Atrial septal defect that warrants closure
8. Complex atheroma in the ascending aorta or aortic arch as evidenced by mobile plaque
9. Left Atrial Appendage size and shape are unsuitable for closure with a WaveCrest or Watchman device
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Biosense Webster, Inc.

INDUSTRY

Sponsor Role collaborator

Coherex Medical

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Vivek Reddy, MD

Role: STUDY_CHAIR

MOUNT SINAI HOSPITAL

Gregg Stone, MD

Role: STUDY_CHAIR

MOUNT SINAI HOSPITAL

Locations

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Grandview Medical Center

Birmingham, Alabama, United States

Site Status

Dignity Health Mercy Gilbert Medical Center

Chandler, Arizona, United States

Site Status

Pacific Heart Institute / St. John's Health Center

Los Angeles, California, United States

Site Status

Medstar Heart and Vascular Institute - Washington Hospital Center

Washington D.C., District of Columbia, United States

Site Status

St. Vincent's Medical Center

Jacksonville, Florida, United States

Site Status

Piedmont Heart Institute

Atlanta, Georgia, United States

Site Status

Wellstar Kennestone

Marietta, Georgia, United States

Site Status

Baptist Health Lexington

Lexington, Kentucky, United States

Site Status

MedStar Union Memorial Hospital

Baltimore, Maryland, United States

Site Status

Marquette General Hospital

Marquette, Michigan, United States

Site Status

Munson Medical Center

Traverse City, Michigan, United States

Site Status

Cardiology Associates Research, LLC

Tupelo, Mississippi, United States

Site Status

Northwell Health

Bay Shore, New York, United States

Site Status

New York University- NYU Langone Cardiac

New York, New York, United States

Site Status

New York University

New York, New York, United States

Site Status

Icahn School of Medicine at Mount Sinai

New York, New York, United States

Site Status

Ohio State University

Columbus, Ohio, United States

Site Status

UPMC Pinnacle Health Cardiovascular Institute

Harrisburg, Pennsylvania, United States

Site Status

Texas Cardiac Arrhythmia Research Foundation

Austin, Texas, United States

Site Status

Baylor Scott & White All Saints Medical Center

Fort Worth, Texas, United States

Site Status

Heart Hospital Baylor Plano (Baylor Research Institute)

Plano, Texas, United States

Site Status

Christus Trinity Clinic Research

Tyler, Texas, United States

Site Status

Virginia Commonwealth University

Richmond, Virginia, United States

Site Status

Monash Health

Melbourne, , Australia

Site Status

St. Vincent's Hospital

Sydney, , Australia

Site Status

Countries

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United States Australia

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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CHX_IP014

Identifier Type: -

Identifier Source: org_study_id

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