Trial Outcomes & Findings for Wire Instrumentation Using Radiofrequency Energy to Impact Transseptal Efficiency (NCT NCT04645342)

NCT ID: NCT04645342

Last Updated: 2023-03-14

Results Overview

First transseptal time was recorded for each participant, starting with insertion of the long guidewire into the femoral short sheath (J wire for RF needle group, VersaCross wire for RF wire group) and stopping once the transseptal sheath was positioned in the LA and the dilator and guidewire were fully removed from the long sheath. Median time in minutes to completion of the first transseptal puncture during the cardiac ablation procedure between the RF needle and RF Wire group was compared as the outcome.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

75 participants

Primary outcome timeframe

0-30 minutes (from insertion of guidewire to removal of guidewire of first transseptal)

Results posted on

2023-03-14

Participant Flow

From 11/30/2020 to 2/2/2022, 75 participants were enrolled and randomized in the study.

261 patients were assessed for eligibility; 61 declined to participate, 118 met exclusion criteria, 7 did not enroll for other reasons.

Participant milestones

Participant milestones
Measure
Baylis RF Needle
Device: conventional Baylis radiofrequency needle Baylis RF needle: Baylis radiofrequency needle is used for transseptal puncture during cardiac ablation procedure.
Baylis Versacross RF Wire
Device: Baylis Versacross radiofrequency wire Baylis Versacross RF wire: Baylis Versacross radiofrequency wire is used for transseptal puncture during cardiac ablation procedure.
Overall Study
STARTED
36
39
Overall Study
COMPLETED
36
39
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Wire Instrumentation Using Radiofrequency Energy to Impact Transseptal Efficiency

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Baylis RF Needle
n=36 Participants
Device: conventional Baylis radiofrequency needle Baylis RF needle: Baylis radiofrequency (RF) needle is used for transseptal puncture during cardiac ablation procedure.
Baylis Versacross RF Wire
n=39 Participants
Device: Baylis Versacross radiofrequency wire Baylis Versacross RF wire: Baylis Versacross radiofrequency (RF) wire is used for transseptal puncture during cardiac ablation procedure.
Total
n=75 Participants
Total of all reporting groups
Age, Continuous
64 years
n=5 Participants
61 years
n=7 Participants
63 years
n=5 Participants
Sex: Female, Male
Female
8 Participants
n=5 Participants
10 Participants
n=7 Participants
18 Participants
n=5 Participants
Sex: Female, Male
Male
28 Participants
n=5 Participants
29 Participants
n=7 Participants
57 Participants
n=5 Participants
Race/Ethnicity, Customized
White
26 Participants
n=5 Participants
28 Participants
n=7 Participants
54 Participants
n=5 Participants
Race/Ethnicity, Customized
Black
1 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
5 Participants
n=5 Participants
5 Participants
n=7 Participants
10 Participants
n=5 Participants
Race/Ethnicity, Customized
Other
4 Participants
n=5 Participants
4 Participants
n=7 Participants
8 Participants
n=5 Participants
Height
177 cm
STANDARD_DEVIATION 8 • n=5 Participants
176 cm
STANDARD_DEVIATION 9 • n=7 Participants
176 cm
STANDARD_DEVIATION 14 • n=5 Participants
Weight
86 kg
n=5 Participants
94 kg
n=7 Participants
91 kg
n=5 Participants
Prior transseptal procedure
7 Participants
n=5 Participants
9 Participants
n=7 Participants
16 Participants
n=5 Participants
Paroxysmal atrial fibrillation/flutter
18 Participants
n=5 Participants
16 Participants
n=7 Participants
34 Participants
n=5 Participants
CHA2DS2VASC score
3 scores on a scale (0-9)
n=5 Participants
3 scores on a scale (0-9)
n=7 Participants
3 scores on a scale (0-9)
n=5 Participants
Transvenous pacemaker or defibrillator
3 Participants
n=5 Participants
4 Participants
n=7 Participants
7 Participants
n=5 Participants
Left atrial size by transthoracic echocardiogram (TTE)
Normal
12 Participants
n=5 Participants
16 Participants
n=7 Participants
28 Participants
n=5 Participants
Left atrial size by transthoracic echocardiogram (TTE)
Mild to moderately enlarged
18 Participants
n=5 Participants
16 Participants
n=7 Participants
34 Participants
n=5 Participants
Left atrial size by transthoracic echocardiogram (TTE)
Severely enlarged
6 Participants
n=5 Participants
7 Participants
n=7 Participants
13 Participants
n=5 Participants
Rhythm at time of transseptal
Sinus or atrial paced
21 Participants
n=5 Participants
21 Participants
n=7 Participants
42 Participants
n=5 Participants
Rhythm at time of transseptal
Atrial fibrillation or atrial flutter
15 Participants
n=5 Participants
18 Participants
n=7 Participants
33 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 0-30 minutes (from insertion of guidewire to removal of guidewire of first transseptal)

First transseptal time was recorded for each participant, starting with insertion of the long guidewire into the femoral short sheath (J wire for RF needle group, VersaCross wire for RF wire group) and stopping once the transseptal sheath was positioned in the LA and the dilator and guidewire were fully removed from the long sheath. Median time in minutes to completion of the first transseptal puncture during the cardiac ablation procedure between the RF needle and RF Wire group was compared as the outcome.

Outcome measures

Outcome measures
Measure
Baylis RF Needle
n=36 Participants
Device: conventional Baylis radiofrequency needle Baylis RF needle: Baylis radiofrequency needle is used for transseptal puncture during cardiac ablation procedure.
Baylis Versacross RF Wire
n=39 Participants
Device: Baylis Versacross radiofrequency wire Baylis Versacross RF wire: Baylis Versacross radiofrequency wire is used for transseptal puncture during cardiac ablation procedure.
Time to Achieve First Transseptal Puncture
9.2 minutes
Interval 5.7 to 11.2
6.9 minutes
Interval 5.2 to 8.4

SECONDARY outcome

Timeframe: 0-30 minutes (from insertion of guidewire to removal of guidewire of second transseptal)

Second transseptal time was recorded for each participant, starting with insertion of the long guidewire into the femoral short sheath (J wire for RF needle group, VersaCross wire for RF wire group) and stopping once the transseptal sheath was positioned in the LA and the dilator and guidewire were fully removed from the long sheath. The median time in minutes to completion of the second transseptal puncture during the cardiac ablation procedure between the RF needle and RF Wire group was compared as a secondary outcome. Participants that did not undergo 2 transseptal punctures were not included in this analysis.

Outcome measures

Outcome measures
Measure
Baylis RF Needle
n=30 Participants
Device: conventional Baylis radiofrequency needle Baylis RF needle: Baylis radiofrequency needle is used for transseptal puncture during cardiac ablation procedure.
Baylis Versacross RF Wire
n=35 Participants
Device: Baylis Versacross radiofrequency wire Baylis Versacross RF wire: Baylis Versacross radiofrequency wire is used for transseptal puncture during cardiac ablation procedure.
Time to Achieve Second Transseptal Puncture
8.4 minutes
Interval 5.5 to 13.4
6.0 minutes
Interval 4.9 to 7.8

SECONDARY outcome

Timeframe: 0-60 minutes (summation of first transseptal and second transseptal times)

Combined transseptal time was calculated for each participant by summing up participants' first and second transseptal times. The median combined transseptal time in minutes between the RF needle and RF Wire group was compared as a secondary outcome. Participants that did not undergo two transseptal punctures were not included in this analysis.

Outcome measures

Outcome measures
Measure
Baylis RF Needle
n=30 Participants
Device: conventional Baylis radiofrequency needle Baylis RF needle: Baylis radiofrequency needle is used for transseptal puncture during cardiac ablation procedure.
Baylis Versacross RF Wire
n=35 Participants
Device: Baylis Versacross radiofrequency wire Baylis Versacross RF wire: Baylis Versacross radiofrequency wire is used for transseptal puncture during cardiac ablation procedure.
Combined Transseptal Time
20.5 minutes
Interval 14.0 to 27.7
14.0 minutes
Interval 10.6 to 15.6

SECONDARY outcome

Timeframe: 0-60 minutes (from insertion of guidewire to removal of guidewire of first transseptal and second transseptal)

Population: All participants randomized underwent a first transseptal puncture. 6 patients from the RF needle group and 4 patients in the RF wire group did not undergo a 2nd transseptal puncture.

Fluoroscopy time (amount of time operators used fluoroscopy during a transseptal puncture) was recorded for each participant, starting with insertion of the long guidewire into the femoral short sheath (J wire for RF needle group, VersaCross wire for RF wire group) and stopping once the transseptal sheath was positioned in the LA and the dilator and guidewire were fully removed from the long sheath. Median fluoroscopy time during the first and second transseptal punctures between the RF needle and RF Wire group was compared as a secondary outcome.

Outcome measures

Outcome measures
Measure
Baylis RF Needle
n=36 Participants
Device: conventional Baylis radiofrequency needle Baylis RF needle: Baylis radiofrequency needle is used for transseptal puncture during cardiac ablation procedure.
Baylis Versacross RF Wire
n=39 Participants
Device: Baylis Versacross radiofrequency wire Baylis Versacross RF wire: Baylis Versacross radiofrequency wire is used for transseptal puncture during cardiac ablation procedure.
Fluoroscopy Time
1st Transseptal
2.0 minutes
Interval 1.6 to 3.2
1.8 minutes
Interval 1.3 to 2.2
Fluoroscopy Time
2nd Transseptal
2.4 minutes
Interval 1.6 to 3.5
1.8 minutes
Interval 1.5 to 2.7

SECONDARY outcome

Timeframe: (0-8 hours) duration of cardiac ablation procedure

An equipment exchange was defined as the removal of the J or RF wire from the dilator and sheath assembly before transseptal puncture; all RF needle punctures required at least 1 equipment exchange, although further exchanges could be performed as necessary if the initial pull-down resulted in inadequate positioning of the sheath and dilator and readvancement of the transseptal assembly into the SVC was necessary. The number of equipment exchanges during the cardiac ablation procedure between the RF need and RF wire groups were compared.

Outcome measures

Outcome measures
Measure
Baylis RF Needle
n=36 Participants
Device: conventional Baylis radiofrequency needle Baylis RF needle: Baylis radiofrequency needle is used for transseptal puncture during cardiac ablation procedure.
Baylis Versacross RF Wire
n=39 Participants
Device: Baylis Versacross radiofrequency wire Baylis Versacross RF wire: Baylis Versacross radiofrequency wire is used for transseptal puncture during cardiac ablation procedure.
Number of Participants With Equipment Exchanges
Number of exchanges = 0
0 Participants
37 Participants
Number of Participants With Equipment Exchanges
Number of exchanges = 1
26 Participants
0 Participants
Number of Participants With Equipment Exchanges
Number of exchanges = 2
5 Participants
2 Participants
Number of Participants With Equipment Exchanges
Number of exchanges >= 3
5 Participants
0 Participants

SECONDARY outcome

Timeframe: complications were assessed during the duration of cardiac ablation procedure (up to 8 hours)

The number of participants with complications during the procedure between the RF needle and RF wire groups was compared as a secondary outcome.

Outcome measures

Outcome measures
Measure
Baylis RF Needle
n=36 Participants
Device: conventional Baylis radiofrequency needle Baylis RF needle: Baylis radiofrequency needle is used for transseptal puncture during cardiac ablation procedure.
Baylis Versacross RF Wire
n=39 Participants
Device: Baylis Versacross radiofrequency wire Baylis Versacross RF wire: Baylis Versacross radiofrequency wire is used for transseptal puncture during cardiac ablation procedure.
Complication Rates
1 Participants
0 Participants

Adverse Events

Baylis RF Needle

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Baylis Versacross RF Wire

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Baylis RF Needle
n=36 participants at risk
Device: conventional Baylis radiofrequency needle Baylis RF needle: Baylis radiofrequency needle is used for transseptal puncture during cardiac ablation procedure.
Baylis Versacross RF Wire
n=39 participants at risk
Device: Baylis Versacross radiofrequency wire Baylis Versacross RF wire: Baylis Versacross radiofrequency wire is used for transseptal puncture during cardiac ablation procedure.
Cardiac disorders
Procedure Complications (temporary AV Block)
2.8%
1/36 • Number of events 1 • Adverse event data was collected over 1 year
0.00%
0/39 • Adverse event data was collected over 1 year

Additional Information

Dr. Thomas Dewland

UCSF

Phone: 415-476-5706

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place