Left Atrial Appendage Closure With WATCHMAN FLX Device in Recurrent Gastrointestinal Bleeding: The GI-FLX Registry

NCT ID: NCT06052358

Last Updated: 2025-09-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Total Enrollment

73 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-08-23

Study Completion Date

2025-06-11

Brief Summary

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The GI-FLX Registry is intended to create a registry of patients with a history of Atrial Fibrillation (AF) and Gastrointestinal (GI) bleed who will receive Left Atrial Appendage Closure (LAAC) with WATCHMAN FLX device and compare to patients with AF and GI bleed who do not have LAAC. The GI-FLX Registry will be a multi-center, non-randomized registry. Approximately 250 prospective patients will be enrolled at all 4 sites. Historical cohort of 250 patients after propensity score matching with WATCHMAN-FLX arm will be included in the final analysis.

Detailed Description

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A large gap in the literature exists as no prior study has evaluated the outcomes of those with prior GI bleeding undergoing LAAC. Furthermore, patients with prior GI bleed may be on no or minimal antithrombotic therapy prior to LAAC and subsequently require escalation of antithrombotic therapy following LAAC. Long-term outcomes including bleeding events will be most relevant and informative to this potentially high-risk subgroup. Therefore, this is an attempt to create a prospective registry describing outcomes of patients with AF and prior GI bleed undergoing LAAC to provide insight into safety and efficacy and will also compare to a historical cohort of patients with AF and GI bleed without LAAC.

Conditions

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Atrial Fibrillation GI Bleeding

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Patients with a history of AF and GI bleeding who will undergo LAAC

This is group of patients who will undergo LAAC with Watchman FLX device and have a history of AF and GI bleed.

LAAC with Watchman FLX device

Intervention Type DEVICE

LAAC with Watchman FLX device

Patients with a history of AF and GI bleeding without LAAC

This is a historical cohort of patients with AF and recurrent GI bleeding without LAAC.

No interventions assigned to this group

Interventions

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LAAC with Watchman FLX device

LAAC with Watchman FLX device

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* All male and female patients who are \> 18 years of age
* Have Atrial Fibrillation
* Have CHADS2VASc \> 2
* Have history of GI bleeding OR hospital admission that required blood transfusion OR emergency room visit requiring stopping of OAC OR outpatient 2 gm of Hgb drop from baseline, with or without evidence of upper or lower GI bleeding and requiring endoscopic procedure with holding of OAC.
* Ability to understand study procedures and to comply with them for the entire length of the study.

Exclusion Criteria

* Inability or unwillingness of individual to give written informed consent.
* Other indications for OAC like deep vein thrombosis (DVT) or Pulmonary embolism (PE) or mechanical heart valve.
* Patient who is pregnant will be excluded (Pregnancy will be excluded by checking urine beta-HCG).
* Patient not following up with our practice / clinic after the procedure
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Kansas City Heart Rhythm Institute, Overland Park, Kansas

UNKNOWN

Sponsor Role collaborator

Texas Cardiac Arrythmia Institute, Austin, Texas

UNKNOWN

Sponsor Role collaborator

Los Robles Health System, Los Robles, California

UNKNOWN

Sponsor Role collaborator

Centennial Medical Center, Nashville, Tennessee

UNKNOWN

Sponsor Role collaborator

Kansas City Heart Rhythm Research Foundation

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Dhanunjaya Lakkireddy, MD

Role: PRINCIPAL_INVESTIGATOR

Kansas City Heart Rhythm Institute

Locations

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Kansas City Heart Rhythm Institute - Roe Clinic

Overland Park, Kansas, United States

Site Status

Overland Park Regional Medical Center

Overland Park, Kansas, United States

Site Status

Research Medical Center Clinic

Kansas City, Missouri, United States

Site Status

Research Medical Center

Kansas City, Missouri, United States

Site Status

Countries

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United States

References

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Decision Memo for Percutaneous Left Atrial Appendage (LAA) Closure Therapy (CAG- 00445N). Washington, DC: Centers for Medicare & Medicaid Services, 2016. In.

Reference Type BACKGROUND

Holmes DR, Reddy VY, Turi ZG, Doshi SK, Sievert H, Buchbinder M, Mullin CM, Sick P; PROTECT AF Investigators. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet. 2009 Aug 15;374(9689):534-42. doi: 10.1016/S0140-6736(09)61343-X.

Reference Type BACKGROUND
PMID: 19683639 (View on PubMed)

Holmes DR Jr, Kar S, Price MJ, Whisenant B, Sievert H, Doshi SK, Huber K, Reddy VY. Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial fibrillation versus long-term warfarin therapy: the PREVAIL trial. J Am Coll Cardiol. 2014 Jul 8;64(1):1-12. doi: 10.1016/j.jacc.2014.04.029.

Reference Type BACKGROUND
PMID: 24998121 (View on PubMed)

Darden D, Duong T, Du C, Munir MB, Han FT, Reeves R, Saw J, Zeitler EP, Al-Khatib SM, Russo AM, Minges KE, Curtis JP, Freeman JV, Hsu JC. Sex Differences in Procedural Outcomes Among Patients Undergoing Left Atrial Appendage Occlusion: Insights From the NCDR LAAO Registry. JAMA Cardiol. 2021 Nov 1;6(11):1275-1284. doi: 10.1001/jamacardio.2021.3021.

Reference Type BACKGROUND
PMID: 34379072 (View on PubMed)

Other Identifiers

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KCHRRF_GI FLX_0022

Identifier Type: -

Identifier Source: org_study_id

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