Transatrial Pericardial Separation to Enhance Safety of Subxiphoid Pericardial Access for Left Atrial Appendage Ligation

NCT ID: NCT06584370

Last Updated: 2024-09-04

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

COMPLETED

Clinical Phase

NA

Total Enrollment

13 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-05-31

Study Completion Date

2015-08-31

Brief Summary

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We use a tiny catheter through the heart to separate the pericardium with gas. We expect this to improve the safety of the Lariat procedure.

Detailed Description

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The Lariat suture device enables non-surgical exclusion of the left atrial appendage possibly to prevent thromboembolism and stroke in patients with atrial fibrillation. Subxiphoid needle access to the pericardium (a standard approach to enter the pericardial space surrounding the heart using a needle underneath the breastbone) during Lariat risks injury to the heart surface that requires surgical repair.

In this protocol the investigators propose test a new method to increase the safety of needle access to the pericardium. Before needle access, the investigators introduce a separate tiny catheter into the pericardium from inside the heart through a tiny hole. The investigators then inject gas to push the heart away from the pericardial needle. This reduces the risk of injuring the heart during the standard Lariat procedure.

Conditions

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Atrial Fibrillation Left Atrial Appendage Ligation Pericardium Epicardial Mapping Heart Atria Cardiac Surgical Procedures Cardiac Catheterization Pneumopericardium Left Atrial Appendage Occlusion

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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Pericardial insufflation with CO2

Intentional transatrial introduction of a microcatheter to insufflate the pericardium with carbon dioxide, to separate the walls of the pericardium

Group Type EXPERIMENTAL

Pericardial insufflation with carbon dioxide through a transatrial microcatheter

Intervention Type PROCEDURE

Separate the walls of the pericardium by insufflating the pericardial space with carbon dioide.

Interventions

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Pericardial insufflation with carbon dioxide through a transatrial microcatheter

Separate the walls of the pericardium by insufflating the pericardial space with carbon dioide.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Undergoing subxiphoid access to the "empty" pericardial space as part of a Lariat left atrial appendage exclusion procedure
* Age ≥ 21 years

Exclusion Criteria

• Does not consent to participate
Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Henry Ford Health System

OTHER

Sponsor Role lead

Responsible Party

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Adam Greenbaum

Co-Director, Structural Heart Disease Program

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Henry Ford Health System

Detroit, Michigan, United States

Site Status

Countries

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United States

References

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Cohn WE, Winkler JA, Tuzun E, Hjelle A, Bassett K, Ahmad A, Frazier OH. Contrast pericardiography facilitates intrapericardial navigation under fluoroscopy. Ann Thorac Surg. 2010 Nov;90(5):1537-40. doi: 10.1016/j.athoracsur.2010.06.025.

Reference Type BACKGROUND
PMID: 20971258 (View on PubMed)

Rogers T, Ratnayaka K, Schenke WH, Faranesh AZ, Mazal JR, O'Neill WW, Greenbaum AB, Lederman RJ. Intentional right atrial exit for microcatheter infusion of pericardial carbon dioxide or iodinated contrast to facilitate sub-xiphoid access. Catheter Cardiovasc Interv. 2015 Aug;86(2):E111-8. doi: 10.1002/ccd.25698. Epub 2014 Oct 28.

Reference Type RESULT
PMID: 25315516 (View on PubMed)

Other Identifiers

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8874

Identifier Type: -

Identifier Source: org_study_id

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