Prospective Evaluation of Open Irrigated Ablation Catheters With High Resolution Mapping to Treat Paroxysmal Atrial Fibrillation

Paroxysmal Atrial Fibrillation Clinical Trial

— INTERRUPT AF  

Official title:

Prospective Evaluation of Open Irrigated Ablation Catheters With High Resolution Mapping to Treat Paroxysmal Atrial Fibrillation

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT03729830
• Other study ID #: 92249986
• Status: Active, not recruiting
• Start date: March 4, 2019
• Est. completion date: December 2026

Study information

• Verified date: April 2024
• Source: Boston Scientific Corporation
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

To obtain data for the Rhythmia™ Mapping System in conjunction with Boston Scientific Open-Irrigated (OI) Catheters for ablation of Paroxysmal Atrial Fibrillation (PAF) according to current international and local guidelines.

Primary objective: To assess acute and long-term outcomes for the Rhythmia Mapping System in conjunction with Boston Scientific Open-Irrigated Ablation Catheters to treat de novo Paroxysmal Atrial Fibrillation. De Novo PAF is defined as subjects undergoing first ablation procedure for PAF with no prior left atrial ablation (RF, Cryo, Surgical).

Description:

STUDY OBJECTIVE(S) -- To obtain data for the Rhythmia™ Mapping System in conjunction with Boston Scientific Open-Irrigated (OI) Catheters for ablation of Paroxysmal Atrial Fibrillation (PAF) according to current international and local guidelines.

PRIMARY OBJECTIVE -- To assess acute and long-term outcomes for the Rhythmia Mapping System in conjunction with Boston Scientific Open-Irrigated Ablation Catheters to treat de novo Paroxysmal Atrial Fibrillation. De Novo PAF is defined as subjects undergoing first ablation procedure for PAF with no prior left atrial ablation (RF, Cryo, Surgical).

INDICATION(S) FOR USE -- Study devices will be used per approved Indications for Use for each geography.

DEVICES / SYSTEM USED IN THE STUDY -- The study will include the following Boston Scientific Open-Irrigated Catheters in geographies where commercially approved for PAF ablation:

• Blazer Open-Irrigated Ablation Catheter

• IntellaNav Open-Irrigated Ablation Catheter

• IntellaNav MiFi Open-Irrigated Ablation Catheter

• IntellaTip MiFi Open-Irrigated Ablation Catheter

• Rhythmia Mapping System Gen 1or Rhythmia HDx, equipped with Software 1.4 or any successive commercially approved versions.

• IntellaMap Orion Catheter

CONTROL DEVICE -- There are no control devices in this study

STUDY DESIGN -- Prospective, non-randomized, multicenter (global), post approval clinical study (PAS). All subjects fitting the enrollment criteria, signing the consent and undergoing the index procedure with the study devices will be followed up for three years to complete the PAS design mandated from the FDA to collect post-market data for Boston Scientific Open-Irrigated Catheters and will be followed for three years.

PLANNED NUMBER OF SUBJECTS -- The study will enroll 415 subjects.

PLANNED NUMBER OF SITES / COUNTRIES -- The study is global (US, EU, Asia-Pacific) with 25-50 centers. A minimum of 50% of the sites will be selected from the US. No study site will be allowed to contribute more than 41 subjects (10% of the 415 enrollments requirement).

FOLLOW-UP SCHEDULE -- Study Follow-ups are at: pre-discharge, 1 month (phone check), 3 months (blanking period), 6 months (phone check), 12 months, 24 months and 36 months.

STUDY DURATION -- Study is expected to be completed in approximately five years (12-24 month enrollment period with three year follow-up).

PARTICIPANT DURATION -- The study duration for each subject is expected to be approximately three years.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 415
• Est. completion date: December 2026
• Est. primary completion date: December 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 20 Years and older

Eligibility

Inclusion Criteria:

1. History of recurrent symptomatic Paroxysmal Atrial Fibrillation, defined as AFib that terminates spontaneously or with intervention within seven days of onset. Minimum documentation includes a physician's note indicating recurrent self-terminating Atrial Fibrillation AND one electrocardiographically documented AF episode within 6 months prior to enrollment.

2. Subjects who are eligible for an ablation procedure for Paroxysmal Atrial Fibrillation with the Rhythmia Mapping system according to current international and local guidelines

3. Subjects who are eligible for an ablation procedure for Paroxysmal Atrial Fibrillation with a Boston Scientific Open-Irrigated Ablation Catheter according to current international and local guidelines

4. Subjects who are willing and capable of providing informed consent

5. Subjects who are willing and capable of participating in all testing associated with this clinical investigation at an approved clinical investigational center

6. Subjects whose age is 20 years or above, or who are of legal age to give informed consent specific to state and national law.

Exclusion Criteria:

1. Subjects enrolled in any other concurrent clinical study, with the exception of local mandatory governmental registries and observational studies/registries, without the written approval from Boston Scientific

2. Subjects unable or unwilling to complete follow-up visits and examination for the duration of the study

3. Subjects who have undergone any previous left atrial cardiac ablation (RF, Cryo, surgical)

4. Subjects who have undergone any cardiac ablation within 30 days prior to enrollment

5. Unrecovered/unresolved Adverse Events from any previous invasive procedure

6. Life expectancy <= three years per physician opinion

7. Women of childbearing potential who are, or plan to become, pregnant during the time of the study (method of assessment upon physician's discretion)

8. Known cardiac thrombus within 60 days prior to enrollment

9. History of CVA, TIA or PE within 90 days prior to enrollment

10. Implanted pacemaker, ICD, or CRT leads within 90 days prior to enrollment

11. Implanted Left atrial appendage closure device prior to the index procedure

12. Prosthetic mitral or tricuspid heart valves (subjects with successful mitral valve repair allowed- annular ring constitutes repair)

13. Left atrial diameter greater than 5.5cm

14. Documented or suspected stenosis of any pulmonary veins.

15. Atrial fibrillation secondary to electrolyte imbalance, thyroid disease, or reversible or non-cardiac cause.

16. Contraindication for anticoagulation

17. Clinically significant mitral valve regurgitation or stenosis per investigator discretion.

18. Any cardiac surgery = 90 days from consent date.

19. Any electrocardiographically documented episode of Persistent AFib, defined as AFib lasting longer than 7 days from onset.

Related Conditions & MeSH terms

• Atrial Fibrillation
• Paroxysmal Atrial Fibrillation

Intervention

Device:
• Boston Scientific Open Irrigated Ablation Catheters
The BSC Open-Irrigated catheters are designed to deliver RF energy to catheter tip electrode for cardiac ablation. The BSC OI catheters incorporate an open-irrigated cooling mechanism through a tip that is partitioned into two chambers. The proximal chamber circulates normal saline (0.9 %) within the tip to cool the proximal electrode and mitigate overheating while the distal chamber allows the fluid to flow through six irrigation holes into the patient's vasculature, thereby cooling the tip/tissue interface.

Locations

Country	Name	City	State
Germany	Juedisches Krankenhaus Berlin	Berlin-Mitte
Germany	Staedtisches Klinikum Karlsruhe	Karlsruhe
Japan	Kokura Memorial Hospital	Fukuoka-ken
Japan	Yokosuka Kyosai Hospital	Kanagawa Prefecture
Korea, Republic of	Keimyung University Dongsan Medical Center	Daegu
Korea, Republic of	Korea University Medical Center	Seoul
Monaco	Centre Hospitalier Princesse Grace	Monaco
United Kingdom	Papworth Hospital	Cambridge
United States	Lehigh Valley Hospital	Allentown	Pennsylvania
United States	HeartPlace Mid-Cities EP	Bedford	Texas
United States	University of Alabama at Birmingham	Birmingham	Alabama
United States	St. Lukes Idaho Cardiology Associates	Boise	Idaho
United States	Kaleida Health	Buffalo	New York
United States	University of Chicago Hospital	Chicago	Illinois
United States	Bethesda North Hospital	Cincinnati	Ohio
United States	Cleveland Clinic Foundation	Cleveland	Ohio
United States	University of Iowa Hospitals and Clinics	Iowa City	Iowa
United States	Dartmouth Hitchcock Medical Center	Lebanon	New Hampshire
United States	Nebraska Heart Institute	Lincoln	Nebraska
United States	Catholic Medical Center	Manchester	New Hampshire
United States	Broward General Medical Center	Miami	Florida
United States	AdventHealth Orlando	Orlando	Florida
United States	Orion Medical	Pasadena	Texas
United States	St. John's Hospital	Springfield	Illinois
United States	Torrance Memorial Medical Center	Torrance	California
United States	Christus Trinity Mother Frances Health System	Tyler	Texas

Sponsors (1)

Lead Sponsor	Collaborator
Boston Scientific Corporation

Countries where clinical trial is conducted

United States,  Germany,  Japan,  Korea, Republic of,  Monaco,  United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Safety event-free rate	The primary safety endpoint is defined as the safety event-free rate at 12 months post-procedure.; Primary safety events will consist of a composite of acute primary safety events (events occurring within seven days post-procedure or hospital discharge, whichever is later), and chronic primary safety events (events occurring through 3 or 12 months post-procedure).	12 months
Primary	Event Free Rate (Primary)	The primary effectiveness endpoint is defined as the event-free rate at 12 months post-procedure.; Primary effectiveness events are defined as: Acute procedural failure; More than one repeat procedure during the blanking period (90 days post index procedure); Documented atrial fibrillation, or new onset of atrial flutter or atrial tachycardia event (= 30 seconds in duration from an event monitor or Holter, or from a 10 second 12-lead EKG) between 91 days and 365 days post index procedure; Any of the following interventions for atrial fibrillation, or new onset of atrial flutter or atrial tachycardia between 91 days and 365 days post index procedure: Repeat procedure; Cardioversion; Prescribed any AAD*; AADs for endpoint will consist of all Class I/III and any Class II/IV medications taken for control of AF/AT/AFL recurrence	12 Months
Secondary	Event Free Rate (Secondary)	The secondary effectiveness endpoint is defined as the event-free at 12 months post-procedure.; Secondary effectiveness events are defined as: Acute procedural failure; More than one repeat procedure during the blanking period (90 days post index procedure); Documented symptomatic atrial fibrillation, or new onset of atrial flutter or atrial tachycardia event (= 30 seconds in duration from an event monitor or Holter, or from a 10 second 12-lead EKG) between 91 days and 365 days post index procedure; Any of the following interventions for atrial fibrillation, or new onset of atrial flutter or atrial tachycardia between 91 days and 365 days post index procedure: Repeat procedure; Cardioversion; Prescribed a higher dose of any AAD* documented at baseline; Prescribed a new AAD* not documented at baseline; AADs for endpoint will consist of all Class I/III and any Class II/IV medications taken for control of AF/AT/AFL recurrence	12 Months