Safety and Performance of the SpherePVI™ Catheter to Treat Paroxysmal Atrial Fibrillation

Atrial Fibrillation Clinical Trial

— SpherePVI  

Official title:

A Safety and Performance Assessment of the SpherePVI™ Catheter and the Affera Mapping and Ablation System to Treat Paroxysmal Atrial Fibrillation

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05144503
• Other study ID #: CP-00012
• Status: Recruiting
• Phase: N/A
• Start date: July 22, 2021
• Est. completion date: July 22, 2025

Study information

• Verified date: February 2024
• Source: Affera, Inc.
• Contact: Sandra Jacobs
• Phone: +31433566609
• Email: sandra.jacobs[@]medtronic.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

A prospective, single-arm, single-center study to evaluate the safety, performance, and effectiveness of the SpherePVI™ Catheter for treating paroxysmal AF.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 50
• Est. completion date: July 22, 2025
• Est. primary completion date: June 22, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 75 Years

Eligibility

Inclusion Criteria:

1. Symptomatic paroxysmal atrial fibrillation (PAF) documented by:

• A physician's note indicating recurrent, self-terminating AF
• At least two electrocardiographically documented AF episodes within 12 months prior to enrollment

2. Failure or intolerance of at least one Class I-IV anti-arrhythmic drug.

3. Suitable candidate for catheter ablation.

4. Age = 18 and < 75 years.

5. Able and willing to give informed consent.

6. Able and willing, and has ample means to comply with all pre-procedure, post-procedure and follow-up testing requirements

Exclusion Criteria:

1. Continuous AF lasting more than 7 days.

2. AF secondary to electrolyte imbalance, thyroid disease, acute alcohol intoxication, or reversible or non-cardiac cause.

3. Previous left atrial catheter or surgical ablation (including septal closure or left atrial appendage closure).

4. Valvular cardiac surgical/percutaneous procedure (e.g., ventriculotomy, atriotomy, and valve repair or replacement and presence of a prosthetic valve).

5. Any carotid stenting or endarterectomy.

6. Any cardiac procedure (surgical or percutaneous) or percutaneous coronary intervention within 90 days prior to the initial procedure.

7. Coronary artery bypass graft (CABG) procedure within the 6 months prior to the index ablation procedure.

8. Awaiting cardiac transplantation or other cardiac surgery within 12 months following the initial ablation procedure.

9. Presence of any type of implantable cardiac defibrillator (with or without biventricular pacing function).

10. Documented thromboembolic event (stroke or transient ischemic attack) within the past 6 months (180 days).

11. Documented left atrial thrombus on imaging.

12. History of blood clotting or bleeding abnormalities.

13. Any condition contraindicating chronic anticoagulation.

14. Myocardial infarction (MI) within the 3 months (90 days) prior to the initial procedure.

15. Body mass index >40 kg/m2.

16. Left atrial diameter >50 mm (anteroposterior).

17. Diagnosed atrial myxoma.

18. Left ventricular ejection fraction (EF) < 40%.

19. Uncontrolled heart failure or NYHA Class III or IV heart failure.

20. Rheumatic heart disease.

21. Hypertrophic cardiomyopathy.

22. Unstable angina.

23. Moderate to severe mitral valve stenosis.

24. Severe mitral regurgitation (regurgitant volume = 60 mL/beat, regurgitant fraction = 50%, and/or effective regurgitant orifice area = 0.40cm2)

25. Primary pulmonary hypertension.

26. Significant restrictive or obstructive pulmonary disease or chronic respiratory condition.

27. Renal failure requiring dialysis.

28. Acute illness, active systemic infection, or sepsis.

29. Significant congenital anomaly or medical problem that, in the opinion of the investigator, would preclude enrollment in this study or compliance with follow-up requirements or would impact the scientific soundness of the clinical trial results.

30. Any woman known to be pregnant or breastfeeding, or any woman of childbearing potential who is not on a reliable form of birth regulation method or abstinence.

31. Current or anticipated participation in any other clinical trial of a drug, device, or biologic during the duration of the study, unless pre-approved by the Sponsor.

32. Presence of intramural thrombus, tumor, or other abnormality that precludes vascular access, catheter introduction, or manipulation.

33. Known drug or alcohol dependency.

34. Life expectancy less than 12 months.

35. Vulnerable subject.

Related Conditions & MeSH terms

• Atrial Fibrillation

Intervention

Device:
• SpherePVI™ Catheter
SpherePVI™ Catheter with the Affera Mapping and Ablation System

Locations

Country	Name	City	State
Lithuania	Vilnius University Hospital	Vilnius

Sponsors (1)

Lead Sponsor	Collaborator
Affera, Inc.

Country where clinical trial is conducted

Lithuania, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Percentage of subjects experiencing a primary safety event	The primary safety outcome is the incidence of the following serious device-related Primary Adverse Events (AEs): Death (within 7 days); Myocardial infarction (within 7 days); Persistent phrenic nerve palsy (within 7 days); Transient ischemic attack (TIA) (within 7 days); Stroke/cerebrovascular accident (CVA) (within 7 days); Thromboembolism (within 7 days); Major vascular access complications / bleeding (within 7 days); Heart block (within 7 days); Gastroparesis (within 7 days); Severe pericarditis (within 7 days); Pulmonary edema (within 7 days); Hospitalization (initial and prolonged) due to cardiovascular or pulmonary AE (within 7 days); Cardiac tamponade / perforation (within 30 days); Pulmonary vein stenosis (within 180 days); Atrio-esophageal fistula (within 180 days)	Up to 6 months
Primary	Percentage of subjects with acute procedure success	The primary efficacy outcome is acute electrical isolation of all pulmonary veins using the study device	During Procedure
Secondary	Percentage of subjects experiencing a device- or procedure-related SAE	The secondary safety outcome is the incidence of device- or procedure-related SAEs as assessed at each follow-up visit.	12 months
Secondary	Product performance evaluated on a 5-point semi-quantitative scale ("strongly disagree" to "strongly agree")	Acute product performance will be evaluated during the procedure and includes the following: SpherePVI™ Catheter handling sufficient to reach reasonable intended targets, as determined by the physician: catheter delivery to the desired ablation sites; completion of ablation procedure; safe removal of catheter from the subject; Electroanatomical navigation and/or mapping sufficient to aid the procedure (if used); Generation of acceptable acute ablation lesions	During Procedure
Secondary	Percentage of subjects free from documented recurrence outside of the blanking period	Chronic efficacy will be evaluated as freedom from documented arrhythmia recurrence outside of a 90-day blanking period. Failure will be reported as both (i) recurrence of AF and (ii) recurrence of any atrial tachyarrhythmia (AF, atrial tachycardia, or atrial flutter).	12 months
Secondary	Percentage of pulmonary veins remaining isolated at remapping	Chronic efficacy evaluated as the number of pulmonary veins that remain isolated during an optional remapping procedure as	75 days
Secondary	Percentage of patients with all pulmonary veins isolated at remapping	Chronic efficacy evaluated as the number of patients with all pulmonary veins isolated during an optional remapping procedure as	75 days