| Eligibility |
Inclusion Criteria:
1. Subject with documented Non-Valvular AF, defined as AF (paroxysmal, persistent, or
permanent) in the absence of moderate-to-severe mitral stenosis or a mechanical heart
valve.
2. Subject must be =18 years of age.
3. Subject has a calculated CHA2DS2-VASc score of 2 or greater, denoting a high risk for
stroke or systemic embolism.
4. Subject is recommended for chronic oral anticoagulation therapy (OAC), but is non
eligible or has an appropriate rationale to seek a non-pharmacologic alternative to
chronic OAC
5. Subject deemed appropriate for LAA closure by the Site Heart Team
6. Subject is eligible for the post-procedural antithrombotic regimen per protocol
7. Subject (or legally authorized representative, (where allowed)) has been informed of
the nature of the study, agrees to its provisions, is willing and able to comply with
the protocol-required medications and follow-up visits, and has provided written
informed consent approved by the appropriate Institutional Review Board (IRB) or
Ethics Committee (EC)
Exclusion Criteria:
1. AF single episode or transient or reversible (e.g., secondary thyroid disorders, acute
alcohol intoxication, trauma, recent major surgical procedures)
2. Recent (within 90 days pre-procedure) stroke or transient ischemic attack
3. Subject with history of acute or recent myocardial infarction (MI) or unstable angina
within 90 days
4. Renal insufficiency, defined as estimated glomerular filtration rate (eGFR) <30
mL/min/1.73 m2, or dialysis at the time of screening
5. Active infection with bacteremia
6. Active COVID-19 infection
7. Cardiac tumor
8. Subject with a history of pericarditis, rheumatic heart disease, or severe cardiac
valvular disease
9. Medical condition (other than AF) that mandates chronic oral anticoagulation (e.g.,
history of unprovoked deep vein thrombosis or pulmonary embolism, or mechanical heart
valve)
10. Severe heart failure (New York Heart Association Class III or IV)
11. Documented symptomatic carotid artery disease (>50% diameter stenosis with prior
ipsilateral stroke or TIA) or known asymptomatic carotid artery disease (diameter
stenosis of >70%)
12. Prior cardiac surgery, history of mitral valve replacement or transcatheter mitral
valve intervention, or any mechanical valve implant
13. Previous AF Ablation procedure in the 90 days before the LAMINAR procedure date
14. Need for AF Ablation procedure to be performed less than 90 days from the LAMINAR
procedure
15. Subject with a history of coronary artery bypass graft (CABG) surgery
16. Recent (within 30 days pre-procedure) or planned (within 60 days postprocedure)
cardiac or non-cardiac interventional or surgical procedure
17. Intracardiac thrombus or dense spontaneous echo contrast, as visualized by TEE within
2 days prior to implant
18. Left ventricular ejection fraction (LVEF) <30%
19. Circumferential pericardial effusion >10 mm or symptomatic pericardial effusion, signs
or symptoms of acute or chronic pericarditis, or evidence of tamponade physiology
20. Atrial septal defect that warrants closure
21. High risk patent foramen ovale (PFO), defined as an atrial septal aneurysm (exclusion
>15 mm or length > 15 mm) or large shunt (early [within 3 beats] or substantial
passage of bubbles)
22. Moderate or severe mitral valve stenosis (mitral valve area <1.5 cm2)
23. Complex atheroma with mobile plaque of the aorta
24. Anatomic conditions that would prevent performance of a LAA occlusion procedure (e.g.,
prior atrial septal defect (ASD) or patent foramen ovale (PFO) surgical repair or
implanted closure device, or obliterated or ligated left atrial appendage).
25. Vascular access precluding delivery of implant with catheter-based system
26. Subject with inferior vena cava (IVC) filter that would interfere with Laminar sheath
insertion
27. Patient is unable to undergo general anesthesia
28. Patient has a condition which precludes adequate transesophageal echocardiographic
(TEE) assessment
29. Patient has a known allergy, hypersensitivity or contraindication to aspirin, heparin,
or device materials (e.g., nickel, titanium, gold) or that would preclude any P2Y12
inhibitor therapy (e.g., clopidogrel, ticlopidine, ticagrelor, prasugrel)
30. The patient has contrast sensitivity that cannot be adequately premedicated
31. Bleeding diathesis or coagulopathy
32. Thrombocytopenia (platelet count <75,000 cells/mm3), thrombocytosis (>700,000
cells/mm3), or leukopenia (white blood cell count <3,000 cells/mm3)
33. Pregnant or nursing patients and those who plan pregnancy in the period up to 1 year
following the index procedure. Female patients of childbearing potential must have a
negative pregnancy test (per site standard test) within 7 days prior to index
procedure.
34. Known other medical illness or known history of substance abuse that may cause
non-compliance with the protocol or protocol-specified medication regimen, confound
the data interpretation, or is associated with a life expectancy of less than 2 years
35. Current participation in another investigational drug or device study
36. Vulnerable Patients groups (minors, cognitively impaired persons, prisoners, persons
whose willingness to volunteer could be unduly influenced by the expectation of
benefits associated with participation or of refusal to participate, such as students,
residents, and employees)
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