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The purpose of the BLOCk-CTI study is to evaluate the safety and effectiveness of the Blazer® Open-Irrigated Ablation Catheter for the treatment of sustained or recurrent type 1 atrial flutter. This study will compare outcomes in patients treated with the Blazer® Open-Irrigated Ablation Catheter to outcomes in patients treated with open-irrigated radiofrequency ablation catheters that have received FDA market approval for the treatment of type 1 atrial flutter.
The BLOCk-CTI study is a prospective, multicenter, single blind, 1:1 randomized study. The study is designed to demonstrate that the safety and effectiveness of the Blazer® Open-Irrigated Ablation Catheter are non-inferior to the safety and effectiveness of the control catheters. In this study, the control catheters are open-irrigated radiofrequency ablation catheters that have received FDA market approval for the treatment of type 1 atrial flutter. (Biosense Webster ThermoCool® ablation catheters (NaviStar™, EZ Steer, or SF) or St. Jude Medical ablation catheters (Therapy™ Cool Path™ or Safire BLU™).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Blazer® Open-Irrigated Ablation Catheter | Experimental | Patients treated with the Blazer® Open-Irrigated Ablation Catheter |
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| Control Catheter | Active Comparator | Patients treated with an open-irrigated radiofrequency ablation catheter that has received FDA market approval for the treatment of type 1 atrial flutter( Biosense Webster ThermoCool® ablation catheters (NaviStar™, EZ Steer, or SF) or St. Jude Medical ablation catheters (Therapy™ Cool Path™ or Safire BLU™), |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Blazer® Open-Irrigated Ablation Catheter | Device | Blazer® Open-Irrigated Ablation Catheter |
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| Measure | Description | Time Frame |
|---|---|---|
| Procedure-related Complication-free Rate | A procedure-related complication is defined as an adverse event that results in death, a life-threatening complication, or a persistent or significant disability/incapacity or required intervention to prevent a permanent impairment of a body function or damage to a body structure. All adverse events related to the investigational or control devices or ablation procedure will be considered procedure-related events. | 7 days post-procedure |
| Acute Success Rate | Acute success is defined as demonstration of bidirectional cavo-tricuspid isthmus block (ie, lack of electrophysiological conduction through the isthmus) 30 minutes after the last radiofrequency application in the cavo-tricuspid isthmus with the investigational or control catheter only. | 30 minutes after the last radiofrequency application in the cavo-tricuspid isthmus |
| Measure | Description | Time Frame |
|---|---|---|
| Chronic Success Rate: All Treated Patients | Chronic success is defined as freedom from recurrence of type 1 atrial flutter at 3-months post-procedure for all treated patients. | 3 months post-procedure |
| Chronic Success Rate: Acute Success Patients |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Tom McElderry, MD | University of Alabama at Birmingham | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Alabama at Birmingham | Birmingham | Alabama | 35294 | United States | ||
| St. Jude Medical Center |
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Subjects were excluded if there were no documented episodes of atrial flutter or inclusion criteria were not met. Roll-in subjects were not randomized.
Subjects were recruited from referring physicians for ablation for type 1 atrial flutter
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| ID | Title | Description |
|---|---|---|
| FG000 | Randomized Blazer® Open-Irrigated Ablation Catheter | Randomized Patients treated with the Blazer® Open-Irrigated Ablation Catheter Blazer® Open-Irrigated Ablation Catheter: Blazer® Open-Irrigated Ablation Catheter |
| FG001 | Randomized Control Catheter |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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Subject was not told by investigator if device used was Investigational or Control. The subject could ask the investigator at end of study at 3 months if they wanted to know which device was used.
| Control Catheter | Device | Open-irrigated radiofrequency ablation catheters that have received FDA market approval for the treatment of type 1 atrial flutter |
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Chronic success is defined as demonstration of acute success and freedom from recurrence of type 1 atrial flutter at 3-months post-procedure. Only randomized patients with acute procedural success will be included in this endpoint.
| 3-months post-procedure |
| Fullerton |
| California |
| 92835 |
| United States |
| Regional Cardiology Associates | Sacramento | California | 95819 | United States |
| Colorado Springs Cardiologist, P.C. | Colorado Springs | Colorado | 80907 | United States |
| Washington Hospital Center | Washington D.C. | District of Columbia | 20010 | United States |
| West Coast Arrhythmia Center | Hudson | Florida | 34667 | United States |
| Tallahassee Memorial Hospital | Tallahassee | Florida | 32308 | United States |
| Emory University Hospital | Atlanta | Georgia | 30308 | United States |
| Georgia Health Sciences University | Augusta | Georgia | 30912 | United States |
| University of Kansas Hospital | Kansas City | Kansas | 66160 | United States |
| Central Baptist Hospital | Lexington | Kentucky | 40503 | United States |
| Brigham and Women's Hospital | Boston | Massachusetts | 02115 | United States |
| Caritas St. Elizabeth's Medical Center | Boston | Massachusetts | 02135 | United States |
| Henry Ford Hospital | Detroit | Michigan | 48202 | United States |
| Nebraska Heart Institute | Lincoln | Nebraska | 68526 | United States |
| Strong Memorial Hospital of the University of Rochester | Rochester | New York | 14642 | United States |
| Moses H. Cone Memorial Hospital | Greensboro | North Carolina | 27401 | United States |
| Cleveland Clinic Foundation | Cleveland | Ohio | 44195 | United States |
| Ohio State University Medical Center | Columbus | Ohio | 43210 | United States |
| Ohio Health Research Institute | Columbus | Ohio | 43214 | United States |
| ProMedica Toledo Hospital | Toledo | Ohio | 43606 | United States |
| Medical University of South Carolina | Charleston | South Carolina | 29403 | United States |
| Texas Cardiac Arrhythmia Research | Austin | Texas | 78705 | United States |
| Hall Garcia Cardiology | Houston | Texas | 77030 | United States |
| Sentara Norfolk General Hospital | Norfolk | Virginia | 23507 | United States |
| Swedish Medical Center | Seattle | Washington | 98133 | United States |
Randomized patients treated with an open-irrigated radiofrequency ablation catheter that has received FDA market approval for the treatment of type 1 atrial flutter Control Catheter: Open-irrigated radiofrequency ablation catheters that have received FDA market approval for the treatment of type 1 atrial flutter |
| FG002 | Roll-in Blazer Open Irrigated Subjects | The use of the Blazer-Open Irrigated Catheter was required after the second study suspension. Previously enrolled subjects prior to suspension were also classified as Roll-in subjects; not counted in endpoint analysis. |
| FG003 | Roll-in Control Catheter | The use of the Control Catheter was optional after the second study suspension in a Roll-in subject. Previously enrolled subjects prior to suspension were also classified as Roll-in subjects; not counted in endpoint analysis. |
| FG004 | Not Randomized to Any Treatment Group Subjects | Five subjects were not Randomized to any treatment group and were not Roll-in subjects. |
| Procedure |
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| 10 Day Follow-up |
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| 3 Month Follow-up |
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| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Randomized Blazer® Open-Irrigated Ablation Catheter | Patients randomized to treatment with the Blazer® Open-Irrigated Ablation Catheter |
| BG001 | Randomized Control Catheter | Patients randomized to treatment with an open-irrigated radiofrequency ablation catheter that has received FDA market approval for the treatment of type 1 atrial flutter Control Catheter: Open-irrigated radiofrequency ablation catheters that have received FDA market approval for the treatment of type 1 atrial flutter |
| BG002 | Roll-In Blazer® Open-Irrigated Ablation Catheter | The use of the Blazer-Open Irrigated Catheter was required after the second study suspension. Previously enrolled subjects prior to suspension were also classified as Roll-in subjects; not counted in endpoint analysis. |
| BG003 | Roll-In Control Catheter | The use of the Control Catheter was optional after the second study suspension in a Roll-in subject. Previously enrolled subjects prior to suspension were also classified as Roll-in subjects; not counted in endpoint analysis |
| BG004 | Not Randomized to Any Treatment Group | Subjects not Randomized to any treatment group and were not Roll-in subjects |
| BG005 | Total | Total of all reporting groups |
| Units | Counts |
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| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
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| Age, Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Procedure-related Complication-free Rate | A procedure-related complication is defined as an adverse event that results in death, a life-threatening complication, or a persistent or significant disability/incapacity or required intervention to prevent a permanent impairment of a body function or damage to a body structure. All adverse events related to the investigational or control devices or ablation procedure will be considered procedure-related events. | The primary outcome analysis is for a further subset of Randomized subjects only who underwent RF ablation; 220 subjects out of the total 302 subjects. All is consistent with the approved statistical analysis plan and information publicly available in the FDA Summary of Safety and Effectiveness Data (SSED) and BSC labeling, the Directions for Use. | Posted | Number | percentage of subjects | 7 days post-procedure |
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| Primary | Acute Success Rate | Acute success is defined as demonstration of bidirectional cavo-tricuspid isthmus block (ie, lack of electrophysiological conduction through the isthmus) 30 minutes after the last radiofrequency application in the cavo-tricuspid isthmus with the investigational or control catheter only. | The primary outcome analysis is for a further subset of Randomized subjects only who underwent RF ablation; 220 subjects out of the total 302 subjects. All is consistent with the approved statistical analysis plan and information publicly available in the FDA Summary of Safety and Effectiveness Data (SSED) and BSC labeling, the Directions for Use. | Posted | Number | percentage of success | 30 minutes after the last radiofrequency application in the cavo-tricuspid isthmus |
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| Secondary | Chronic Success Rate: All Treated Patients | Chronic success is defined as freedom from recurrence of type 1 atrial flutter at 3-months post-procedure for all treated patients. | The secondary outcome analysis is for a subset of Randomized subjects only who underwent RF ablation; 220 subjects out of the total 302 subjects. All is consistent with the approved statistical analysis plan and information publicly available in the FDA Summary of Safety and Effectiveness Data (SSED) and BSC labeling, the Directions for Use. | Posted | Number | percentage of subjects | 3 months post-procedure |
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| Secondary | Chronic Success Rate: Acute Success Patients | Chronic success is defined as demonstration of acute success and freedom from recurrence of type 1 atrial flutter at 3-months post-procedure. Only randomized patients with acute procedural success will be included in this endpoint. | The secondary outcome analysis is for a further subset of Randomized subjects only who underwent RF ablation and classified as acute success; 194 of the total 302 subjects. All consistent with approved statistical analysis plan and information publicly available in the FDA SSED and BSC the Directions for Use. | Posted | Number | percentage of chronic success | 3-months post-procedure |
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Within 3 months of the index RF ablation procedure
Only subjects at risk for adverse events, (Randomized and Roll-in for the Blazer Open-irrigated catheter and the Control Catheters) are included in the calculation of the adverse event rate. The calculation of the adverse event rate does NOT include the five Non-randomized subjects who were NOT treated with either the Blazer Open-irrigated catheter or the Control Catheter.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Randomized Blazer® Open-Irrigated Ablation Catheter | Randomized patients treated with the Blazer® Open-Irrigated Ablation Catheter (procedure patients) Blazer® Open-Irrigated Ablation Catheter: Blazer® Open-Irrigated Ablation Catheter Note that only subjects at risk for an adverse event (treated subjects) are included in the calculation of the adverse event rates | 1 | 125 | 7 | 109 | 50 | 109 |
| EG001 | Randomized Control Catheter | Randomized patients treated with an open-irrigated radiofrequency ablation catheter that has received FDA market approval for the treatment of type 1 atrial flutter (procedure patients) Control Catheter: Open-irrigated radiofrequency ablation catheters that have received FDA market approval for the treatment of type 1 atrial flutter Note that only subjects at risk for an adverse event (treated subjects) are included in the calculation of the adverse event rates | 0 | 125 | 2 | 111 | 61 | 111 |
| EG002 | Roll-in Blazer® Open-Irrigated Ablation Catheter | Roll-in patients treated with the Blazer® Open-Irrigated Ablation Catheter (procedure patients) Blazer® Open-Irrigated Ablation Catheter: Blazer® Open-Irrigated Ablation Catheter Note that only subjects at risk for an adverse event (treated subjects) are included in the calculation of the adverse event rates | 0 | 30 | 5 | 28 | 16 | 28 |
| EG003 | Roll-in Control Catheter | Roll-in patients treated with an open-irrigated radiofrequency ablation catheter that has received FDA market approval for the treatment of type 1 atrial flutter (procedure patients) Control Catheter: Open-irrigated radiofrequency ablation catheters that have received FDA market approval for the treatment of type 1 atrial flutter Note that only subjects at risk for an adverse event (treated subjects) are included in the calculation of the adverse event rates | 0 | 17 | 2 | 12 | 7 | 12 |
| EG004 | Non-Randomized to Any Treatment Group | Five subjects were not randomized to any treatment group and were not Roll-in subjects. Therefore, these five subjects were not treated with the Blazer Open-irrigated catheter or a Control catheter. Note that only subjects at risk for an adverse event (treated subjects) are included in the calculation of the adverse event rates | 0 | 5 | 0 | 5 | 0 | 5 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Cardiovascular Accident (CVA) Resulting in Death | Nervous system disorders | CVA | Systematic Assessment | Cardiovascular Accident (CVA) Resulting in Death |
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| Hypotension | Cardiac disorders | Hypotension | Systematic Assessment | Hypotension |
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| Congestive Heart Failure | Cardiac disorders | CHF | Systematic Assessment | Congestive Heart Failure |
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| Vasovagal Reaction | Nervous system disorders | Vasovagal Reaction | Systematic Assessment | syncope |
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| Junctional Rhythm | Cardiac disorders | conduction disorder | Systematic Assessment | Junctional Rhythm Requiring Pacemaker Implantation |
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| Pseudoaneurysm with Hematoma | Vascular disorders | Pseudoaneurysm | Systematic Assessment | Pseudoaneurysm with Hematoma |
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| Pseudoaneurysm | Vascular disorders | Pseudoaneurysm | Systematic Assessment | Pseudoaneurysm |
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| Urinary Tract Infection | Infections and infestations | Urinary Tract Infect | Systematic Assessment | Urinary Tract Infection |
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| 3rd Degree Heart Block | Cardiac disorders | Systematic Assessment |
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| Atrial Fibrillation | Cardiac disorders | Systematic Assessment | AF |
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| Chest pain iscemic | Cardiac disorders | Systematic Assessment |
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| Myocardial perforation with tamponade | Cardiac disorders | Systematic Assessment |
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| Nonsustained ventricular tachycardia | Cardiac disorders | Systematic Assessment | NSVT |
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| Sinus Bradycardia | Cardiac disorders | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Ablation related Events | Cardiac disorders | Procedure-related | Systematic Assessment | events related to ablation procedure |
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| Cardiovascular related | Cardiac disorders | Cardiovascular | Systematic Assessment | arrhythmias, chest pain, CVA, symptoms |
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| Non-cardiovascular | General disorders | Non-cardiovascular | Systematic Assessment | Non-cardiovascular |
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Two interim study suspensions occurred during enrollment that did not impact the integrity of the data and subsequent analyses.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Timothy Meyer; Director of Clinical Trials | Boston Scientific | 651 581 3425 | Timothy.meyer@bsci.com |
| ID | Term |
|---|---|
| D001282 | Atrial Flutter |
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Male |
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