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Demonstrate the safety and performance of the Zenith LAA Occlusion System and procedure to occlude the Left Atrial Appendage (LAA) from the left atrium (LA) using a minimally invasive technique.
Indication - LAA closure in patients with non-valvular atrial fibrillation, with an ostial diameter between 18 mm and 26 mm
The study objective is to demonstrate the safety and performance of the Zenith LAA Occlusion System and procedure to occlude the Left Atrial Appendage (LAA) from the left atrium (LA) using a minimally invasive technique.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Zenith LAA Occlusion System | Experimental | Zenith LAA Occlusion System Implantation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Zenith LAA Occlusion System | Device | LAA closure in patients with non-valvular atrial fibrillation, with an ostial diameter between 17 mm and 25 mm |
|
| Measure | Description | Time Frame |
|---|---|---|
| Procedural success | Acute procedural success is defined as the delivery and release of the Zenith LAA Occlusion System in the target location (LAA) without any device or procedure related serious adverse events until the post-procedure discharge or 72 hours (whichever comes first) | 72 hours |
| Mechanical device closure | Mechanical device closure - residual jet around the device ≤5 mm at 45 days by TOE | 45 days |
| Measure | Description | Time Frame |
|---|---|---|
| Device related thrombus | LAAO device-related thrombus as assessed by TOE at 45 days and by CCTA at 12 months | 45 days and 12 months |
| SAE | All SAEs device and/or procedure-related post-procedure and to the end of the study |
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Inclusion Criteria:
Exclusion Criteria:
Within 30 days before the procedure date:
Exhibited NYHA class III or IV heart failure symptoms
Known bleeding disorders (such as bleeding diathesis, thrombocytopenia [platelet count <100 X 109/L], severe anaemia [haemoglobin of <8 g/dL], or INR >2 [spontaneous])
Within 90 days before the procedure date:
Documented history of myocardial infarction or unstable angina
Documented embolic stroke, TIA or suspected neurologic event
Chronic renal insufficiency (eGFR ≤15mL/min per 1.73 m2 (CKD-EPI)) or end-stage renal disease
Requires long-term oral anticoagulation therapy for a condition other than AF
Diagnosed active local or systemic infection, septicaemia, active pericarditis, or fever of unknown origin
Known acquired or inherited propensity for forming blood clots (e.g., malignancy and factor V Leiden mutation) established by prior objective testing
Contraindication to the standard of care post-implantation antithrombotic medication regime (e.g., dual antiplatelet therapy (DAPT)/direct oral anticoagulant (DOAC)
Rheumatic heart disease
Implanted mechanical valve prosthesis
Documented carotid disease, defined as greater than 70% stenosis without symptoms or greater than 50% stenosis with symptoms
Body mass index greater than 40 kg/m2
Patient is pregnant or breastfeeding or plans/desires to get pregnant within the next 12 months post-procedure
Current or planned enrolment in an investigation or study of an investigational device or investigational drug that would interfere with this study and the required follow-up
Mental impairment or other psychiatric conditions which may not allow the patient to understand the nature, significance, and scope of the study
Any other criteria (including physical and mental health), medical illness, or comorbidity which would make the subject unsuitable to participate in this study as determined by the clinical site principal investigator
Patients with known allergy or sensitivity to nitinol (nickel and titanium) or any of the other materials in the Zenith LAA Occlusion System Implant
Life expectancy of less than 1 year
Inability, unwillingness, or contraindication to undergo Trans-Oesophageal and/or Trans-Thoracic Echocardiogram (TOE/TTE) or Cardiac Computed Tomography Angiography (CCTA) imaging or any catheterisation procedures
Any anatomical condition that precludes the patient from undergoing LAA occlusion with the AuriGen Zenith LAA Occlusion System implant procedure, as determined by the principal investigator
Imaging Exclusion Criteria:
Patients with a maximal ostial left atrial appendage diameter >25 mm or <17 mm by pre-procedural ECG-gated CT scan, to fit the Zenith LAA Occlusion System
Patients where CCTA analysis suggests that the Zenith LAA Occlusion System may not be suitable
Intracardiac thrombus diagnosed by CCTA or echocardiography
Previous occlusion/ligation of the LAA (by any surgical or percutaneous method)
Documented presence of implanted closure devices (e.g. Atrial septal defect (ASD), Patent foramen ovale (PFO) or Ventricular septal defect (VSD) device) for congenital defect treatment
Documented Left Ventricular Ejection Fraction (LVEF) <30%
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Nuwani Edirisinghe | Contact | +447581155987 | nuwani.edirisinghe@aurigenmedical.com | |
| John Thompson | Contact | +353 863525057 | john.thompson@aurigenmedical.com |
| Name | Affiliation | Role |
|---|---|---|
| Felix Mahfoud | Internal Medicine and Cardiology, Saarland University Hospital | Principal Investigator |
| Christian Ukena | Saarland University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Royal Melbourne Hospital | Not yet recruiting | Parkville | Victoria | 3050 | Australia |
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| ID | Term |
|---|---|
| D001281 | Atrial Fibrillation |
| D020521 | Stroke |
| ID | Term |
|---|---|
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
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Implantation of Zenith LAA Occlusion System
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| through study completion, an average of 1 year |
| Stroke | Ischemic stroke through 12 months | 12 months |
| Thromboembolism | Systemic thromboembolism through 12 months | 12 months |
| Device closure | Mechanical device closure - residual jet around the device ≤5 mm at 6 months (if it is not achieved at 45 Days) | 6 months |
| Device use questionnaire | Use of the Zenith LAA Occlusion System per Device use questionnaire (Operator) | up to 24 hours |
| Changes in Quality of Life score according to SF-12 questionnaire | Patient-reported health quality at Baseline, 45 days, 6 months, and 12 months | Baseline, 45 days, 6 months and 12 months |
| Sandeep Panikker |
| University Hospitals Coventry & Warwickshire NHS Trust |
| Principal Investigator |
| Auckland City Hospital | Recruiting | Auckland | New Zealand |
|
| Christchurch Hospital | Recruiting | Christchurch | New Zealand |
|
| D013568 |
| Pathological Conditions, Signs and Symptoms |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |