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AtriCure CryoICE Lesions for Persistent and Long-standing Persistent Atrial Fibrillation Treatment (ICE-AFIB)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
ClinicalTrials.gov Identifier: NCT03732794
Recruitment Status : Recruiting
First Posted : November 7, 2018
Last Update Posted : June 4, 2019
Sponsor:
Information provided by (Responsible Party):
AtriCure, Inc.

Brief Summary:
The primary objective of this study is to evaluate the safety and effectiveness of the AtriCure CryoICE system in performing the Cox-Maze III lesion set, in conjunction with LAA exclusion using the AtriClip device.

Condition or disease Intervention/treatment Phase
Atrial Fibrillation Persistent Atrial Fibrillation Longstanding Persistent Atrial Fibrillation Device: AtriCure CryoICE & AtriClip LAA Exclusion Not Applicable

Detailed Description:

The AtriCure CryoICE Ablation System is being studied to ablate cardiac tissue during surgery for the treatment of Persistent and Long-standing Persistent atrial fibrillation in open concomitant cardiac surgery.

The effectiveness of the device will be demonstrated by establishing that the device effectively eliminates persistent and long-standing persistent atrial fibrillation in a clinically significant proportion of treated patients.


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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 150 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: AtriCure CryoICE Lesions for Persistent and Long-standing Persistent Atrial Fibrillation Treatment During Concomitant On-Pump Endo/Epicardial Cardiac Surgery
Actual Study Start Date : January 30, 2019
Estimated Primary Completion Date : July 2020
Estimated Study Completion Date : July 2023

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: AtriCure CryoICE & AtriClip LAA Exclusion
AtriCure CryoICE system performing the Cox-Maze III lesion set, in conjunction with LAA exclusion using the AtriClip device.
Device: AtriCure CryoICE & AtriClip LAA Exclusion
AtriCure CryoICE system in performing the Cox-Maze III lesion set, in conjunction with LAA exclusion using the AtriClip device.




Primary Outcome Measures :
  1. Primary Effectiveness Endpoint: Freedom from AF/AFL/AT [ Time Frame: 12 months ]
    Freedom from AF/AFL/AT lasting >30 seconds in duration 12-months following the ablation procedure in the absence of Class I or III AADs.

  2. Safety Endpoint: composite acute major adverse event (MAE) rate [ Time Frame: 30 days ]
    The composite acute major adverse event (MAE) rate, within 30-days post-procedure and deaths after 30-days if death is procedure related.


Secondary Outcome Measures :
  1. Composite post-procedure MAE rate (Safety). [ Time Frame: 12 months ]
    Long-term safety based on MAE rate at 12-months post-procedure

  2. Pacemaker implantation (Safety). [ Time Frame: 12 months ]
    Percentage of implantation of a permanent pacemaker either in the operative period (<30 days postoperative) or at any time during follow-up period.

  3. Overall SAE rate (Safety) [ Time Frame: 12 months ]
    Long-term safety based on SAE rate at 12-months post-procedure

  4. Freedom from AF/AFL/AT in presence of previously failed Class I or III AADs (Effectiveness) [ Time Frame: 12 months ]
    Freedom from AF/AFL/AT lasting >30 seconds in duration 12-months following the ablation procedure in presence of previously failed Class I or III AADs.

  5. Freedom from AF/AFL/AT regardless of Class I or III AADs (Effectiveness) [ Time Frame: 12 months ]
    Freedom from AF/AFL/AT lasting >30 seconds in duration 12-months following the ablation procedure regardless of Class I or III AADs.

  6. AFEQT QoL Score (Effectiveness) [ Time Frame: 12 months ]

    Based on composite score (0-100). A score of 0 corresponds to complete disability (or responding "extremely" limited, difficult or bothersome to all questions answered), while a score of 100 corresponds to no disability (or responding "not at all" limited, difficult or bothersome to all questions answered).

    AFEQT Evaluates Health Related Quality of Life (HRQoL) across three domains Symptoms - Four questions specifically targeted to assess AF related symptoms Daily Activities - Eight questions that evaluate daily function in AF patients Treatment Concerns - Six questions that assess AF treatment concerns in patients The overall composite score and domains will be summarized by presenting the means, medians, standard deviations, interquartile ranges, minimum, and maximum


  7. Acute procedural success (Effectiveness) [ Time Frame: Intra-operative period ]
    Absence of AF at end of procedure



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Subject is greater than or equal to 18 years of age
  2. Subject has history of persistent or long-standing persistent atrial fibrillation as defined by the 2017 HRS/EHRA/ECAS Guidelines
  3. Stable Subject that is scheduled to undergo non-emergent cardiac surgical procedure(s) to be performed on cardiopulmonary bypass including open-heart surgery for one or more of the following: Mitral valve repair or replacement, Aortic valve repair or replacement, Tricuspid valve repair or replacement, and Coronary artery bypass procedures
  4. Left Ventricular Ejection Fraction ≥ 30% (determined by echocardiography or cardiac catheterization performed within 60 days of enrollment as documented in patient medical history)
  5. Subject is willing and able to provide written informed consent
  6. Subject has a life expectancy of at least 5 years
  7. Subject is willing and able to return for scheduled follow-up visits.

Exclusion Criteria:

  1. Stand-alone AF without indication(s) for concomitant CABG and/or valve surgery
  2. Previous surgical Maze procedure
  3. Wolff-Parkinson-White syndrome or other Supra-Ventricular arrhythmia, AV nodal reentry
  4. Prior cardiac surgery (Redo)
  5. Subjects requiring surgery other than CABG and/or cardiac valve surgery and/or patent foramen ovale repair, and/or atrial septal defect repair.
  6. Class IV NYHA heart failure symptoms
  7. Prior history of cerebrovascular accident within 6 months or at any time if there is residual neurological deficit
  8. Documented ST elevation MI within the 6 weeks prior to study enrollment
  9. Need for emergent cardiac surgery (i.e. cardiogenic shock)
  10. Known carotid artery stenosis greater than 80%
  11. Documented AF duration of greater than five years
  12. LA diameter >7 cm by TTE
  13. Current diagnosis of active systemic infection
  14. Severe peripheral arterial occlusive disease defined as claudication with minimal exertion
  15. Renal failure requiring dialysis or hepatic failure
  16. A known drug and/or alcohol addiction
  17. Mental impairment or other conditions which may not allow the subject to understand the nature, significance and scope of the study
  18. Pregnancy or desire to get pregnant within 12-months of the study treatment
  19. Preoperative need for an intra-aortic balloon pump or intravenous inotropes
  20. Requires anti-arrhythmic drug therapy for the treatment of a ventricular arrhythmia
  21. Subjects who have been treated with thoracic radiation
  22. Subjects in current chemotherapy
  23. Subjects on long term treatment with oral or injected steroids (not including intermittent use of inhaled steroids for respiratory diseases)
  24. Subjects with known connective tissue disorders
  25. Subjects with known hypertrophic obstructive cardiomyopathy
  26. Subjects with known cold agglutinin

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03732794


Contacts
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Contact: Nfii K Ndikintum, PhD, MBA 513-644-8192 nndikintum@atricure.com
Contact: Maria Rhoades, CCRP, MSN 513-755-4561 mrhoades@atricure.com

Locations
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United States, District of Columbia
Washington Adventist Hospital Recruiting
Washington, District of Columbia, United States, 20912
Contact: Ying Yuan, RN,BSN,MHA    301-891-5612      
Principal Investigator: Niv Ad, MD         
United States, Illinois
Northwestern Medicine Recruiting
Chicago, Illinois, United States, 60611
Contact: Anna Huskin, RN    312-695-4067      
Principal Investigator: Patrick McCarthy, MD         
United States, Indiana
Franciscan Health Recruiting
Indianapolis, Indiana, United States, 46237
Contact: Angela Cainfield, RN    317-893-1916      
Principal Investigator: Marc W Gerdisch, MD         
United States, Maryland
University Of Maryland Recruiting
Baltimore, Maryland, United States, 21201
Contact: Freshta Akbari    410-328-4562      
Principal Investigator: James Gammie, MD         
United States, Michigan
University of Michigan Recruiting
Ann Arbor, Michigan, United States, 48109
Contact: Nicole Shuler, RN    734-232-4297      
Principal Investigator: Matthew Romano, MD         
United States, New York
Mount Sinai Icahn School of Medicine Recruiting
New York, New York, United States, 10029
Contact: Michael Fusilero    212-241-8905      
Principal Investigator: David Adams, MD         
United States, Ohio
Cleveland Clinic Foundation Recruiting
Cleveland, Ohio, United States, 44195
Contact: Tom Callihan    216-444-0379      
Principal Investigator: Marc Gillinov, MD         
United States, West Virginia
West Virginia University Recruiting
Morgantown, West Virginia, United States, 26506
Contact: Chad Glaze    304-598-6092      
Principal Investigator: Vinay Badhwar, MD         
Sponsors and Collaborators
AtriCure, Inc.
Investigators
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Principal Investigator: Niv Ad, MD Washington Adventist Hospital

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Responsible Party: AtriCure, Inc.
ClinicalTrials.gov Identifier: NCT03732794     History of Changes
Other Study ID Numbers: CP2018-1
First Posted: November 7, 2018    Key Record Dates
Last Update Posted: June 4, 2019
Last Verified: November 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: Yes
Device Product Not Approved or Cleared by U.S. FDA: No
Pediatric Postmarket Surveillance of a Device Product: No

Additional relevant MeSH terms:
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Atrial Fibrillation
Arrhythmias, Cardiac
Heart Diseases
Cardiovascular Diseases
Pathologic Processes