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Electrical Coupling Information From The RHYTHMIA HDx Mapping System and DIRECTSENSE Technology In The Treatment of Paroxysmal Atrial Fibrillation (LOCALIZE CF) (LOCALIZE CF)

Primary Purpose

Paroxysmal Atrial Fibrillation

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Ablation procedure
Sponsored by
Boston Scientific Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Paroxysmal Atrial Fibrillation

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. History of recurrent, symptomatic, paroxysmal atrial fibrillation (PAF), defined as atrial fibrillation (AF) that terminates spontaneously or with intervention (either procedure or drug therapy) within seven days of onset. Minimum documentation includes at least one AF episode electrocardiographically documented and at least one additional symptomatic recurrence with or without electrocardiographic documentation, within 365 days prior to enrollment.
  2. Subjects who are eligible for an ablation procedure for paroxysmal AF according to international and local guidelines on catheter ablation of AF.
  3. Subjects refractory or intolerant to at least one Beta Blocker, Calcium Channel Blocker, class I or III antiarrhythmic medication taken for the treatment of AF/AT (Atrial Tachycardia)/AFL (Atrial Flutter) or contraindicated to any class I or III antiarrhythmic medications, Beta Blocker or Calcium Channel Blocker.
  4. Subjects who are willing and capable of providing informed consent.
  5. Subjects who are willing and capable of participating in all testing associated with this clinical investigation at an approved clinical investigational center.
  6. Subjects whose age is 18 years or above, or who are of legal age to give informed consent specific to local and national law.

Exclusion Criteria:

  1. Any known contraindication to an AF ablation or anticoagulation
  2. Continuous AF lasting longer than seven days from onset (no episodes within 365 days from enrollment)
  3. History of previous LA ablation or surgical treatment for AF/AT/AFL
  4. AF secondary to electrolyte imbalance, thyroid disease, or reversible or non-cardiac cause
  5. Subjects with life expectancy ≤ 6 months
  6. Structural heart disease, heart conditions, or implanted devices as described below:

    1. Left ventricular ejection fraction < 35% based on the most recent imaging (≤ 180 days prior to enrollment)*
    2. LA diameter > 5.5 cm or LA volume >50 ml/m² indexed based on the most recent imaging (≤ 180 days prior to enrollment)*
    3. Heart failure with New York Heart Association (NYHA) Class III or IV
    4. Previous cardiac surgery (e.g. ventriculotomy or atriotomy, CABG, PTCA, stent procedure) within 90 days prior to enrollment
    5. Implantable cardiac device procedures (e.g. PM, ICD, CRT) within 30 days prior to enrollment
    6. Severe valvular disease or presence of a prosthetic - mechanical or biological - heart valve in the LA (not including valve repair and annular rings)
    7. Severe mitral valve regurgitation or stenosis
    8. Known or pre-existing severe pulmonary vein stenosis
    9. Interatrial baffle, closure device, patch, or patent foramen ovale (PFO) occluder
    10. Presence of LA appendage occlusion device
    11. Presence of any pulmonary vein stents
    12. Unstable angina or ongoing myocardial ischemia
    13. Previous myocardial infarction within 90 days prior to enrollment
    14. Vena cava embolic protection filter devices and/or known femoral thrombus;
    15. Known left atrial thrombus, myxoma, or intracardiac mural thrombus
  7. History of blood clotting or bleeding disease
  8. Any prior history of documented cerebral infarct, TIA, or systemic embolism [excluding a post-operative deep vein thrombosis (DVT)] ≤180 days prior to enrollment
  9. Active systemic infection
  10. Pregnant, lactating (current or anticipated during study follow up), or women of childbearing potential who are, or plan to become, pregnant during the time of the study (method of assessment upon physician's discretion)
  11. Subjects who are currently enrolled in any other concurrent study, with the exception of local mandatory governmental registries and observational studies/registries, without written approval from the sponsor

Sites / Locations

  • Vivantes Klinikum Am Urban
  • Städtisches Klinikum Karlsruhe
  • Casa di Cura Montevergine S.p.A.
  • Centro Cardiologico Monzino
  • Clinica Universidad de Navarra

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

PVI procedure

Arm Description

Subjects will undergo ablation treatment of the pulmonary veins with the Rhythmia HDx mapping system with DirectSense technology. Subjects indicated for ablation treatment of de-novo PAF will be selected based on the inclusion/exclusion criteria and if deemed to be eligible for participation, will be asked to sign the Informed Consent Form. For all enrolled subjects who undergo the ablation procedure, the subjects will be treated with the commercial Rhythmia HDx System with commercially available Software Version 4.0.1 or greater (commercially approved version) with DIRECTSENSE™ and Force Computation Software Module; the IntellaMap Orion mapping catheter and the IntellaNav StablePoint ablation catheter.

Outcomes

Primary Outcome Measures

Association between Local Impedance drop values and PV reconnections
Correlation between local impedance drop collected during the blinded index procedure and sites of late PV reconnection/durable block at 3-months.

Secondary Outcome Measures

Association between Local Impedance drop values and acute PV reconnections
Correlation between local impedance drop collected during the blinded index procedure and sites of acute gaps/block after a 20-minute wait period.

Full Information

First Posted
February 2, 2021
Last Updated
May 10, 2023
Sponsor
Boston Scientific Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT04740801
Brief Title
Electrical Coupling Information From The RHYTHMIA HDx Mapping System and DIRECTSENSE Technology In The Treatment of Paroxysmal Atrial Fibrillation (LOCALIZE CF)
Acronym
LOCALIZE CF
Official Title
Electrical Coupling Information From The RHYTHMIA HDx Mapping System and DIRECTSENSE Technology In The Treatment of Paroxysmal Atrial Fibrillation: A Non-Randomized Prospective Study With Contact Force
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Completed
Study Start Date
June 28, 2021 (Actual)
Primary Completion Date
July 21, 2022 (Actual)
Study Completion Date
September 16, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Boston Scientific Corporation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The objective of this study is to evaluate whether local impedance (DIRECTSENSE™) drop on the INTELLANAV STABLEPOINT™ ablation catheter is associated with late pulmonary vein (PV) reconnections and durable conduction block in patients undergoing de novo PV isolation (PVI) for treatment of paroxysmal atrial fibrillation (PAF).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Paroxysmal Atrial Fibrillation

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
60 (Actual)

8. Arms, Groups, and Interventions

Arm Title
PVI procedure
Arm Type
Other
Arm Description
Subjects will undergo ablation treatment of the pulmonary veins with the Rhythmia HDx mapping system with DirectSense technology. Subjects indicated for ablation treatment of de-novo PAF will be selected based on the inclusion/exclusion criteria and if deemed to be eligible for participation, will be asked to sign the Informed Consent Form. For all enrolled subjects who undergo the ablation procedure, the subjects will be treated with the commercial Rhythmia HDx System with commercially available Software Version 4.0.1 or greater (commercially approved version) with DIRECTSENSE™ and Force Computation Software Module; the IntellaMap Orion mapping catheter and the IntellaNav StablePoint ablation catheter.
Intervention Type
Device
Intervention Name(s)
Ablation procedure
Intervention Description
Catheter ablation of pulmonary veins with the Rhythmia HDx mapping system, IntellaMap Orion mapping catheter and IntellaNav StablePoint ablation catheter
Primary Outcome Measure Information:
Title
Association between Local Impedance drop values and PV reconnections
Description
Correlation between local impedance drop collected during the blinded index procedure and sites of late PV reconnection/durable block at 3-months.
Time Frame
0-3 months
Secondary Outcome Measure Information:
Title
Association between Local Impedance drop values and acute PV reconnections
Description
Correlation between local impedance drop collected during the blinded index procedure and sites of acute gaps/block after a 20-minute wait period.
Time Frame
0-1 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: History of recurrent, symptomatic, paroxysmal atrial fibrillation (PAF), defined as atrial fibrillation (AF) that terminates spontaneously or with intervention (either procedure or drug therapy) within seven days of onset. Minimum documentation includes at least one AF episode electrocardiographically documented and at least one additional symptomatic recurrence with or without electrocardiographic documentation, within 365 days prior to enrollment. Subjects who are eligible for an ablation procedure for paroxysmal AF according to international and local guidelines on catheter ablation of AF. Subjects refractory or intolerant to at least one Beta Blocker, Calcium Channel Blocker, class I or III antiarrhythmic medication taken for the treatment of AF/AT (Atrial Tachycardia)/AFL (Atrial Flutter) or contraindicated to any class I or III antiarrhythmic medications, Beta Blocker or Calcium Channel Blocker. Subjects who are willing and capable of providing informed consent. Subjects who are willing and capable of participating in all testing associated with this clinical investigation at an approved clinical investigational center. Subjects whose age is 18 years or above, or who are of legal age to give informed consent specific to local and national law. Exclusion Criteria: Any known contraindication to an AF ablation or anticoagulation Continuous AF lasting longer than seven days from onset (no episodes within 365 days from enrollment) History of previous LA ablation or surgical treatment for AF/AT/AFL AF secondary to electrolyte imbalance, thyroid disease, or reversible or non-cardiac cause Subjects with life expectancy ≤ 6 months Structural heart disease, heart conditions, or implanted devices as described below: Left ventricular ejection fraction < 35% based on the most recent imaging (≤ 180 days prior to enrollment)* LA diameter > 5.5 cm or LA volume >50 ml/m² indexed based on the most recent imaging (≤ 180 days prior to enrollment)* Heart failure with New York Heart Association (NYHA) Class III or IV Previous cardiac surgery (e.g. ventriculotomy or atriotomy, CABG, PTCA, stent procedure) within 90 days prior to enrollment Implantable cardiac device procedures (e.g. PM, ICD, CRT) within 30 days prior to enrollment Severe valvular disease or presence of a prosthetic - mechanical or biological - heart valve in the LA (not including valve repair and annular rings) Severe mitral valve regurgitation or stenosis Known or pre-existing severe pulmonary vein stenosis Interatrial baffle, closure device, patch, or patent foramen ovale (PFO) occluder Presence of LA appendage occlusion device Presence of any pulmonary vein stents Unstable angina or ongoing myocardial ischemia Previous myocardial infarction within 90 days prior to enrollment Vena cava embolic protection filter devices and/or known femoral thrombus; Known left atrial thrombus, myxoma, or intracardiac mural thrombus History of blood clotting or bleeding disease Any prior history of documented cerebral infarct, TIA, or systemic embolism [excluding a post-operative deep vein thrombosis (DVT)] ≤180 days prior to enrollment Active systemic infection Pregnant, lactating (current or anticipated during study follow up), or women of childbearing potential who are, or plan to become, pregnant during the time of the study (method of assessment upon physician's discretion) Subjects who are currently enrolled in any other concurrent study, with the exception of local mandatory governmental registries and observational studies/registries, without written approval from the sponsor
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ignacio Garcia Bolao, MD
Organizational Affiliation
Clinica Universitaria de Navarra
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Hüseyin Ince, MD
Organizational Affiliation
Vivantes Klinikum am Urban
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Francesco Solimene, MD
Organizational Affiliation
Casa Di Cura 'Montevergine' S.P.A.
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Armin Luik, MD
Organizational Affiliation
Staedtisches Klinikum Karlsruhe
Official's Role
Principal Investigator
Facility Information:
Facility Name
Vivantes Klinikum Am Urban
City
Berlin
ZIP/Postal Code
10967
Country
Germany
Facility Name
Städtisches Klinikum Karlsruhe
City
Karlsruhe
ZIP/Postal Code
76133
Country
Germany
Facility Name
Casa di Cura Montevergine S.p.A.
City
Mercogliano
State/Province
Avellino
ZIP/Postal Code
83013
Country
Italy
Facility Name
Centro Cardiologico Monzino
City
Milano
ZIP/Postal Code
20138
Country
Italy
Facility Name
Clinica Universidad de Navarra
City
Pamplona
ZIP/Postal Code
31008
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
No requests for study data have been made at this time, however Boston's Scientific's policy on data sharing can be found at http:// www.bostonscientific.com/en-US/data-sharing-requests.html

Learn more about this trial

Electrical Coupling Information From The RHYTHMIA HDx Mapping System and DIRECTSENSE Technology In The Treatment of Paroxysmal Atrial Fibrillation (LOCALIZE CF)

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