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Safety and Performance of the SpherePVI™ Catheter to Treat Paroxysmal Atrial Fibrillation (SpherePVI)

Primary Purpose

Atrial Fibrillation

Status
Recruiting
Phase
Not Applicable
Locations
Lithuania
Study Type
Interventional
Intervention
SpherePVI™ Catheter
Sponsored by
Affera, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Atrial Fibrillation

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Symptomatic paroxysmal atrial fibrillation (PAF) documented by:

    • A physician's note indicating recurrent, self-terminating AF
    • At least two electrocardiographically documented AF episodes within 12 months prior to enrollment
  2. Failure or intolerance of at least one Class I-IV anti-arrhythmic drug.
  3. Suitable candidate for catheter ablation.
  4. Age ≥ 18 and < 75 years.
  5. Able and willing to give informed consent.
  6. Able and willing, and has ample means to comply with all pre-procedure, post-procedure and follow-up testing requirements

Exclusion Criteria:

  1. Continuous AF lasting more than 7 days.
  2. AF secondary to electrolyte imbalance, thyroid disease, acute alcohol intoxication, or reversible or non-cardiac cause.
  3. Previous left atrial catheter or surgical ablation (including septal closure or left atrial appendage closure).
  4. Valvular cardiac surgical/percutaneous procedure (e.g., ventriculotomy, atriotomy, and valve repair or replacement and presence of a prosthetic valve).
  5. Any carotid stenting or endarterectomy.
  6. Any cardiac procedure (surgical or percutaneous) or percutaneous coronary intervention within 90 days prior to the initial procedure.
  7. Coronary artery bypass graft (CABG) procedure within the 6 months prior to the index ablation procedure.
  8. Awaiting cardiac transplantation or other cardiac surgery within 12 months following the initial ablation procedure.
  9. Presence of any type of implantable cardiac defibrillator (with or without biventricular pacing function).
  10. Documented thromboembolic event (stroke or transient ischemic attack) within the past 6 months (180 days).
  11. Documented left atrial thrombus on imaging.
  12. History of blood clotting or bleeding abnormalities.
  13. Any condition contraindicating chronic anticoagulation.
  14. Myocardial infarction (MI) within the 3 months (90 days) prior to the initial procedure.
  15. Body mass index >40 kg/m2.
  16. Left atrial diameter >50 mm (anteroposterior).
  17. Diagnosed atrial myxoma.
  18. Left ventricular ejection fraction (EF) < 40%.
  19. Uncontrolled heart failure or NYHA Class III or IV heart failure.
  20. Rheumatic heart disease.
  21. Hypertrophic cardiomyopathy.
  22. Unstable angina.
  23. Moderate to severe mitral valve stenosis.
  24. Severe mitral regurgitation (regurgitant volume ≥ 60 mL/beat, regurgitant fraction ≥ 50%, and/or effective regurgitant orifice area ≥ 0.40cm2)
  25. Primary pulmonary hypertension.
  26. Significant restrictive or obstructive pulmonary disease or chronic respiratory condition.
  27. Renal failure requiring dialysis.
  28. Acute illness, active systemic infection, or sepsis.
  29. Significant congenital anomaly or medical problem that, in the opinion of the investigator, would preclude enrollment in this study or compliance with follow-up requirements or would impact the scientific soundness of the clinical trial results.
  30. Any woman known to be pregnant or breastfeeding, or any woman of childbearing potential who is not on a reliable form of birth regulation method or abstinence.
  31. Current or anticipated participation in any other clinical trial of a drug, device, or biologic during the duration of the study, unless pre-approved by the Sponsor.
  32. Presence of intramural thrombus, tumor, or other abnormality that precludes vascular access, catheter introduction, or manipulation.
  33. Known drug or alcohol dependency.
  34. Life expectancy less than 12 months.
  35. Vulnerable subject.

Sites / Locations

  • Vilnius University HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

SpherePVI™ Catheter

Arm Description

Subjects treated with the SpherePVI™ Catheter

Outcomes

Primary Outcome Measures

Percentage of subjects experiencing a primary safety event
The primary safety outcome is the incidence of the following serious device-related Primary Adverse Events (AEs): Death (within 7 days) Myocardial infarction (within 7 days) Persistent phrenic nerve palsy (within 7 days) Transient ischemic attack (TIA) (within 7 days) Stroke/cerebrovascular accident (CVA) (within 7 days) Thromboembolism (within 7 days) Major vascular access complications / bleeding (within 7 days) Heart block (within 7 days) Gastroparesis (within 7 days) Severe pericarditis (within 7 days) Pulmonary edema (within 7 days) Hospitalization (initial and prolonged) due to cardiovascular or pulmonary AE (within 7 days) Cardiac tamponade / perforation (within 30 days) Pulmonary vein stenosis (within 180 days) Atrio-esophageal fistula (within 180 days)
Percentage of subjects with acute procedure success
The primary efficacy outcome is acute electrical isolation of all pulmonary veins using the study device

Secondary Outcome Measures

Percentage of subjects experiencing a device- or procedure-related SAE
The secondary safety outcome is the incidence of device- or procedure-related SAEs as assessed at each follow-up visit.
Product performance evaluated on a 5-point semi-quantitative scale ("strongly disagree" to "strongly agree")
Acute product performance will be evaluated during the procedure and includes the following: SpherePVI™ Catheter handling sufficient to reach reasonable intended targets, as determined by the physician: catheter delivery to the desired ablation sites completion of ablation procedure safe removal of catheter from the subject Electroanatomical navigation and/or mapping sufficient to aid the procedure (if used) Generation of acceptable acute ablation lesions
Percentage of subjects free from documented recurrence outside of the blanking period
Chronic efficacy will be evaluated as freedom from documented arrhythmia recurrence outside of a 90-day blanking period. Failure will be reported as both (i) recurrence of AF and (ii) recurrence of any atrial tachyarrhythmia (AF, atrial tachycardia, or atrial flutter).
Percentage of pulmonary veins remaining isolated at remapping
Chronic efficacy evaluated as the number of pulmonary veins that remain isolated during an optional remapping procedure as
Percentage of patients with all pulmonary veins isolated at remapping
Chronic efficacy evaluated as the number of patients with all pulmonary veins isolated during an optional remapping procedure as

Full Information

First Posted
October 20, 2021
Last Updated
February 14, 2022
Sponsor
Affera, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05144503
Brief Title
Safety and Performance of the SpherePVI™ Catheter to Treat Paroxysmal Atrial Fibrillation
Acronym
SpherePVI
Official Title
A Safety and Performance Assessment of the SpherePVI™ Catheter and the Affera Mapping and Ablation System to Treat Paroxysmal Atrial Fibrillation
Study Type
Interventional

2. Study Status

Record Verification Date
February 2022
Overall Recruitment Status
Recruiting
Study Start Date
July 22, 2021 (Actual)
Primary Completion Date
July 22, 2022 (Anticipated)
Study Completion Date
July 22, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Affera, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A prospective, single-arm, single-center study to evaluate the safety, performance, and effectiveness of the SpherePVI™ Catheter for treating paroxysmal AF.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
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
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
SpherePVI™ Catheter
Arm Type
Experimental
Arm Description
Subjects treated with the SpherePVI™ Catheter
Intervention Type
Device
Intervention Name(s)
SpherePVI™ Catheter
Intervention Description
SpherePVI™ Catheter with the Affera Mapping and Ablation System
Primary Outcome Measure Information:
Title
Percentage of subjects experiencing a primary safety event
Description
The primary safety outcome is the incidence of the following serious device-related Primary Adverse Events (AEs): Death (within 7 days) Myocardial infarction (within 7 days) Persistent phrenic nerve palsy (within 7 days) Transient ischemic attack (TIA) (within 7 days) Stroke/cerebrovascular accident (CVA) (within 7 days) Thromboembolism (within 7 days) Major vascular access complications / bleeding (within 7 days) Heart block (within 7 days) Gastroparesis (within 7 days) Severe pericarditis (within 7 days) Pulmonary edema (within 7 days) Hospitalization (initial and prolonged) due to cardiovascular or pulmonary AE (within 7 days) Cardiac tamponade / perforation (within 30 days) Pulmonary vein stenosis (within 180 days) Atrio-esophageal fistula (within 180 days)
Time Frame
Up to 6 months
Title
Percentage of subjects with acute procedure success
Description
The primary efficacy outcome is acute electrical isolation of all pulmonary veins using the study device
Time Frame
During Procedure
Secondary Outcome Measure Information:
Title
Percentage of subjects experiencing a device- or procedure-related SAE
Description
The secondary safety outcome is the incidence of device- or procedure-related SAEs as assessed at each follow-up visit.
Time Frame
12 months
Title
Product performance evaluated on a 5-point semi-quantitative scale ("strongly disagree" to "strongly agree")
Description
Acute product performance will be evaluated during the procedure and includes the following: SpherePVI™ Catheter handling sufficient to reach reasonable intended targets, as determined by the physician: catheter delivery to the desired ablation sites completion of ablation procedure safe removal of catheter from the subject Electroanatomical navigation and/or mapping sufficient to aid the procedure (if used) Generation of acceptable acute ablation lesions
Time Frame
During Procedure
Title
Percentage of subjects free from documented recurrence outside of the blanking period
Description
Chronic efficacy will be evaluated as freedom from documented arrhythmia recurrence outside of a 90-day blanking period. Failure will be reported as both (i) recurrence of AF and (ii) recurrence of any atrial tachyarrhythmia (AF, atrial tachycardia, or atrial flutter).
Time Frame
12 months
Title
Percentage of pulmonary veins remaining isolated at remapping
Description
Chronic efficacy evaluated as the number of pulmonary veins that remain isolated during an optional remapping procedure as
Time Frame
75 days
Title
Percentage of patients with all pulmonary veins isolated at remapping
Description
Chronic efficacy evaluated as the number of patients with all pulmonary veins isolated during an optional remapping procedure as
Time Frame
75 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Symptomatic paroxysmal atrial fibrillation (PAF) documented by: A physician's note indicating recurrent, self-terminating AF At least two electrocardiographically documented AF episodes within 12 months prior to enrollment Failure or intolerance of at least one Class I-IV anti-arrhythmic drug. Suitable candidate for catheter ablation. Age ≥ 18 and < 75 years. Able and willing to give informed consent. Able and willing, and has ample means to comply with all pre-procedure, post-procedure and follow-up testing requirements Exclusion Criteria: Continuous AF lasting more than 7 days. AF secondary to electrolyte imbalance, thyroid disease, acute alcohol intoxication, or reversible or non-cardiac cause. Previous left atrial catheter or surgical ablation (including septal closure or left atrial appendage closure). Valvular cardiac surgical/percutaneous procedure (e.g., ventriculotomy, atriotomy, and valve repair or replacement and presence of a prosthetic valve). Any carotid stenting or endarterectomy. Any cardiac procedure (surgical or percutaneous) or percutaneous coronary intervention within 90 days prior to the initial procedure. Coronary artery bypass graft (CABG) procedure within the 6 months prior to the index ablation procedure. Awaiting cardiac transplantation or other cardiac surgery within 12 months following the initial ablation procedure. Presence of any type of implantable cardiac defibrillator (with or without biventricular pacing function). Documented thromboembolic event (stroke or transient ischemic attack) within the past 6 months (180 days). Documented left atrial thrombus on imaging. History of blood clotting or bleeding abnormalities. Any condition contraindicating chronic anticoagulation. Myocardial infarction (MI) within the 3 months (90 days) prior to the initial procedure. Body mass index >40 kg/m2. Left atrial diameter >50 mm (anteroposterior). Diagnosed atrial myxoma. Left ventricular ejection fraction (EF) < 40%. Uncontrolled heart failure or NYHA Class III or IV heart failure. Rheumatic heart disease. Hypertrophic cardiomyopathy. Unstable angina. Moderate to severe mitral valve stenosis. Severe mitral regurgitation (regurgitant volume ≥ 60 mL/beat, regurgitant fraction ≥ 50%, and/or effective regurgitant orifice area ≥ 0.40cm2) Primary pulmonary hypertension. Significant restrictive or obstructive pulmonary disease or chronic respiratory condition. Renal failure requiring dialysis. Acute illness, active systemic infection, or sepsis. Significant congenital anomaly or medical problem that, in the opinion of the investigator, would preclude enrollment in this study or compliance with follow-up requirements or would impact the scientific soundness of the clinical trial results. Any woman known to be pregnant or breastfeeding, or any woman of childbearing potential who is not on a reliable form of birth regulation method or abstinence. Current or anticipated participation in any other clinical trial of a drug, device, or biologic during the duration of the study, unless pre-approved by the Sponsor. Presence of intramural thrombus, tumor, or other abnormality that precludes vascular access, catheter introduction, or manipulation. Known drug or alcohol dependency. Life expectancy less than 12 months. Vulnerable subject.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Meital Mazor, PhD
Phone
8582202137
Email
mmazor@affera.com
Facility Information:
Facility Name
Vilnius University Hospital
City
Vilnius
Country
Lithuania
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gediminas Račkauskas, MD. PhD

12. IPD Sharing Statement

Plan to Share IPD
No

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Safety and Performance of the SpherePVI™ Catheter to Treat Paroxysmal Atrial Fibrillation

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