Atrial fibrillation is associated with increased risk of stroke mostly because of clot formation in the left atrial appendage, a small alcove in the left atrium heart chamber. Plugging this appendage with an implantable plug type device, which is placed via a catheter painlessly in the femoral vein, has been proven to be a reliable alternative to the standard anti-clotting medication in a number of recent international trials. The Omega device is a new design of such a plug, made from biocompatible and compressible nitinol and fabric. Up to 195 patients will be enrolled in Europe, assuming that enrolment will stop once the Omega™ device has been successfully implanted in 150 evaluable patients. The primary performance endpoint of the study is LAA closure (defined as complete seal or efficient seal with a peri-device leak ≤ 5 mm) at 60 days (+/- 15 days) visit documented by transoesophageal echocardiogram (TEE/TOE) with colour flow Doppler.
This is a single arm study to assess the safety and performance of the Omega™ Left Atrial Appendage (LAA) Occluder in patients with Non-valvular atrial fibrillation (NVAF) and high bleeding risk. The study will be conducted in accordance with the ISO standard ISO 14155 (Clinical investigation of medical devices for human subjects - Good clinical practice) and other legal requirements as applicable. The primary performance endpoint of the study is LAA closure (defined as complete seal or efficient seal with a peri-device leak ≤ 5 mm) at 60 days (+/- 15 days) visit documented by transoesophageal echocardiogram (TEE/TOE) with colour flow Doppler. The primary safety endpoint of the study is device-related complications (serious adverse events \[SAEs\]) through 60 days (+/- 15 days) post-procedural. Following consent a number of assessments will be undertaken prior to the procedure to ensure the study eligibility criteria are met. These assessments include; medical history, physical exams, ECG, blood tests, transthoracic echocardiogram, transesophageal echocardiogram and cardiac CT. The implant procedure will usually be performed under general anaesthetic. A thin catheter is inserted in the femoral vein in the right groin area and advanced under X-Ray guidance to the right atrium, then a very small needle is used to cross through to the left atrium to allow the delivery catheter to place the Omega in the Appendage, guided by both X-Ray and transesophageal echo. A medication regimen for endocarditis prophylaxis anticoagulation is recommended post procedure. Following discharge, patients will be seen again at 60 days, 6 months and 12 months to collect data for the primary performance endpoint (by TTE or TEE) and safety endpoints (mRS, stroke/TIA assessments, and ECG). An interim analysis is planned following the collection of 60 day data for the first 10 patients implanted with the device. An additional interim analysis will be performed following the collection of 60 days (+/- 15 days) data for the first 50 patients implanted with the device. Final analysis will be performed once all 150 subjects have been implanted with the device and completed the study to further document and confirm the safety and effectiveness of the device.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
20
catheter delivery of Omega device in the left atrial appendage
Rigshospitalet
Copenhagen, Denmark
Chulalongkorn University
Pathum Wan, Bangkok, Thailand
LAA closure
Complete seal or efficient seal with a peri-device leak ≤ 5 mm documented by transoesophageal echocardiogram (TEE/TOE) with colour flow Doppler.
Time frame: at 60 days (+/- 15 days)
Device-related complications
Serious adverse event criteria set out in the protocol and being assessed as related to the study device.
Time frame: through 60 days post-procedure
Procedure-related complications
Meeting the serious adverse event criteria set out in the protocol and being assessed as related to the study procedure.
Time frame: 1 to 6 days post-procedure
Major bleeding
Defined as ≥ BARC 3 bleed
Time frame: From procedure to 12 months
Ischemic stroke
Confirmed by Neurologic assessment and appropriate CT/MR imaging
Time frame: From procedure to 12 months
Systemic embolism
Confirmed by appropriate imaging.
Time frame: From procedure to 12 months
Pericardial effusion/tamponade
Per protocol
Time frame: From procedure to 12 months
Technical success
Composite of: Occlusion of the LAA, No device-related complications, No leak \>5mm on colour Doppler Transesophageal Echocardiography (TEE),
Time frame: At implant
Procedural success
Composite of: Technical success, No procedure-related complications except uncomplicated (minor) device embolization resolved by percutaneous retrieval during the procedure without surgical intervention or damage to surrounding cardiovascular structures.
Time frame: At procedure
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.