About this trial
The CLAAS® device will be evaluated for safety and efficacy by establishing its performance is non-inferior to the commercially available WATCHMAN® and Amulet™ left atrial appendage closure devices in patients with non-valvular atrial fibrillation. Patients who are eligible for the trial will be randomized to receive either the CLAAS device or the WATCHMAN or Amulet™ devices and will be followed for 5 years after device implant.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Male or non-pregnant female aged ≥18 years
Documented non-valvular AF (paroxysmal, persistent, or permanent)
High risk of stroke or systemic embolism, defined as CHA2DS2-VASc score of ≥ 3
Has an appropriate rationale to seek a non-pharmacologic alternative to long-term oral anticoagulation
Disqualifiers
Pregnant or nursing patients and those who plan pregnancy in the period up to one year following the index procedure. Female patients of childbearing potential must have a negative pregnancy test (per site standard test) within 7 days prior to index procedure.
Anatomic conditions that would prevent performance of an LAA occlusion procedure (e.g., atrial septal defect (ASD) requiring closure, high-risk patent foramen ovale (PFO) requiring closure, a highly mobile inter-atrial septal aneurysm precluding a safe TSP, presence of a PFO/ASD closure device, history of surgical ASD repair or history of surgical LAAO closure)
Atrial fibrillation that is defined by a single occurrence or that is transient or reversible (e.g., secondary thyroid disorders, acute alcohol intoxication, trauma, recent major surgical procedures)
A medical condition (other than atrial fibrillation) that mandates long-term oral anticoagulation (e.g., history of unprovoked deep vein thrombosis or pulmonary embolism, or prosthetic mechanical heart valve)
Trial design
Parallel
Treatments tested in this trial
CLAAS
DeviceCLAAS
WATCHMAN left atrial appendage closure device / Amulet left atrial appendage occluder
DeviceWATCHMAN left atrial appendage closure device / Amulet left atrial appendage occluder
Treatment groups
Trial outcomes
Primary outcomes
Procedure-related complications, all-cause death, major bleeding
The primary safety endpoint is a composite of 1) major procedure-related complications including a) cardiac perforation, b) pericardial effusion requiring drainage, c) ischemic stroke, d) device embolization, and e) major vascular complications, or 2) major bleeding, or 3) all-cause death
Ischemic stroke and systemic embolism
The primary effectiveness endpoint is a composite of ischemic stroke and systemic embolism through 18 months.
Secondary outcomes
Procedure-related complications, all-cause death, major bleeding
All elements of the Primary Safety Endpoint will be reported descriptively for all subjects through 5 years: a composite of 1) major procedure-related complications including a) cardiac perforation, b) pericardial effusion requiring drainage, c) ischemic stroke, d) device embolization, and e) major vascular complications, or 2) major bleeding, or 3) all-cause death
Device Success
A secondary performance and efficacy endpoint is Device Success, defined as LAAO device deployed and implanted in correct position
Technical success
A secondary performance and efficacy endpoint is Technical Success, defined as Device Success, complete closure or peri-device residual leak ≤5 mm in width on TEE, as evaluated by independent imaging core lab without device-related complications \[evaluated post-procedure\].
Procedure success
A secondary performance and efficacy endpoint is Procedure Success, defined as Technical Success without in-hospital major procedure-related complications (excluding minor device embolization) evaluated at hospitalization or at 7 days whichever is first.
Sponsors and contacts
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