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Trial registered on ANZCTR
Registration number
ACTRN12614000050651
Ethics application status
Approved
Date submitted
8/01/2014
Date registered
17/01/2014
Date last updated
14/05/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Evaluation of the AtriClip for completeness of left atrial appendage closure in cardiac surgery patients with concomitant atrial fibrillation
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Scientific title
Evaluation of the AtriClip for completeness of left atrial appendage closure in cardiac surgery patients with concomitant atrial fibrillation
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Secondary ID [1]
283555
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none
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Universal Trial Number (UTN)
U1111-1150-0735
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Atrial fibrillation in cardiac surgery patients
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Condition category
Condition code
Cardiovascular
290853
290853
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0
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Other cardiovascular diseases
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Surgery
291271
291271
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0
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Surgical techniques
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Left atrial appendage closure with AtriClip LAA exclusion system. The AtriClip is a polyester fabric covered titanium clip. It is placed with the use of an applicator and adds about 5 to 10 minutes to the cardiac surgical procedure time
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Intervention code [1]
288247
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Treatment: Devices
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Intervention code [2]
288601
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Treatment: Surgery
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Comparator / control treatment
No control group. Results are compared with reports from the literature.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Completeness left atrial appendage closure. Post operative trans esophageal echocardiogram is used to assess left atrial appendage closure
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Assessment method [1]
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Timepoint [1]
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3-6 months post operatively
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Secondary outcome [1]
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Bleeding from left atrial appendage. Assessed intra-operatively and by observing post-operative blood loss.
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Assessment method [1]
305438
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Timepoint [1]
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first week post-operatively
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Secondary outcome [2]
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Neurological events (stroke, TIA). Assessed via medical history and radiological investigation as indicated.
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Assessment method [2]
306402
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Timepoint [2]
306402
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3-6 months
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Secondary outcome [3]
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Thromboembolic events.
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Assessment method [3]
306403
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Timepoint [3]
306403
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3-6 month post operatively. Assessed via medical history and radiological investigation or ultrasonography as indicated.
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Secondary outcome [4]
306404
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Easy of application
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Assessment method [4]
306404
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Timepoint [4]
306404
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Intraoperatively the surgeon rates ease of application 1-5 (easy - difficult) and aortic cross clamp time and cardiopulmonary bypass time are noted
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Secondary outcome [5]
306405
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Postoperative length of stay
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Assessment method [5]
306405
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Timepoint [5]
306405
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Post-operative hospital stay is monitored
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Secondary outcome [6]
306406
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presence of atrial fibrillation.
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Assessment method [6]
306406
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Timepoint [6]
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3-6 months post operatively with ECG +/- holter monitoring
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Eligibility
Key inclusion criteria
Cardiac surgery patients with concomitant atrial fibrillation
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Redo surgery patients, Left atrial appendage thrombus, nickle-titanium alloy or nitinol allergy
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
At the pre-operative assessment process, patient in atrial fibrillation undergoing concomitant cardiac surgery via a sternotomy, will be recruited. Enrolled patients will recieve treatment. There is no comparision group
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
not applicable
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The percentage of patients who have complete exclusion of the left atrial appendage after the Atriclip will be obtained using intra-operative and post-operative transoesophageal echocardiogram.
All continuous variables will be summarized using descriptive statistics, including the mean, standard deviation, median, quartiles, minimum and maximum. All categorical variables will be summarized using the number and percent of subjects within each category. The variables that will be described are: Age, Sex, ease of application, aortic cross clamp time, Cardiopulmonary bypass time, complications (CVA, TIA, Bleeding from atrial appendage, thromboembolism), length of stay, presence of atrial fibrillation.
A one proportion test will be used to assess our closure rate compared to previous studies.
We hypothesised a percentage of 90% of complete exclusion of the left atrial appendage using the AtriClip , and previous studies showed rates of approximately 60% with the various other techniques. With 20 patients we could detect a significant difference of 27% with 80% power and a 5% level of significance, which is sufficient to determine effectiveness of the AtriClip.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
14/02/2014
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
20
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Sir Charles Gairdner Hospital - Nedlands
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Recruitment postcode(s) [1]
7550
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6009 - Nedlands
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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N Stenning & Co Ltd
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Address [1]
288239
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174 Parramatta Road Camperdown NSW 2050
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Country [1]
288239
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Australia
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Primary sponsor type
Individual
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Name
Dr L Sanders
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Address
Sir Charles Gairdner hospital, Hospital Ave, Nedlands, WA6009
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
286957
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J Passage
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Address [1]
286957
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Sir Charles Gairdner Hospital, Hospital ave, Nedlands, WA6009
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Country [1]
286957
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
290144
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Sir Charles Gairdner Hospital Human Research Ethics Committee
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Ethics committee address [1]
290144
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Sir Charles Gairdner hosp, Hospital avenue, Nedlands, WA6009
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Ethics committee country [1]
290144
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Australia
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Date submitted for ethics approval [1]
290144
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Approval date [1]
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15/10/2013
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Ethics approval number [1]
290144
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Quality improvement No 4333
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Summary
Brief summary
The left atrial appendage (LAA) is the most common source of thrombus in patients with atrial fibrillation (AF). Such thrombus has the potential to embolise to the brain, causing stroke. Ligation of the appendage is a commonly performed concomitant procedure in patients with AF undergoing heart surgery for other reasons . Current literature suggests that complete exclusion of the left atrial appendage occurs in only 40% of patients undergoing ligation and intra-atrial closure. A small amount of data suggests better long term exclusion of the LAA with the Atriclip device. In addition there is little risk of bleeding compare to excision and oversewing. We would like to collect data on patients undergoing left atrial appendage ligation using the Atriclip device
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Lucas H Sanders
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Address
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Sir Charles Gairdner hospital, hospital avenue, Nedlands, WA6009
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Country
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Australia
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Phone
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+61893463333
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
36747
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Lucas H Sanders
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Address
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Sir Charles Gairdner hospital, hospital avenue, Nedlands, WA6009
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Country
36747
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Australia
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Phone
36747
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+61893463333
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Fax
36747
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Email
36747
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[email protected]
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Contact person for scientific queries
Name
36748
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Lucas H Sanders
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Address
36748
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Sir Charles Gairdner hospital, hospital avenue, Nedlands, WA6009
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Country
36748
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Australia
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Phone
36748
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+61893463333
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Fax
36748
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Email
36748
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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