Prospective, multicenter, open, single group target value method to evaluate the safety and effectiveness of left atrial appendage clipping system in preventing ischemic stroke in patients with atrial fibrillation

注册号:

Registration number:

ChiCTR2400080521 

最近更新日期:

Date of Last Refreshed on:

2024-01-31 15:06:50 

注册时间:

Date of Registration:

2024-01-31 00:00:00 

注册号状态:

补注册

Registration Status:

Retrospective registration

注册题目:

前瞻性、多中心、开放性、单组目标值法评价左心耳夹闭系统预防房颤患者缺血性卒中的安全性和有效性的研究

Public title:

Prospective, multicenter, open, single group target value method to evaluate the safety and effectiveness of left atrial appendage clipping system in preventing ischemic stroke in patients with atrial fibrillation

注册题目简写:

English Acronym:

研究课题的正式科学名称:

前瞻性、多中心、开放性、单组目标值法评价左心耳夹闭系统预防房颤患者缺血性卒中的安全性和有效性的研究

Scientific title:

Prospective, multicenter, open, single group target value method to evaluate the safety and effectiveness of left atrial appendage clipping system in preventing ischemic stroke in patients with atrial fibrillation

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

孙玉舫 

研究负责人:

倪一鸣 

Applicant:

Sun Yufang 

Study leader:

Ni Yiming 

申请注册联系人电话:

Applicant telephone:

+86 180 1900 8461

研究负责人电话:

Study leader's telephone:

+86 571 8723 6685

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

yufang.sun@cardimed.com.cn

研究负责人电子邮件:

Study leader's E-mail:

niyiming@hotmail.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

北京市大兴区天富大街9幢7号全部普惠生物

研究负责人通讯地址:

浙江大学医学院附属第一医院

Applicant address:

No.7 Warehouse,No.9 Tianfu Street, Daxing District,Beijing

Study leader's address:

79 Qingchun Road,Hangzhou310003,Zhejiang

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

北京普惠生物医学工程有限公司

Applicant's institution:

Permed Biomedical Engineering Co., Ltd

研究负责人所在单位:

浙江大学医学院附属第一医院

Affiliation of the Leader:

the First Affiliated HospitalCollege of Medicine, Zhejiang University

是否获伦理委员会批准:

是/Yes

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2018伦审第(315)号

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

浙江大学医学院附属第一医院医学伦理委员会

Name of the ethic committee:

Approval Letter of Ethics Committee of the First Affiliated HospitalCollege of Medicine, Zhejiang University

伦理委员会批准日期:

Date of approved by ethic committee:

2018-10-23 00:00:00

伦理委员会联系人:

周惠丽

Contact Name of the ethic committee:

Huili Zhou

伦理委员会联系地址:

浙江省杭州市庆春路79号

Contact Address of the ethic committee:

79 Qingchun Road,Hangzhou310003,Zhejiang

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 571 8723 6685

伦理委员会联系人邮箱:

Contact email of the ethic committee:

yixuelunli123@163.com

研究实施负责(组长)单位:

浙江大学医学院附属第一医院

Primary sponsor:

The First Affiliated HospitalCollege of Medicine, Zhejiang University

研究实施负责(组长)单位地址:

浙江省杭州市庆春路79号

Primary sponsor's address:

79 Qingchun Road,Hangzhou310003,Zhejiang

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

北京

市(区县):

大兴区

Country:

China

Province:

Beijing

City:

Daxing

单位(医院):

北京市普惠生物医学工程有限公司

具体地址:

北京市大兴区天富大街9幢7号全部普惠生物

Institution
hospital:

Permed Biomedical Engineering Co., Ltd

Address:

No.7 Warehouse,No.9 Tianfu Street, Daxing District,Beijing

经费或物资来源:

北京普惠生物医学工程有限公司

Source(s) of funding:

Permed Biomedical Engineering Co., Ltd

Target disease:

atrial fibrillation

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

单臂 

Study design:

Single arm 

研究目的:

评价北京市普惠生物医学工程有限公司左心耳夹闭系统预防房颤患者缺血性卒中的安全性和有效性  

Objectives of Study:

To evaluate the safety and effectiveness of left atrial appendage clamping system of Beijing PerMed Biomedical Engineering Co., Ltd. in preventing ischemic stroke in patients with atrial fibrillation

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

患者需满足以下所有入选标准方可入组本试验: 1. 年龄≥18 周岁,≤80 周岁,男性或非妊娠期女性患者; 2. 患者本人或其监护人获悉本试验性质并同意参与本试验的全部条款, 自愿签署经伦理委员会批准的知情同意书,同意接受术后治疗方案和随访要求,能够完成随访及随访要求的检查; 3. 有心电图证实的心房颤动史(阵发性、持续性或长期持续性房颤)的患者; 4. CHA2DS2-VASc 评分 ≥2;(附录 2) 5. HAS-BLED 评分 ≥ 2; (附录 3) 6. LVEF>50%; 7. 房颤患者或者需要同期行以下之一常规直视心外科手术的房颤患者,其中包括: 二尖瓣瓣膜置换术、主动脉瓣瓣膜置换术、心脏冠状动脉旁路移植术; 8. 至少有 1 年以上的生存预期的患者;

Inclusion criteria

Patients should meet all the following inclusion criteria before being enrolled in this trial: 1. age ≥ 18 years old, ≤ 80 years old, male or non pregnant female patients; 2. the patient or his guardian was informed of the nature of the trial and agreed to participate in all the terms of the trial, voluntarily signed the informed consent approved by the ethics committee, agreed to accept the postoperative treatment plan and follow-up requirements, and was able to complete the follow-up and follow-up inspection requirements; 3. patients with ECG confirmed history of atrial fibrillation (paroxysmal, persistent or long-term persistent atrial fibrillation); 4. Cha2ds2 VASC score ≥ 2; (Appendix 2) 5. Has-bled score ≥ 2; (Appendix 3) 6. LVEF > 50%; 7. patients with atrial fibrillation or those who need to undergo one of the following conventional open heart surgery at the same time, including mitral valve replacement, aortic valve replacement, and coronary artery bypass grafting; 8. patients with at least 1-year survival expectation;

排除标准:

患者如果符合下述任意一条,将不得入选本试验 临床诊断 1. 术前60天内的心肌梗死患者; 2. 心功能IV级的心力衰竭患者(NYHA);(附录4) 3. 30天内的脑卒中或3天内的短暂性脑缺血发作(TIA)的患者; 4. 心脏外科手术史或怀疑心包粘连的患者; 5. 活动性感染、败血症或不明原因发热的患者; 6. 活动性心内膜炎,心内有赘生物的患者; 7. 心包炎或有心包穿刺史的患者; 8. 心脏肿瘤或其它部位肿瘤,预计寿命在1年以内的患者; 9. 有高凝血状态、血栓性疾病病史的患者; 10.肥厚型心肌病、室性心动过速的患者; 实验室检查 1. 血液学异常(白细胞WBC<4×109/L、血红蛋白HGB<90g/L、血小板PLT<50×109/L); 2. 慢性肾脏病3期,定义为肾小球滤过率(eGFR)<[60ml/(min*1.73m2)]和(或)需要透析(附录5); 3. 中、重度慢性阻塞性肺疾病患者(附录6); 4. 体重指数(BMI)>35; 与手术/器械相关 1.有左心耳干预史的患者; 2.植入型心率转复除颤器(ICD)术后患者; 3.有导管消融术伴穿孔或并发症史者; 4.有经皮冠状动脉介入穿孔史者; 5.术前30天内有心脏或胸外科手术史者; 6.术后6个月内计划进行房性心律失常消融术者; 7.术后6个月内计划电复律者; 8.计划6个月内接受结构性心脏病外科治疗者; 9.心脏移植术后的患者; 10.对金属镍钛合金,阿司匹林,氯吡格雷,肝素过敏或禁忌的患者; 超声排除标准 1.不能或不愿接受术中经食道超声心动图检查(TEE)的患者; 2.超声心动图测量左心耳根部直径≤29 mm或≥50 mm; 3.根据TTE判断左心房(LA)或左心耳(LAA)内存在血栓; 4.有明显的且原因不明的心包积液(少-中量); 5.左心房前后径≥6cm者; 6.颈动脉狭窄超过直径的60%的患者; 7.有症状的颈动脉狭窄患者; 8.双侧颈动脉狭窄>50%的患者;

Exclusion criteria:

Patients will not be enrolled in this trial if they meet any of the following conditions: clinical diagnosis 1 Patients with myocardial infarction within 60 days before operation; 2. heart failure patients with cardiac function grade IV (NYHA); (Appendix 4) 3. patients with stroke within 30 days or transient ischemic attack (TIA) within 3 days; 4. patients with a history of cardiac surgery or suspected pericardial adhesions; 5. patients with active infection, sepsis or fever of unknown cause; 6. patients with active endocarditis and vegetations in the heart; 7. patients with pericarditis or history of pericardial puncture; 8. patients with cardiac tumors or tumors in other parts with an expected life expectancy of less than 1 year; laboratory examination 1. Hematological abnormalities (white blood cell WBC<4) × 109/L, hemoglobin HGB < 90g/L, platelet PLT < 50 × 109/L); 2. Chronic kidney disease stage 3, defined as glomerular filtration rate (eGFR)<[60ml/(min * 1.73m)] and/or require dialysis (Appendix 5); 3. Patients with moderate to severe chronic obstructive pulmonary disease (Appendix 6); 4. Body mass index (BMI)>35 Related to surgery/instruments 1. Patients with a history of left atrial appendage intervention; 2. Postoperative patients with implantable heart rate defibrillators (ICDs); 3. Individuals with a history of catheter ablation with perforation or complications; 4. Individuals with a history of percutaneous coronary intervention perforation; 5. Individuals with a history of cardiac or thoracic surgery within 30 days prior to surgery; 6. Patients who plan to undergo atrial arrhythmia ablation surgery within 6 months after surgery; 7. Planned electroconversion within 6 months after surgery; 8. Patients who plan to receive surgical treatment for structural heart disease within 6 months; 9. Patients after heart transplantation; 10. Patients who are allergic or contraindicated to metal nickel titanium alloys, aspirin, clopidogrel, or heparin; Ultrasound exclusion criteria 1. patients who are unable or unwilling to accept intraoperative transesophageal echocardiography (TEE); 2. echocardiographic measurement of left atrial appendage root diameter ≤ 29 mm or ≥ 50 mm; 3. thrombus in left atrium (LA) or left atrial appendage (LAA) according to TTE; 4. there is obvious and unexplained pericardial effusion (low to medium volume); 5. left atrial anteroposterior diameter ≥ 6cm; 6. patients with carotid stenosis more than 60% of the diameter; 7. symptomatic patients with carotid stenosis; 8. patients with bilateral carotid stenosis > 50%;

研究实施时间:

Study execute time:

From 2018-08-07 00:00:00 To 2023-11-15 00:00:00  

征募观察对象时间:

Recruiting time:

From 2019-03-04 00:00:00 To 2020-08-03 00:00:00  

干预措施:

Interventions:

组别:

单组

样本量:

74

Group:

Single group

Sample size:

干预措施:

试验器械植入后定期随访

干预措施代码:

Intervention:

Regular follow-up after implantation of experimental instruments

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

浙江 

市(区县):

 

Country:

China 

Province:

Zhejiang  

City:

 

单位(医院):

浙江大学医学院附属第一医院 

单位级别:

三甲 

Institution
hospital:

the First Affiliated HospitalCollege of Medicine, Zhejiang University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

福建 

市(区县):

 

Country:

China 

Province:

Fujian 

City:

 

单位(医院):

福建医科大学附属协和医院 

单位级别:

三甲 

Institution
hospital:

Fujian Medical University Union Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China 

Province:

Jiangsu 

City:

 

单位(医院):

南京市第一医院 

单位级别:

三甲 

Institution
hospital:

Nanjing First Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖南 

市(区县):

 

Country:

China 

Province:

Hunan 

City:

 

单位(医院):

中南大学湘雅第二医院 

单位级别:

三甲 

Institution
hospital:

The Second Hospital of Central South University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

浙江省 

市(区县):

 

Country:

China 

Province:

Zhejiang Province 

City:

 

单位(医院):

浙江省人民医院 

单位级别:

三甲 

Institution
hospital:

Zhejiang Provincial People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China 

Province:

Jiangsu 

City:

 

单位(医院):

南京医科大学第一附属医院 

单位级别:

三甲 

Institution
hospital:

The First Affiliated Hospital of Nanjing Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广州 

市(区县):

 

Country:

China 

Province:

Guangzhou 

City:

 

单位(医院):

广州医科大学附属第一医院 

单位级别:

三甲 

Institution
hospital:

The First Affiliated Hospital of Guangzhou Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

四川 

市(区县):

 

Country:

China 

Province:

sichuan 

City:

 

单位(医院):

西南医科大学附属医院 

单位级别:

三甲 

Institution
hospital:

Affiliated Hospital of Southwest Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

浙江 

市(区县):

 

Country:

China 

Province:

Zhejiang 

City:

 

单位(医院):

宁波市医疗中心李惠利医院 

单位级别:

三甲 

Institution
hospital:

Lihuili hospital, Ningbo Medical Center

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

无器械相关的严重不良事件率

指标类型:

主要指标

Outcome:

Incidence of no device related serious adverse events

Type:

Primary indicator

测量时间点:

术后 30 天

测量方法:

Measure time point of outcome:

30 days postoperatively

Measure method:

指标中文名:

左心耳完全关闭率

指标类型:

主要指标

Outcome:

The complete closure rate of left atrial appendage

Type:

Primary indicator

测量时间点:

术后 3 个月

测量方法:

Measure time point of outcome:

3 months after operation

Measure method:

指标中文名:

心血管源性死亡发生率

指标类型:

次要指标

Outcome:

Incidence of cardiovascular death

Type:

Secondary indicator

测量时间点:

术后 6、12 个月

测量方法:

Measure time point of outcome:

6 and 12 months after operation

Measure method:

指标中文名:

心肌梗塞发生率

指标类型:

次要指标

Outcome:

Incidence of myocardial infarction

Type:

Secondary indicator

测量时间点:

术后 6、12 个月

测量方法:

Measure time point of outcome:

6 and 12 months after operation

Measure method:

指标中文名:

试验器械相关的心脏结构或其他身体结构严重受损发生率

指标类型:

次要指标

Outcome:

Incidence of serious damage to heart structure or other body structure related to the test device

Type:

Secondary indicator

测量时间点:

术后 6、12 个月

测量方法:

Measure time point of outcome:

6 and 12 months after operation

Measure method:

指标中文名:

大出血发生率

指标类型:

次要指标

Outcome:

Incidence of major bleeding

Type:

Secondary indicator

测量时间点:

术后 6、12 个月

测量方法:

Measure time point of outcome:

6 and 12 months after operation

Measure method:

指标中文名:

脑卒中及非中枢神经系统栓塞的发生率

指标类型:

次要指标

Outcome:

Incidence of stroke and non central nervous system embolism

Type:

Secondary indicator

测量时间点:

术后 6、12 个月

测量方法:

Measure time point of outcome:

6 and 12 months after operation

Measure method:

指标中文名:

术中左心耳完全关闭率

指标类型:

次要指标

Outcome:

Complete closure rate of left atrial appendage during operation

Type:

Secondary indicator

测量时间点:

术中

测量方法:

通过影像学(TEE、TTE 或 CTA)评估,左心耳与左心房之间存在残余分流,且残余分流直径≤3mm 和左心耳 残腔深度≤10 mm

Measure time point of outcome:

during operation

Measure method:

According to imaging (TEE, TTE, or CTA) evaluation, there is residual shunt between the left atrial appendage and the left atrium, with a residual shunt diameter of ≤ 3mm and a residual cavity depth of ≤ 10mm in the left atrial appendage

指标中文名:

器械技术成功率

指标类型:

次要指标

Outcome:

Device technology success rate

Type:

Secondary indicator

测量时间点:

测量方法:

技术成功定义为:左心耳上成功植入器械

Measure time point of outcome:

Measure method:

Technical success is defined as the successful implantation of instruments on the left atrial appendage

指标中文名:

不良事件发生率

指标类型:

次要指标

Outcome:

Adverse event occurrence rate

Type:

Secondary indicator

测量时间点:

术后 6、12 个月

测量方法:

Measure time point of outcome:

6 and 12 months after operation

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

尿液

组织:

Sample Name:

Urine

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

标本中文名:

血液

组织:

Sample Name:

Blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

结束

/Completed

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 80 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

Randomization Procedure (please state who generates the random number sequence and by what method):

None

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

Blinding:

None

是否共享原始数据:

IPD sharing

No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

Resman 临床试验公共管理平台 www.medresman.org.cn

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Resman Clinical Trial Management Public Platform, www.medresman.org.cn

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

本试验采用电子数据收集系统(Electronic Data Capture,EDC)完成试验数据的收集和管理。数据管理员根据试验方案建立EDC系统中对应的电子病例报告表(electronic Case Report Form, eCRF),并对数据库数据的完整性、一致性和准确性而进行逻辑核查。进行数据收集,数据核查和修改,最后进行数据库锁定及资料归档。 例如 EDC系统提供在线核查方式。当研究者或CRC录入数据时,EDC系统会发出实时警告用于提醒核对数据;数据管理员将对服务器已保存的数据进行逻辑核查,并将错误的数据以人工质疑的形式通过EDC发布。监查员需定期检查eCRF,并评估其完整性和一致性。为确保关键数据之间无差异,对eCRF和源文件进行溯源。由主要研究者或其授权指定人员对eCRF进行所有的记录、修正和变更。监查员不能录入eCRF的数据。一旦eCRF的临床数据被发送到中心服务器,将对数据的修改留下更正轨迹(修改留痕),即将记录下改变的原因、更改人姓名以及时间和日期。在临床数据录入电子病例报告表之前,将对研究中心人员进行权限分配。如果需要数据修订,监查员或数据管理员将在EDC系统中提出质疑,研究者或授权的研究中心人员需对发布的质疑进行回答。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

This trial used an electronic data collection system (electronic data capture, EDC) to complete the collection and management of trial data. The data manager establishes the corresponding electronic case report form (ECRF) in the EDC system based on the trial protocol and logistically verifies the integrity, consistency, and accuracy of the database data. Data collection, data verification and revision were performed, and finally, database lock and data archiving were performed. For example, the EDC system provides an on-line means of verification. When data are entered by the investigator or CRC, the EDC system issues a real-time warning to alert checks to the data; The data administrator will perform a logical verification of the data already held by the server and release the erroneous data via the EDC in the form of a manual query. The monitor is required to periodically review the ecrfs and assess their integrity and consistency. To ensure no differences between critical data, ecrfs and source documents were traceable. All records, amendments, and changes to the ecrfs were made by the principal investigator or his authorized designee. The monitor was unable to enter data for the ECRF. Once the clinical data from the ECRF is sent to the central server, a correction track will be left for the changes to the data (change left mark), i.e., the reason for the change, change of person name, and time and date will be recorded. Study Center personnel will be assigned authority prior to clinical data entry on the electronic case report form. If a data revision is required, the monitor or data manager will raise a question in the EDC system, and the investigator or authorized Study Center personnel will be required to answer the question of release.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2024-01-31 15:06:44