RecruitingNot ApplicableNCT04298723

Comparison of LAA-Closure vs Oral Anticoagulation in Patients With NVAF and Status Post Intracranial Bleeding.

Randomized Comparison of Interventional Closure of the Left Atrial Appendage Using a LAA Closure Device Versus Oral Anticoagulation Therapy in Patients With Non-valvular Atrial Fibrillation and Status Post Intracranial Bleeding.


Sponsor

Jena University Hospital

Enrollment

530 participants

Start Date

Jun 16, 2020

Study Type

INTERVENTIONAL

Conditions

Summary

Atrial fibrillation is the most common cardiac arrhythmia. In atrial fibrillation, there is a risk that clots can form in the heart, especially in the left atrium. If these clots come loose, there is a risk of stroke. To prevent strokes, patients with atrial fibrillation and status post ICB can be treated with anticoagulants. This medication therapy prevents blood clots from forming in the heart, but can also cause bleeding. Another therapy option is the occlusion of the left atrium. After closure of the left atrium, only a short anticoagulation therapy is necessary until the occluder has healed. The aim of the study is to compare these two treatment approaches. In this study only already approved drugs and occlusion systems will be used.


Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study compares two strategies for stroke prevention in people with irregular heart rhythm (atrial fibrillation) who have already had a bleed inside the brain. One strategy is a small device implanted in the heart (LAA closure device) to block the area where blood clots form; the other is continuing blood-thinning medications. **You may be eligible if...** - You have documented atrial fibrillation (irregular heartbeat) - You have a moderate to high stroke risk score (CHA2DS2VASc score of 2 or more) - You had a bleed inside your skull more than 6 weeks ago - Your heart anatomy is suitable for the LAA closure device - You are at least 18 years old **You may NOT be eligible if...** - You need blood thinners for reasons other than atrial fibrillation (e.g., mechanical heart valves, clotting disorders) - You have an active infection or heart valve infection (endocarditis) - You have a blood clot in the left side of your heart - You have significant disability from a previous stroke (modified Rankin scale score of 4 or more) - You have severe liver failure - You have symptomatic carotid artery disease that has not been treated Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DEVICEPercutaneous closure of the LAA (Watchman / Watchman FLX)

LAA closure procedure will be done by experienced operators according to the local SOP. LAA closure will be performed under fluoroscopic and TEE guidance within conscious sedation or general anesthesia. Antibiotic single-shot prophylaxis should be administered peri-procedurally (i.e., cefazolin 2 g). The specific anatomy of the LAA is evaluated and an appropriately sized CE-marked device (Watchman or Watchman FLX) is deployed. LAA angiography and TEE imaging is performed to identify optimal positioning of the device and to exclude a relevant leak. Following device deployment, patients will receive a therapy according to the manufacturers IFU, currently Aspirin and clopidogrel for 3 months followed by single Aspirin up to 12 months. Alternatively, 3 months of NOAC followed by Aspirin monotherapy up to 12 months are possible.


Locations(33)

University Hospital Mannheim

Mannheim, Baden-Wurttemberg, Germany

RHÖN-KLINIKUM Campus Bad Neustadt

Bad Neustadt an der Saale, Bavaria, Germany

Therapiezentrum Burgau

Burgau, Bavaria, Germany

REGIOMED Klinikum Coburg

Coburg, Bavaria, Germany

Universitätsklinikum Erlangen

Erlangen, Bavaria, Germany

Klinikum Ingolstadt

Ingolstadt, Bavaria, Germany

RoMed Klinikum

Rosenheim, Bavaria, Germany

Cardiologicum Hamburg

Hamburg, Free and Hanseatic City of Hamburg, Germany

Asklepios Klinik Wandsbek

Hamburg, Free and Hanseatic City of Hamburg, Germany

Asklepios Klinik Nord Heidberg

Hamburg, Free and Hanseatic City of Hamburg, Germany

Asklepios Klinik Altona

Hamburg, Free and Hanseatic City of Hamburg, Germany

Herz-Kreislauf-Zentrum

Rotenburg an der Fulda, Hesse, Germany

Evangelisches Klinikum Bethel

Bielefeld, North Rhine-Westphalia, Germany

Klinikum Dortmund

Dortmund, North Rhine-Westphalia, Germany

Knappschaft Kliniken

Dortmund, North Rhine-Westphalia, Germany

Westpfalz-Klinikum

Kaiserslautern, Rhineland-Palatinate, Germany

Katholisches Klinikum Koblenz • Montabaur

Koblenz, Rhineland-Palatinate, Germany

Klinikum Chemnitz

Chemnitz, Saxony, Germany

Dresden Heart Center

Dresden, Saxony, Germany

University Hospital Leipzig

Leipzig, Saxony, Germany

Klinikum St. Georg

Leipzig, Saxony, Germany

Heart Center Leipzig

Leipzig, Saxony, Germany

Helios Klinikum Pirna

Pirna, Saxony, Germany

Heinrich-Braun-Klinikum (HBK)

Zwickau, Saxony, Germany

University Hospital Magdeburg

Magdeburg, Saxony-Anhalt, Germany

Universitätsklinikum Schleswig-Holstein (UKSH)

Lübeck, Schleswig-Holstein, Germany

Charité - Universitätsmedizin Berlin (CBF)

Berlin, State of Berlin, Germany

Charité - Universitätsmedizin Berlin (CVK

Berlin, State of Berlin, Germany

Helios Klinikum Erfurt

Erfurt, Thuringia, Germany

University Hospital Jena

Jena, Thuringia, Germany

Uniwersytecki Szpital Kliniczny w Poznaniu

Poznan, Greater Poland Voivodeship, Poland

Polsko-Amerykańskie Kliniki Serca

Bielsko-Biala, Silesian Voivodeship, Poland

Górnośląskim Centrum Medycznym

Katowice, Silesian Voivodeship, Poland

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NCT04298723


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