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使用AMPLATZER护身符装置评估接受左心耳封堵治疗的房颤和高卒中风险患者真实世界临床结局的全球注册研究的原理与设计——基于导管的左心耳封堵现有/正在进行的注册研究视角

Rationale and design of a global registry to evaluate real-world clinical outcomes in patients with atrial fibrillation and high risk of stroke treated with left atrial appendage occlusion using the AMPLATZER amulet device-Perspective of available/ongoing registries of catheter-based LAA occlusion.

作者信息

Hildick-Smith David, Diener Hans-Christoph, Schmidt Boris, Paul Vincent, Settergren Magnus, Teiger Emmanuel, Camm John, Tondo Claudio, Landmesser Ulf

机构信息

Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, United Kingdom.

Department of Neurology, University Duisburg-Essen, Essen, Germany.

出版信息

Catheter Cardiovasc Interv. 2018 Feb 15;91(3):540-547. doi: 10.1002/ccd.27252. Epub 2017 Sep 1.

Abstract

OBJECTIVES

To describe the rationale and design of a global prospective registry on catheter-based left atrial appendage (LAA) occlusion using the second generation AMPLATZER Amulet LAA occlusion device and to provide a comprehensive perspective on available/ongoing registries for catheter-based LAA occlusion.

BACKGROUND

Given the increasing clinical application of catheter-based LAA occlusion, there is an important need for prospective real-world clinical data regarding this cardiac intervention.

METHODS

The Global Amplatzer Amulet LAA registry aims to provide prospective real-world data from an all-comer population of atrial fibrillation (AF) patients undergoing catheter-based LAA occlusion for stroke prevention. This observational, prospective, multicenter registry will provide peri-procedural and long-term clinical outcome data for catheter-based LAA occlusion using a second generation LAA occlusion device. The global registry will enroll 1,000 patients at up to 75 institutions. Patients will be followed for 2 years after implantation. Primary endpoints will report procedural and long-term data on ischemic stroke, systemic embolism, cardiovascular death and major bleeding. The study will involve independent event adjudication and echocardiographic core laboratory evaluation. Long-term follow-up data are expected in 2018.

RESULTS

The Global Amplatzer Amulet LAA registry will collect safety and efficacy information on catheter-based LAA occlusion. Characteristics of available and ongoing catheter-based LAA occlusion registries are described.

CONCLUSIONS

There is an important need for prospective real-world clinical data of catheter-based LAA occlusion given the increasing application of this intervention. The present global real-world registry will expand our knowledge on peri-procedural and long-term outcome of catheter-based LAA occlusion using a second generation occlusion device.

摘要

目的

描述一项关于使用第二代AMPLATZER Amulet左心耳(LAA)封堵装置进行基于导管的LAA封堵的全球前瞻性注册研究的基本原理和设计,并全面介绍现有的/正在进行的基于导管的LAA封堵注册研究。

背景

鉴于基于导管的LAA封堵在临床中的应用日益增加,对于该心脏介入治疗的前瞻性真实世界临床数据有着迫切需求。

方法

全球AMPLATZER Amulet注册研究旨在提供来自接受基于导管的LAA封堵以预防卒中的房颤(AF)患者全人群的前瞻性真实世界数据。这项观察性、前瞻性、多中心注册研究将提供使用第二代LAA封堵装置进行基于导管的LAA封堵的围手术期和长期临床结局数据。全球注册研究将在多达75个机构招募1000名患者。患者将在植入后随访2年。主要终点将报告缺血性卒中、全身性栓塞、心血管死亡和大出血的手术及长期数据。该研究将涉及独立的事件判定和超声心动图核心实验室评估。预计2018年可获得长期随访数据。

结果

全球AMPLATZER Amulet LAA注册研究将收集基于导管的LAA封堵的安全性和有效性信息。描述了现有的和正在进行的基于导管的LAA封堵注册研究的特点。

结论

鉴于这种介入治疗的应用日益增加,对于基于导管的LAA封堵的前瞻性真实世界临床数据有着迫切需求。目前的全球真实世界注册研究将扩展我们对使用第二代封堵装置进行基于导管的LAA封堵围手术期和长期结局的认识。

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