zenith laa occlusion system

Conditions: Atrial Fibrillation; Left Atrial Appendage; Stroke

Summary: demonstrate the safety and performance of the zenith laa occlusion system and procedure to occlude the left atrial appendage (laa) from the left atrium (la) using a minimally invasive technique. indication - laa closure in patients with non-valvular atrial fibrillation, with an ostial diameter between 18 mm and 26 mm

the study objective is to demonstrate the safety and performance of the zenith laa occlusion system and procedure to occlude the left atrial appendage (laa) from the left atrium (la) using a minimally invasive technique.

Eligibility criteria:
inclusion criteria: 1. age ≥18 at the time of screening 2. documented diagnosis of non-valvular af 3. clinical indication for laa occlusion 4. willing and able to return to and comply with scheduled follow-up visits and testing, including medical treatment as required by the protocol. 5. willing and able to provide written informed consent exclusion criteria: within 30 days before the procedure date: 1. exhibited nyha class iii or iv heart failure symptoms 2. known bleeding disorders (such as bleeding diathesis, thrombocytopenia \[platelet count \ 2 \[spontaneous\]) within 90 days before the procedure date: 3. documented history of myocardial infarction or unstable angina 4. documented embolic stroke, tia or suspected neurologic event 5. chronic renal insufficiency (egfr ≤15ml/min per 1.73 m2 (ckd-epi)) or end-stage renal disease 6. requires long-term oral anticoagulation therapy for a condition other than af 7. diagnosed active local or systemic infection, septicaemia, active pericarditis, or fever of unknown origin 8. known acquired or inherited propensity for forming blood clots (e.g., malignancy and factor v leiden mutation) established by prior objective testing 9. contraindication to the standard of care post-implantation antithrombotic medication regime (e.g., dual antiplatelet therapy (dapt)/direct oral anticoagulant (doac) 10. rheumatic heart disease 11. implanted mechanical valve prosthesis 12. documented carotid disease, defined as greater than 70% stenosis without symptoms or greater than 50% stenosis with symptoms 13. body mass index greater than 40 kg/m2 14. patient is pregnant or breastfeeding or plans/desires to get pregnant within the next 12 months post-procedure 15. current or planned enrolment in an investigation or study of an investigational device or investigational drug that would interfere with this study and the required follow-up 16. mental impairment or other psychiatric conditions which may not allow the patient to understand the nature, significance, and scope of the study 17. any other criteria (including physical and mental health), medical illness, or comorbidity which would make the subject unsuitable to participate in this study as determined by the clinical site principal investigator 18. patients with known allergy or sensitivity to nitinol (nickel and titanium) or any of the other materials in the zenith laa occlusion system implant 19. life expectancy of less than 1 year 20. inability, unwillingness, or contraindication to undergo trans-oesophageal and/or trans-thoracic echocardiogram (toe/tte) or cardiac computed tomography angiography (ccta) imaging or any catheterisation procedures 21. any anatomical condition that precludes the patient from undergoing laa occlusion with the aurigen zenith laa occlusion system implant procedure, as determined by the principal investigator imaging exclusion criteria: 22. patients with a maximal ostial left atrial appendage diameter \>25 mm or \<17 mm by pre-procedural ecg-gated ct scan, to fit the zenith laa occlusion system 23. patients where ccta analysis suggests that the zenith laa occlusion system may not be suitable 24. intracardiac thrombus diagnosed by ccta or echocardiography 25. previous occlusion/ligation of the laa (by any surgical or percutaneous method) 26. documented presence of implanted closure devices (e.g. atrial septal defect (asd), patent foramen ovale (pfo) or ventricular septal defect (vsd) device) for congenital defect treatment 27. documented left ventricular ejection fraction (lvef) \<30%

Keywords: laa occlusion left atrial appendage atrial fibrillation laa closure