Atrial FibrillationNCT03173534
WATCH-TAVR, WATCHMAN for Patients With Atrial Fibrillation Undergoing Transcatheter Aortic Valve Replacement
A study testing WATCHMAN and TAVR in people with Atrial Fibrillation and Aortic Valve Stenosis, run by samir kapadia at 32 sites in United States.
Trial summary
To evaluate the safety and effectiveness of the left atrial appendage occlusion with WATCHMAN Device in prevention of stroke and bleeding in patients with atrial fibrillation (AF) undergoing transcatheter aortic valve replacement (TAVR). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Atrial Fibrillation, Aortic Valve Stenosis
- What is being tested?
- WATCHMAN and TAVR
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 350 participants
- Where
- 32 sitesUnited States
- Study dates
- 15 Dec 2017to 6 Dec 2022
- Phase
- Interventional
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Men and women ≥ 18 years of age.
- The patient meets criteria for and is scheduled to undergo TAVR procedure
- The patient has documented paroxysmal, persistent, or permanent atrial fibrillation.
- The patient meets the WATCHMAN labeling guidelines and is eligible to undergo the WATCHMAN implantation procedure.
- The patient is eligible for short term warfarin therapy.
- The patient or legal representative is able to understand and willing to provide written informed consent to participate in the trial.
- The patient is able and willing to return for required follow-up visits and examinations.
Who cannot join
- The patient had a stroke or TIA within the last 6 months prior to enrollment.
- Contraindication for short term anticoagulation.
- 3 .Moderate or severe Mitral Stenosis with mean gradient across Mitral Valve >10 mm Hg or Mitral Valve Area < 1.2cm2.
- 4. The patient has symptomatic carotid disease (i.e.,carotid stenosis ≥ 50% associated with ipsilateral transient or visual TIA evidenced by amaurosis fugax, ipsilateral hemispheric TIAs or ipsilateral stroke within 6 months).
- 5. Prior occlusion of LAA.
- 6. The patient has an implanted mechanical mitral valve.
Show all 17Show fewer
- 7. The patient requires long-term warfarin therapy due to:
- Secondary to conditions such as prior arterial embolism or other indications such as pulmonary embolism or deep vein thrombosis within the previous 6 months
- The patient is in a hypercoaguable state; exclude the patient if per medical record documentation, the patient meets any of the following criteria:
- Thrombosis occurring ≤ 40 years of age
- Idiopathic or recurrent VTE (venous thrombo-embolism)
- Thrombosis at an unusual site (cerebral veins, hepatic veins, renal veins, IVC, mesenteric veins)
- Family history of VTE or of inherited prothrombotic disorder, recurrence/extension of thrombosis while adequately anticoagulated.
- 8. The patient is actively enrolled in another trial of a cardiovascular device or an investigational drug (post-market study participation and registries are acceptable).
- 9. The patient is pregnant or pregnancy is planned during the course of the investigation if patient is of child bearing potential.
- 10. Any clinically significant medical condition or presence of any laboratory abnormality prior to randomization that is considered by the investigator to be clinically important and could interfere with the conduct of the study or not meeting procedure guidelines for TAVR or WATCHMAN.
- 11. The patient has a life expectancy of less than two years.
Trial locations and contacts
32 sites in 1 country.
32 sites in 1 country
United States32 sites
Austin Heart
Austin, Texas, 78756
Massachusetts General Hospital
Boston, Massachusetts, 02114
University at Buffalo
Buffalo, New York, 14203
Sutter Health/Palo Alto Medical Foundation
Burlingame, California, 94010
The Cleveland Clinic
Cleveland, Ohio, 44195
The Ohio State University
Columbus, Ohio, 43210
OhioHealth Research Institute
Columbus, Ohio, 43214
Henry Ford Hospital
Detroit, Michigan, 48202
Ascension St. John Hospital
Detroit, Michigan, 48236
Inova Fairfax Hospital
Falls Church, Virginia, 22042
Parkview Research Center
Fort Wayne, Indiana, 46845
St. Vincent Heart Center
Indianapolis, Indiana, 46290
University of Iowa Hospitals and Clinics
Iowa City, Iowa, 52242
Baptist Health Jacksonville
Jacksonville, Florida, 32207
UCHealth Medical Center of the Rockies
Loveland, Colorado, 80538
Morristown Medical Center
Morristown, New Jersey, 07960
Intermountain Medical Center
Murray, Utah, 84107
Columbia University Medical Center
New York, New York, 10032
INTEGRIS Baptist Medical Center
Oklahoma City, Oklahoma, 73112
CHI Health Research Center
Omaha, Nebraska, 68124
Banner University Medical Center
Phoenix, Arizona, 85006
Heart Hospital Baylor Plano
Plano, Texas, 75093
Santa Barbara Cottage Hospital
Santa Barbara, California, 93105
Prairie Cardiovascular Consultants
Springfield, Illinois, 62701
Medstar Washington University
St Louis, Missouri, 63110
Northside Hospital
St. Petersburg, Florida, 33709
Tallahassee Research Institute
Tallahassee, Florida, 32308
Medstar Washington Hospital Center
Washington D.C., District of Columbia, 20010
Aspirus Research Institute
Wausau, Wisconsin, 54401
Lexington Cardiology
West Columbia, South Carolina, 29169
Pinnacle Health
Wormleysburg, Pennsylvania, 17043
WellSpan York Hospital
York, Pennsylvania, 17403
About this study
Official title: WATCHMAN for Patients With Atrial Fibrillation Undergoing Transcatheter Aortic Valve Replacement
To evaluate the safety and effectiveness of the left atrial appendage occlusion with WATCHMAN Device in prevention of stroke and bleeding in patients with atrial fibrillation (AF) undergoing transcatheter aortic valve replacement (TAVR).
Read the detailed description
WATCH-TAVR is a prospective, multicenter, randomized controlled trial. Only centers with approval for commercial WATCHMAN implantation will be included in this trial. Subjects will be enrolled at up to 32 centers in the United States. There will be up to 350 subjects enrolled, with 175 patients randomized to TAVR + medical therapy and 175 patients randomized to simultaneous TAVR+WATCHMAN to accumulate the necessary 191 primary events. Enrollment is expected to occur over the course of 18 months. Patients will be followed for a total of 2 years. Patients with non-valvular AF undergoing standard of care commercial TAVR will be enrolled in the trial.
For patients who receive the WATCHMAN device, plan of care will follow WATCHMAN labeling.Patients randomized to receive the WATCHMAN device will receive anticoagulation with warfarin and aspirin for 6 weeks after the procedure. After 6 weeks, the plan of care will follow WATCHMAN labeling. Patients randomized to the TAVR + medical therapy arm will be treated in accordance with standard of care with either warfarin, other anticoagulant/antiplatelet therapy, or no anticoagulation at the discretion of the treating physician. All patients will continue to receive routine post-TAVR follow-up and care.Patients will be monitored for primary and secondary endpoints as outlined. Baseline information and laboratory data will be collected as described in the protocol.
At trial conclusion, total number of subjects enrolled was 349. There were 172 subjects enrolled in the TAVR + Medical Therapy arm and 177 subjects enrolled in the TAVR + WATCHMAN arm.
- Conditions
- Atrial Fibrillation, Aortic Valve Stenosis
- Being tested
- WATCHMAN, TAVR
- Medical subject headings
- Atrial Fibrillation, Aortic Valve Stenosis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
WATCHMANDevice
WATCHMAN Device is composed of a self-expanding nitinol structure with a porous membrane on the proximal face. The implant device is delivered to the Left Atrial Appendage by femoral venous access and transseptal puncture to enter the left atrium.
TAVRDevice
Transcatheter Aortic Valve Replacement
| Study group | Role | What they receive |
|---|---|---|
| TAVR + Medical Therapy | Active comparator | n=172 will undergo Transcatheter Aortic Valve Replacement (TAVR) alone with medical management for atrial fibrillation Receives: Device: TAVR |
| TAVR + WATCHMAN | Experimental | n=177 will undergo simultaneous Transcatheter Aortic Valve Replacement (TAVR) with a WATCHMAN device. Receives: Device: WATCHMAN; Device: TAVR |
What is being measured
The primary outcome is the main question the study is designed to answer.
Composite of All-cause Mortality, Stroke and Bleeding
First occurrence of all-cause mortality, stroke (ischemic or hemorrhagic), or bleeding (life-threatening and major) events through 2 years post-randomization.
Measured: Through 2 year post-randomization
Secondary outcomes (3)
All-cause Mortality
All deaths through 2 year
Measured: Through 2 year post-randomization
Stroke
First occurrence of any ischemic or hemorrhagic stroke through 2 year
Measured: Through 2 year post-randomization
Bleeding
First occurrence of any life-threatening or major bleeding through 2 year
Measured: Through 2 year post-randomization
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Jun 2017
- Study start15 Dec 2017
- Primary completion6 Dec 2022
- Study completion6 Dec 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Atrial FibrillationStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Patients will be randomized in a 1:1 allocation ratio to the following treatment arms TAVR + Medical Therapy (n=175) or simultaneous TAVR + WATCHMAN (n=175)
- Masking
- None (open label)
- Enrolment
- 350 participants (actual)
Sponsor and investigators
- Lead sponsor
- samir kapadia
- Sponsor type
- University, hospital or other
- Collaborators
- Boston Scientific Corporation, The Cleveland Clinic
- Responsible party
- Sponsor-investigator, samir kapadia, The Cleveland Clinic
- Investigators
- Samir Kapadia, MD, Principal investigator, The Cleveland Clinic
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03173534
- Sponsor's protocol ID
- WATCH-TAVR
- Status last verified
- May 2024
- First submitted
- 23 May 2017
- Last updated
- 22 May 2024
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
- Individual data sharing
- No
Publications
Kapadia SR, Krishnaswamy A, Whisenant B, Potluri S, Iyer V, Aragon J, Gideon P, Strote J, Leonardi R, Agarwal H, Larrain G, Sanchez C, Panaich SS, Harvey J, Vahl T, Menon V, Wolski K, Wang Q, Leon MB. Concomitant Left Atrial Appendage Occlusion and Transcatheter Aortic Valve Replacement Among Patients With Atrial Fibrillation. Circulation. 2024 Mar 5;149(10):734-743. doi: 10.1161/CIRCULATIONAHA.123.067312. Epub 2023 Oct 24.
PubMed 37874908