NCT00129545

Brief Summary

This is a multi-center, prospective, randomized study, stratified by center, comparing the WATCHMAN device to long term warfarin therapy, demonstrating that the treatment arm is non-inferior to the control arm. This study was amended to allow for a non-randomized arm and increased enrollment.

Trial Health

90
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
800

participants targeted

Target at P75+ for phase_2 atrial-fibrillation

Timeline
Completed

Started Feb 2005

Longer than P75 for phase_2 atrial-fibrillation

Geographic Reach
3 countries

62 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

February 1, 2005

Completed
6 months until next milestone

First Submitted

Initial submission to the registry

August 10, 2005

Completed
2 days until next milestone

First Posted

Study publicly available on registry

August 12, 2005

Completed
8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 1, 2013

Completed
9 months until next milestone

Study Completion

Last participant's last visit for all outcomes

May 1, 2014

Completed
1 year until next milestone

Results Posted

Study results publicly available

May 15, 2015

Completed
Last Updated

May 15, 2015

Status Verified

April 1, 2015

Enrollment Period

8.5 years

First QC Date

August 10, 2005

Results QC Date

October 3, 2014

Last Update Submit

April 29, 2015

Conditions

Keywords

Atrial FibrillationAFA FibStrokeCoumadinWarfarinBlood thinning medicationtransient ischemic attack (TIA)WATCHMANLeft atrial appendageLAA isolationLAA occlusion

Outcome Measures

Primary Outcomes (2)

  • Composite of Stroke, Systemic Embolism and Cardiovascular or Unexplained Death

    A Bayesian model allowed for sequential evaluation of the primary endpoints, event rates reported per 100 patient-years (calculated as 100\*N events/Total patient-years)

    5 years

  • The Occurrence of Life-threatening Events, Including Device Embolization or Serious Bleeding Events

    Serious bleeding events evaluated by the Clinical Events Committee included pericardial effusion requiring drainage, cranial bleeding events due to any source, gastrointestinal bleeds requiring transfusion, and any bleeding related to the device or procedure that necessitates an operation.

    5 years

Secondary Outcomes (1)

  • Procedure Success

    Initial implant procedure

Study Arms (3)

WATCHMAN

EXPERIMENTAL

Implant of WATCHMAN Left Atrial Appendage Closure Technology

Device: WATCHMAN Left Atrial Appendage Closure Technology

Warfarin control

ACTIVE COMPARATOR

Subjects are treated with current standard of care Oral Anticoagulation Therapy with Warfarin

Drug: Warfarin

Roll-in

OTHER

Implant of WATCHMAN Left Atrial Appendage Closure Technology. Up to 3 non-randomized subjects per site, these subjects were not included in the primary analysis.

Device: WATCHMAN Left Atrial Appendage Closure Technology

Interventions

Implant of WATCHMAN Left Atrial Appendage Closure Technology

Also known as: WATCHMAN
Roll-inWATCHMAN

Subjects receive warfarin

Also known as: Coumadin
Warfarin control

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patient has paroxysmal, persistent or permanent non-valvular atrial fibrillation (AF)
  • Eligible for long term warfarin
  • CHADS score \>= 1 \[congestive heart failure (CHF), history of high blood pressure, 75 years of age or older, diabetes, prior stroke or transient ischemic attack (TIA)\]

You may not qualify if:

  • Contraindicated for warfarin
  • Contraindicated for aspirin or clopidogrel (Plavix)
  • Congestive heart failure (CHF) Class 4
  • Implanted mechanical valve
  • Atrial septal or Patent Foramen Ovale (PFO) device
  • Platelets \< 100,000 or hemoglobin \< 10
  • Left ventricular ejection fraction (LVEF) \< 30%

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (62)

Advanced Cardiac Specialists

Gilbert, Arizona, 85233, United States

Location

Arizona Arrhythmia

Scottsdale, Arizona, 85251, United States

Location

Foundation for Cardiovascular Medicine

La Jolla, California, 92037, United States

Location

Los Angeles Cardiology Associates

Los Angeles, California, 90017, United States

Location

Cedars-Sinai Medical Center

Los Angeles, California, 90048, United States

Location

El Camino Hospital

Mountain View, California, 94040, United States

Location

Orange County Heart

Orange County, California, 92868, United States

Location

UC Davis Medical Center

Sacramento, California, 95817, United States

Location

St. John's Hospital / Pacific Heart

Santa Monica, California, 90404, United States

Location

Washington Hospital Center

Washington D.C., District of Columbia, 20010, United States

Location

University of Miami

Miami, Florida, 33136, United States

Location

Baptist Cardiac and Vascular Institute

Miami, Florida, 33176, United States

Location

Bay Heart Group

Tampa, Florida, 33607, United States

Location

Emory University Midtown Hospital

Atlanta, Georgia, 30308, United States

Location

Piedmont Hospital

Atlanta, Georgia, 30309, United States

Location

Emory University Hospital

Atlanta, Georgia, 30322, United States

Location

University of Chicago

Chicago, Illinois, 60637, United States

Location

North Shore University

Evanston, Illinois, 60201, United States

Location

Loyola University Medical Center

Maywood, Illinois, 60153, United States

Location

Prairie Education Research Cooperative

Springfield, Illinois, 60637, United States

Location

Baptist Hospital West

Lexington, Kentucky, 40503, United States

Location

University of Kentucky

Lexington, Kentucky, 40536-0294, United States

Location

Terrebonne General Medical Center

Houma, Louisiana, 70360, United States

Location

Ochsner Clinic

New Orleans, Louisiana, 70121, United States

Location

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

Location

University of Michigan Medical Center

Ann Arbor, Michigan, 48109, United States

Location

William Beaumont

Royal Oak, Michigan, 48073, United States

Location

Abbott Northwestern Hospital

Minneapolis, Minnesota, 55407, United States

Location

Mayo Clinic

Rochester, Minnesota, 55902, United States

Location

St. Paul Heart Clinic

Saint Paul, Minnesota, 55102, United States

Location

University of Mississippi Healthcare Center

Jackson, Mississippi, 39216, United States

Location

St. Luke's Hospital

Kansas City, Missouri, 64111, United States

Location

Nebraska Heart Institute

Lincoln, Nebraska, 68526, United States

Location

Cooper University Hospital

Camden, New Jersey, 08103, United States

Location

New Mexico Heart Institute

Albuquerque, New Mexico, 87102, United States

Location

New York University Medical Center

New York, New York, 10016, United States

Location

Columbia University Medical Center

New York, New York, 10032, United States

Location

Mt. Sinai Medical Center

New York, New York, United States

Location

Summa Health System

Akron, Ohio, 44304, United States

Location

Lindner Clinical Trial Center

Cincinnati, Ohio, 45219, United States

Location

Cleveland Clinic Foundation

Cleveland, Ohio, 44195, United States

Location

Ohio State University

Columbus, Ohio, 43210, United States

Location

Riverside Methodist Hospital

Columbus, Ohio, 43214, United States

Location

Geisinger Medical Center

Danville, Pennsylvania, 17822, United States

Location

Harrisburg Hospital / Associated Cardiology

Harrisburg, Pennsylvania, 17110, United States

Location

Allegheny General Hospital

Pittsburgh, Pennsylvania, 15212, United States

Location

Presbyterian University Hospital

Pittsburgh, Pennsylvania, 15213, United States

Location

Moffitt Heart & Vascular

Wormleysburg, Pennsylvania, 17043, United States

Location

Mercy Medical Center West

Knoxville, Tennessee, 37934, United States

Location

St. Thomas Research Institute

Nashville, Tennessee, United States

Location

Texas Cardiac Arrhythmia

Austin, Texas, 78705, United States

Location

St. Lukes Episcopal Hospital

Houston, Texas, 77030, United States

Location

Intermountain Medical Center

Salt Lake City, Utah, 84107, United States

Location

University of Virginia

Charlottesville, Virginia, 22908, United States

Location

Inova Fairfax Hospital

Falls Church, Virginia, 22042, United States

Location

Sentara Norfolk General Hospital

Norfolk, Virginia, 23507, United States

Location

Swedish Medical Center

Seattle, Washington, 98104, United States

Location

Marshfield Clinic

Marshfield, Wisconsin, 54449, United States

Location

Na Homolce

Prague, 15030, Czechia

Location

Krankenhaus der Barmherzige Bruder

Regensburg, Bavaria, 93049, Germany

Location

Cardiovasculares Centrum Frankfurt - Sankt Katharinen

Frankfurt am Main, Hesse, 60389, Germany

Location

Herzzentrum

Leipzig, Germany

Location

Related Publications (8)

  • Dukkipati SR, Holmes DR Jr, Doshi SK, Kar S, Singh SM, Gibson D, Price MJ, Natale A, Mansour M, Sievert H, Houle VM, Allocco DJ, Reddy VY. Impact of Peridevice Leak on 5-Year Outcomes After Left Atrial Appendage Closure. J Am Coll Cardiol. 2022 Aug 2;80(5):469-483. doi: 10.1016/j.jacc.2022.04.062.

  • Brouwer TF, Whang W, Kuroki K, Halperin JL, Reddy VY. Net Clinical Benefit of Left Atrial Appendage Closure Versus Warfarin in Patients With Atrial Fibrillation: A Pooled Analysis of the Randomized PROTECT-AF and PREVAIL Studies. J Am Heart Assoc. 2019 Dec 3;8(23):e013525. doi: 10.1161/JAHA.119.013525. Epub 2019 Nov 22.

  • Price MJ, Reddy VY, Valderrabano M, Halperin JL, Gibson DN, Gordon N, Huber KC, Holmes DR Jr. Bleeding Outcomes After Left Atrial Appendage Closure Compared With Long-Term Warfarin: A Pooled, Patient-Level Analysis of the WATCHMAN Randomized Trial Experience. JACC Cardiovasc Interv. 2015 Dec 28;8(15):1925-1932. doi: 10.1016/j.jcin.2015.08.035. Epub 2015 Nov 25.

  • Reddy VY, Sievert H, Halperin J, Doshi SK, Buchbinder M, Neuzil P, Huber K, Whisenant B, Kar S, Swarup V, Gordon N, Holmes D; PROTECT AF Steering Committee and Investigators. Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: a randomized clinical trial. JAMA. 2014 Nov 19;312(19):1988-98. doi: 10.1001/jama.2014.15192.

  • Alli O, Doshi S, Kar S, Reddy V, Sievert H, Mullin C, Swarup V, Whisenant B, Holmes D Jr. Quality of life assessment in the randomized PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) trial of patients at risk for stroke with nonvalvular atrial fibrillation. J Am Coll Cardiol. 2013 Apr 30;61(17):1790-8. doi: 10.1016/j.jacc.2013.01.061. Epub 2013 Feb 28.

  • Reddy VY, Doshi SK, Sievert H, Buchbinder M, Neuzil P, Huber K, Halperin JL, Holmes D; PROTECT AF Investigators. Percutaneous left atrial appendage closure for stroke prophylaxis in patients with atrial fibrillation: 2.3-Year Follow-up of the PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients with Atrial Fibrillation) Trial. Circulation. 2013 Feb 12;127(6):720-9. doi: 10.1161/CIRCULATIONAHA.112.114389. Epub 2013 Jan 16.

  • Reddy VY, Holmes D, Doshi SK, Neuzil P, Kar S. Safety of percutaneous left atrial appendage closure: results from the Watchman Left Atrial Appendage System for Embolic Protection in Patients with AF (PROTECT AF) clinical trial and the Continued Access Registry. Circulation. 2011 Feb 1;123(4):417-24. doi: 10.1161/CIRCULATIONAHA.110.976449. Epub 2011 Jan 17.

  • Holmes DR, Reddy VY, Turi ZG, Doshi SK, Sievert H, Buchbinder M, Mullin CM, Sick P; PROTECT AF Investigators. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet. 2009 Aug 15;374(9689):534-42. doi: 10.1016/S0140-6736(09)61343-X.

Related Links

MeSH Terms

Conditions

Atrial FibrillationStrokeIschemic Attack, Transient

Interventions

Warfarin

Condition Hierarchy (Ancestors)

Arrhythmias, CardiacHeart DiseasesCardiovascular DiseasesPathologic ProcessesPathological Conditions, Signs and SymptomsCerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesBrain Ischemia

Intervention Hierarchy (Ancestors)

4-HydroxycoumarinsCoumarinsBenzopyransPyransHeterocyclic Compounds, 1-RingHeterocyclic CompoundsHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-Ring

Results Point of Contact

Title
Watchman Trial Manager
Organization
Boston Scientific

Study Officials

  • David Holmes, MD

    Mayo Clinic

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restriction Type
LTE60
Restrictive Agreement
Yes

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 10, 2005

First Posted

August 12, 2005

Study Start

February 1, 2005

Primary Completion

August 1, 2013

Study Completion

May 1, 2014

Last Updated

May 15, 2015

Results First Posted

May 15, 2015

Record last verified: 2015-04

Locations