NCT02879448

Brief Summary

The Amulet™ device will be evaluated for safety and efficacy by demonstrating its performance is non-inferior to the commercially available WATCHMAN® left atrial appendage closure device in patients with non-valvular atrial fibrillation. Patients who are eligible for the trial will be randomized to receive either the Amulet device or the WATCHMAN device and will be followed for 5 years after device implant.

Trial Health

98
On Track

Trial Health Score

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

Strong global presence with extensive site network
Enrollment
1,878

participants targeted

Target at P75+ for not_applicable stroke

Timeline
Completed

Started Aug 2016

Longer than P75 for not_applicable stroke

Geographic Reach
11 countries

115 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

First Submitted

Initial submission to the registry

August 22, 2016

Completed
2 days until next milestone

Study Start

First participant enrolled

August 24, 2016

Completed
1 day until next milestone

First Posted

Study publicly available on registry

August 25, 2016

Completed
4.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 7, 2020

Completed
1.1 years until next milestone

Results Posted

Study results publicly available

January 11, 2022

Completed
2.4 years until next milestone

Study Completion

Last participant's last visit for all outcomes

May 24, 2024

Completed
Last Updated

February 26, 2025

Status Verified

January 1, 2025

Enrollment Period

4.3 years

First QC Date

August 22, 2016

Results QC Date

November 9, 2021

Last Update Submit

February 24, 2025

Conditions

Keywords

Non-valvular atrial fibrillationLeft Atrial Appendage

Outcome Measures

Primary Outcomes (3)

  • Primary Safety Endpoint: Composite Endpoint Rate of Procedure-related Complications, or All-cause Death or Major Bleeding (Defined as Type 3 or Greater Based on the Bleeding Academic Research Consortium (BARC) Definition) (Non-inferiority Analysis)

    Procedure related complications are adverse events adjudicated by the Clinical Events Committee (CEC), as procedure related and requiring either invasive surgical or percutaneous intervention. All-cause deaths (cardiovascular or non-cardiovascular) were assessed. Major Bleeding * Type 3a: * Any transfusion with overt bleeding * Overt bleeding+Hb drop of ≥ 3 to \< 5 g/dL (provided Hb drop is related to bleed) * Type 3b: * Overt bleeding+Hb drop ≥ 5 g/dL (provided Hb drop is related to bleed) * Cardiac tamponade * Bleeding requiring surgical intervention for (Watchman) * Bleeding requiring intravenous vasoactive drugs * Type 3c: * Intracranial hemorrhage including subdural hemorrhages * Subcategories confirmed by autopsy/imaging/lumbar puncture * Intraocular bleed compromising vision * Type 5a: Probably fatal bleeding * Type 5b: Definite fatal bleeding

    At 12-months

  • Primary Effectiveness Endpoint: Composite Rate of Ischemic Stroke or Systemic Embolism (Non-inferiority Analysis)

    Ischemic Stroke: An acute symptomatic episode of focal cerebral, spinal, or retinal dysfunction caused by an infarction of central nervous system tissue. Systemic Embolism: Acute vascular insufficiency or occlusion of the extremities or any non-central nervous system (non-CNS) organ associated with clinical, imaging, surgical/autopsy evidence of arterial occlusion in the absence of other likely mechanism (e.g. trauma, atherosclerosis, or instrumentation). When there is presence of prior peripheral artery disease, angiographic or surgical or autopsy evidence is required to show abrupt arterial occlusion.

    At 18-months

  • Mechanism of Action Primary Endpoint: Rate of Device Closure, by the Echocardiography Core Lab (Non-inferiority Analysis)

    Device closure (defined as residual jet around the device ≤ 5 mm) at the 45-day visit documented by transesophageal echocardiogram (TEE/TOE) defined by Doppler flow was assessed.

    At 45-days

Secondary Outcomes (5)

  • Composite Rate of All Stroke, Systemic Embolism, or Cardiovascular/Unexplained Death (Non-inferiority Analysis)

    At 18-months

  • Rate of Major Bleeding (Superiority Analysis)

    At 18-months

  • Superiority Test of Primary Safety Endpoint: Composite Endpoint Rate of Procedure-related Complications, or All-cause Death or Major Bleeding (Defined as Type 3 or Greater Based on the Bleeding Academic Research Consortium (BARC) Definition)

    At 12-months

  • Superiority Test of Primary Effectiveness Endpoint: Composite Rate of Ischemic Stroke or Systemic Embolism

    At 18-months

  • Superiority Test of Primary Mechanism of Action Endpoint: Rate of Device Closure, by the Echocardiography Core Lab

    At 45-days

Study Arms (2)

Amulet

EXPERIMENTAL

Amulet left atrial appendage occluder

Device: Amulet Left Atrial Appendage Occluder

WATCHMAN (Control)

ACTIVE COMPARATOR

WATCHMAN left atrial appendage closure device

Device: WATCHMAN Left Atrial Appendage Closure

Interventions

Transcatheter left atrial appendage closure

Amulet

Transcatheter left atrial appendage closure

WATCHMAN (Control)

Eligibility Criteria

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

You may qualify if:

  • years of age or older
  • Documented paroxysmal, persistent, or permanent non-valvular atrial fibrillation (AF) and the patient has not been diagnosed with rheumatic mitral valvular heart disease
  • At high risk of stroke or systemic embolism defined as CHADS2 score ≥ 2 or a CHA2DS2-VASc score of ≥ 3
  • Has an appropriate rationale to seek an alternative to warfarin or other anticoagulation medication
  • Deemed suitable for LAA closure by a multidisciplinary team of medical professionals (including an independent non-interventional physician) involved in the formal and shared decision- making process, and by use of an evidence-based decision tool on oral anticoagulation (final determination must be documented in the subject's medical record)
  • Able to comply with the required medication regimen post-device implant
  • Able to understand and willing to provide written informed consent to participate in the trial
  • Able and willing to return for required follow-up visits and examinations

You may not qualify if:

  • Requires long-term oral anticoagulation therapy for a condition other than atrial fibrillation
  • Contraindicated for or allergic to aspirin, clopidogrel, or warfarin use
  • Indicated for chronic P2Y12 platelet therapy inhibitor
  • Is considered at high risk for general anesthesia, in the opinion of the investigator, and/or based on past adverse reaction(s) requiring medical intervention or which resulted in prolongation of hospital stay (criterion is only applicable where general anesthesia is planned for the study procedure).
  • Has undergone atrial septal defect (ASD) repair or has an ASD closure device present
  • Has undergone patent foramen ovale (PFO) repair or has a PFO closure device implanted
  • Implanted with a mechanical valve prosthesis
  • Has any of the customary contraindications for a percutaneous catheterization procedure (e.g. subject is too small to accommodate the transesophageal echocardiogram (TEE/TOE) probe or required catheters, or subject has active infection or bleeding disorder)
  • Stroke or transient ischemic attack (TIA) within 90 days prior to randomization or implant procedure (as applicable)
  • Underwent any cardiac or non-cardiac intervention or surgery within 30 days prior to randomization, or intervention or surgery is planned within 60 days after implant procedure (e.g. cardioversion, ablation, cataract surgery, etc.)
  • Myocardial infarction (MI) within 90 days prior to randomization
  • New York Heart Association Class IV Congestive Heart Failure
  • Left ventricular ejection Fraction (LVEF) ≤30%
  • Symptomatic carotid artery disease (defined as \>50% stenosis with symptoms of ipsilateral transient or visual TIA evidenced by amaurosis fugax, ipsilateral hemispheric TIAs or ipsilateral stroke); if subject has a history of carotid stent or endarterectomy the subject is eligible if there is \<50% stenosis
  • Reversible cause of AF (i.e. secondary thyroid disorders, acute alcohol intoxication, trauma, recent major surgical procedures)
  • +19 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (115)

Heart Center Research, LLC.

Huntsville, Alabama, 35801, United States

Location

Banner-University Medical Center Phoenix

Phoenix, Arizona, 85006, United States

Location

Arizona Cardiovascular Research Center

Phoenix, Arizona, 85016, United States

Location

St. Bernards Medical Center

Jonesboro, Arkansas, 72401, United States

Location

Arkansas Heart Hospital

Little Rock, Arkansas, 72211, United States

Location

Scripps Health

La Jolla, California, 92037, United States

Location

Kaiser Permanente Los Angeles Medical Center

Los Angeles, California, 90027, United States

Location

USC University Hospital

Los Angeles, California, 90033-5313, United States

Location

Cedars-Sinai Medical Center

Los Angeles, California, 90048, United States

Location

El Camino Hospital

Mountain View, California, 94040, United States

Location

University of California - Davis Medical Center

Sacramento, California, 95817, United States

Location

Mercy Medical Group - Cardiology

Sacramento, California, 95819, United States

Location

San Diego Cardiac Center

San Diego, California, 92123, United States

Location

Pacific Heart Institute

Santa Monica, California, 90404, United States

Location

South Denver Cardiology Associates PC

Littleton, Colorado, 80120, United States

Location

Medical Center of the Rockies

Loveland, Colorado, 80538, United States

Location

Washington Hospital Center

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

Location

Bradenton Cardiology Center

Bradenton, Florida, 34205, United States

Location

Delray Medical Center

Delray Beach, Florida, 33484, United States

Location

Broward General Medical Center

Fort Lauderdale, Florida, 33316, United States

Location

Baptist Medical Center

Jacksonville, Florida, 32207, United States

Location

Watson Clinic Center

Lakeland, Florida, 33805, United States

Location

Baptist Hospital of Miami

Miami, Florida, 33176, United States

Location

Tallahassee Research Institute

Tallahassee, Florida, 32308, United States

Location

Emory University Hospital

Atlanta, Georgia, 30322, United States

Location

Northeast Georgia Medical Center

Gainesville, Georgia, 30501, United States

Location

The Queen's Medical Center

Honolulu, Hawaii, 96813, United States

Location

Northwestern Memorial Hospital

Chicago, Illinois, 60611, United States

Location

Rush University Medical Center

Chicago, Illinois, 60612, United States

Location

Midwest Cardiovascular Institute

Naperville, Illinois, 60540, United States

Location

Advocate Christ Medical Center

Oak Lawn, Illinois, 60453, United States

Location

Advocate Health and Hospitals Corporation

Oakbrook Terrace, Illinois, 60181, United States

Location

St. Vincent Hospital

Indianapolis, Indiana, 46240-0970, United States

Location

Kansas University Medical Center

Kansas City, Kansas, 66160, United States

Location

Kansas City Cardiac Arrhythmia Research Foundation

Overland Park, Kansas, 66211, United States

Location

Cardiovascular Research Institute of Kansas

Wichita, Kansas, 67226, United States

Location

Baptist Health Lexington

Lexington, Kentucky, 40503, United States

Location

University of Kentucky

Lexington, Kentucky, 40536, United States

Location

Ochsner Medical Center

New Orleans, Louisiana, 70121, United States

Location

Lahey Clinic Medical Center

Burlington, Massachusetts, 01805, United States

Location

Charlton Memorial Hospital

Fall River, Massachusetts, 02720, United States

Location

Henry Ford Hospital

Detroit, Michigan, 48202, United States

Location

Sparrow Clinical Research Institute

Lansing, Michigan, 48912, United States

Location

Beaumont Hospital, Royal Oak

Royal Oak, Michigan, 48073, United States

Location

VA Medical Center Minneapolis

Minneapolis, Minnesota, 55417, United States

Location

St. Cloud Hospital (Central MN Heart Clinic)

Saint Cloud, Minnesota, 56303, United States

Location

St. Joseph's Hospital

Saint Paul, Minnesota, 55102, United States

Location

North Mississippi Medical Center

Tupelo, Mississippi, 38801, 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

Hackensack University Medical Center

Hackensack, New Jersey, 07601-1901, United States

Location

Saint Barnabas Medical Center

Livingston, New Jersey, 07039, United States

Location

Jersey Shore University Medical Center

Neptune City, New Jersey, 07753, United States

Location

Albany Medical Center

Albany, New York, 12208, United States

Location

Winthrop-University Hospital

Mineola, New York, 11501, United States

Location

New York University Hospital

New York, New York, 10016, United States

Location

Mount Sinai Hospital

New York, New York, 10019, United States

Location

New York Presbyterian/Columbia University Medical Center

New York, New York, 10032, United States

Location

Mission Health & Hospitals

Asheville, North Carolina, 28801, United States

Location

Wake Forest University Medical Center Clinical Sciences

Winston-Salem, North Carolina, 27157-1045, United States

Location

University Hospitals Cleveland Medical Center

Cleveland, Ohio, 44106, United States

Location

The Cleveland Clinic Foundation

Cleveland, Ohio, 44195, United States

Location

Oklahoma Heart Institute at Utica

Tulsa, Oklahoma, 74104, United States

Location

Legacy Emanuel Hospital and Health Center

Portland, Oregon, 97227, United States

Location

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, 15213, United States

Location

Lankenau Institute for Medical Research

Wynnewood, Pennsylvania, 19096, United States

Location

WellSpan Health

York, Pennsylvania, 17403-3676, United States

Location

Roper Hospital

Charleston, South Carolina, 29401, United States

Location

Medical University of South Carolina

Charleston, South Carolina, 29425, United States

Location

St. Thomas Hospital

Nashville, Tennessee, 37205, United States

Location

Vanderbilt Heart Institute

Nashville, Tennessee, 37212, United States

Location

Texas Cardiac Arrhythmia

Austin, Texas, 78705, United States

Location

Austin Heart

Austin, Texas, 78756, United States

Location

The Methodist Hospital

Houston, Texas, 77030, United States

Location

The Heart Hospital Baylor Plano

Plano, Texas, 75093, United States

Location

South Texas Cardiovascular Consultants

San Antonio, Texas, 78201, United States

Location

University of Utah Hospital

Salt Lake City, Utah, 84132, United States

Location

University of Vermont College of Medicine

Burlington, Vermont, 05405-0068, United States

Location

University of Virginia Medical Center

Charlottesville, Virginia, 22908, United States

Location

Sentara Norfolk General Hospital

Norfolk, Virginia, 23507, United States

Location

Swedish Medical Center

Seattle, Washington, 98107, United States

Location

West Virginia University Hospital

Morgantown, West Virginia, 26506, United States

Location

Aurora Medical Group

Milwaukee, Wisconsin, 53215, United States

Location

Specialist Cardiology

Wahroonga, New South Wales, 2076, Australia

Location

Greenslopes Private Hospital

Greenslopes, Queensland, 4120, Australia

Location

St. Andrew's Hospital

Adelaide, South Australia, 5000, Australia

Location

HeartCare St John of God Wexford Medical Centre

Murdoch, Western Australia, 6150, Australia

Location

Vancouver General Hospital (U of BC)

Vancouver, British Columbia, V5Z 1M9, Canada

Location

Institut de Cardiologie de Montreal (Montreal Heart Inst.)

Montreal, Quebec, H1T 1C8, Canada

Location

Nemocnice Na Homolce

Prague, Central Bohemia, 15030, Czechia

Location

Skejby University Hospital

Aarhus, 8200, Denmark

Location

Rigshospitalet

Copenhagen, 2100, Denmark

Location

Kliniken Villingen-Schwenningen

Villingen-Schwenningen, Bad-wur, 78052, Germany

Location

Klinikum Coburg GmbH

Coburg, Bavaria, 96450, Germany

Location

Internistisches Klinikum München SUD

Munich, Bavaria, 81379, Germany

Location

Cardioangiologisches Centrum am Bethanien Krankenhaus

Frankfurt am Main, Hesse, 60389, Germany

Location

CardioVaskuläres Centrum St. Katharinen

Frankfurt am Main, Hesse, 60389, Germany

Location

Evangelisches Krankenhaus Bielefeld

Bielefeld, North Rhine, 33617, Germany

Location

Medizinische Einrichtungen der Universität Düsseldorf

Düsseldorf, North Rhine, 40225, Germany

Location

Elisabeth-Krankenhaus Essen GmbH

Essen, North Rhin, 45138, Germany

Location

UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität Mainz

Mainz, Rhineland, 55131, Germany

Location

Herzzentrum Leipzig GmbH

Leipzig, Saxony, 04289, Germany

Location

Universitätsmedizin Berlin - Campus Benjamin Franklin (CBF)

Berlin, 12200, Germany

Location

Asklepios Klinik St. Georg

Hamburg, 20099, Germany

Location

Ospedale San Raffaele - Aritmologia

Milan, Lombard, 20132, Italy

Location

St. Antonius Ziekenhuis

Nieuwegein, Utrecht, 3435 CM, Netherlands

Location

Santa Maria Hospital

Lisbon, Lisbon District, 1649-035, Portugal

Location

Hospital Universitario Virgen Macarena

Seville, Andalusia, 41007, Spain

Location

Hospital General Juan Ramon Jimenez

Huelva, Andalu, 21005, Spain

Location

Hospital Universitario de Salamanca

Salamanca, Castille and León, 37007, Spain

Location

Hospital de la Santa Creu I Sant Pau

Barcelona, Catalonia, 08025, Spain

Location

Clínica Universidad de Navarra

Pamplona, Navarre, 31008, Spain

Location

Center Inselspital Bern

Bern, 3010, Switzerland

Location

Related Publications (8)

  • Nielsen-Kudsk JE, Schmidt B, Windecker S, Shah N, Gray W, Ellis CR, Koulogiannis K, Anderson JA, Gage R, Lakkireddy D. Characterization and Clinical Outcomes of High-Risk Device-Related Thrombus in the Amulet IDE Trial. JACC Clin Electrophysiol. 2025 Jul;11(7):1543-1554. doi: 10.1016/j.jacep.2025.02.016. Epub 2025 Apr 9.

  • Lakkireddy D, Ellis CR, Thaler D, Swarup V, Gambhir A, Hermiller J, Nielsen-Kudsk JE, Worthley S, Nair D, Schmidt B, Horton R, Gupta N, Anderson JA, Zhao H, Alkhouli M, Windecker S. 5-Year Results From the AMPLATZER Amulet Left Atrial Appendage Occluder Randomized Controlled Trial. J Am Coll Cardiol. 2025 Mar 25;85(11):1141-1153. doi: 10.1016/j.jacc.2024.10.101. Epub 2024 Nov 18.

  • Lakkireddy D, Thaler D, Ellis CR, Swarup V, Gambhir A, Hermiller J, Nielsen-Kudsk JE, Worthley S, Nair D, Schmidt B, Horton R, Gupta N, Anderson JA, Gage R, Alkhouli M, Windecker S. 3-Year Outcomes From the Amplatzer Amulet Left Atrial Appendage Occluder Randomized Controlled Trial (Amulet IDE). JACC Cardiovasc Interv. 2023 Aug 14;16(15):1902-1913. doi: 10.1016/j.jcin.2023.06.022.

  • Lakkireddy D, Nielsen-Kudsk JE, Windecker S, Thaler D, Price MJ, Gambhir A, Gupta N, Koulogiannis K, Marcoff L, Mediratta A, Anderson JA, Gage R, Ellis CR. Mechanisms, predictors, and evolution of severe peri-device leaks with two different left atrial appendage occluders. Europace. 2023 Aug 2;25(9):euad237. doi: 10.1093/europace/euad237.

  • Schmidt B, Nielsen-Kudsk JE, Ellis CR, Thaler D, Sabir SA, Gambhir A, Landmesser U, Shah N, Gray W, Swarup V, Lim DS, Koulogiannis K, Anderson JA, Gage R, Lakkireddy D. Incidence, Predictors, and Clinical Outcomes of Device-Related Thrombus in the Amulet IDE Trial. JACC Clin Electrophysiol. 2023 Jan;9(1):96-107. doi: 10.1016/j.jacep.2022.07.014. Epub 2022 Sep 28.

  • Alkhouli M, Russo AM, Thaler D, Windecker S, Anderson JA, Gage R, Lakkireddy D. Sex Differences in Safety and Effectiveness of LAAO: Insights From the Amulet IDE Trial. JACC Cardiovasc Interv. 2022 Nov 14;15(21):2143-2155. doi: 10.1016/j.jcin.2022.06.037. Epub 2022 Oct 12.

  • Price MJ, Ellis CR, Nielsen-Kudsk JE, Thaler D, Gupta N, Koulogiannis K, Anderson JA, Gage R, Lakkireddy D. Peridevice Leak After Transcatheter Left Atrial Appendage Occlusion: An Analysis of the Amulet IDE Trial. JACC Cardiovasc Interv. 2022 Nov 14;15(21):2127-2138. doi: 10.1016/j.jcin.2022.09.001.

  • Lakkireddy D, Thaler D, Ellis CR, Swarup V, Sondergaard L, Carroll J, Gold MR, Hermiller J, Diener HC, Schmidt B, MacDonald L, Mansour M, Maini B, O'Brien L, Windecker S. Amplatzer Amulet Left Atrial Appendage Occluder Versus Watchman Device for Stroke Prophylaxis (Amulet IDE): A Randomized, Controlled Trial. Circulation. 2021 Nov 9;144(19):1543-1552. doi: 10.1161/CIRCULATIONAHA.121.057063. Epub 2021 Aug 30.

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

Cerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular Diseases

Results Point of Contact

Title
Jordan Anderson, Clinical Scientist
Organization
Abbott Medical

Study Officials

  • Dhanunjaya Lakkireddy, MD

    University of Kansas

    STUDY CHAIR
  • David Thaler, MD, PhD

    The Comprehensive Stroke Center at Tufts Medical Center

    STUDY CHAIR
  • Stephan Windecker, MD, PhD

    Inselspital, University of Bern

    STUDY CHAIR

Publication Agreements

PI is Sponsor Employee
No
Restriction Type
OTHER
Restrictive Agreement
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 22, 2016

First Posted

August 25, 2016

Study Start

August 24, 2016

Primary Completion

December 7, 2020

Study Completion

May 24, 2024

Last Updated

February 26, 2025

Results First Posted

January 11, 2022

Record last verified: 2025-01

Data Sharing

IPD Sharing
Will not share

Locations