CLINICAL TRIAL / NCT06063538
Prevention of Postoperative Atrial Fibrillation (POAF) Using Intra-Pericardial Amiodarone
- Interventional
- Recruiting
- NCT06063538
Contact Information
A Prospective Study Using Intra-Pericardial Amiodarone for the Prevention of Postoperative Atrial Fibrillation (POAF) in Patients Undergoing Cardiac Arterial Bypass Grafting and/or Valve Surgery
The purpose of this study is to evaluate the combination of CardiaMend, with the addition of amiodarone in the prevention of postoperative atrial fibrillation (POAF) in patients undergoing cardiac arterial bypass grafting (CABG) or valve surgery.
This study involves using CardiaMend, an FDA cleared (K210331) pericardial reconstruction
matrix with the addition of amiodarone, an FDA approved antiarrhythmic drug, as a
prevention of post operative atrial fibrillation.
This is a single-center, prospective randomized study enrolling adult subjects undergoing
isolated cardiac arterial bypass or valve surgery, via complete median sternotomy.
CardiaMend will be used according to the Instructions for Use, and then patted dry to
facilitate implantation. Four ampules of amiodarone (150mg/3ml; 12cc total volume) will
be drawn into a syringe. 2cc will be dripped over the right atrium and a small CardiaMend
patch placed to cover this area. Another 2cc will be used over the left atrium and
covered with the CardiaMend. The anterior pericardial space will be closed without
putting pressure on the underlying structures using the CardiaMend attached to the native
pericardium utilizing running 4-0 monofilament suture. A small edge may be left open for
drain placement and a small slit for the Left Internal Mammary Artery (LIMA) in case of
CABG. The remaining 8 cc of amiodarone will be instilled to the closed pericardial space.
Patients will have continuous electrocardiogram (EKG) until discharge. If clinically
indicated, patients will receive a monitor for home monitoring per standard of care.
Gender
All
Age Group
20 Years to 85 Years
Accepting Healthy Volunteers
No
Inclusion Criteria:
- Subject aged 20-85 years old.
- Patients able to provide written informed consent, understand, and be willing to
comply with study-related procedures.
- Participants who are scheduled to undergo open-chest cardiac surgery via complete
median sternotomy. Includes:
- Coronary artery bypass graft (CABG) and/or valve repair/replacement procedures
(aortic, mitral, or tricuspid)
- Isolated ascending aortic aneurysm replacement/repair
- Note: Left atrial appendage (LAA) procedures are allowed if CABG and/or valve
repair or replacement is the qualifying surgical procedure, but is not a
qualifying surgical procedure on its own.
- In sinus rhythm at the time of office visit and prior electrocardiogram (EKG) (note:
continuous EKG monitoring for 48 hours is not required).
Exclusion Criteria:
- Subject unable to give voluntary written informed consent, is unlikely to cooperate
or is legally incompetent, including subjects who are institutionalized by court or
official order, or in a dependency relationship with, testing center or
investigator.
- Any condition which could interfere with the subject's ability to comply with the
study.
- Ongoing participation in an interventional clinical study or during the preceding 30
days.
- Female subjects who are pregnant, breastfeeding, were pregnant within the last three
months, or are planning to become pregnant during the course of the study.
- Active skin or deep infection at the site of implantation.
- History of chronic wounds or wound-healing disorders.
- Known connective tissue diseases (e.g. Ehlers-Danlos syndrome, Epidermolysis
bullosa, Marfan syndrome, Osteogenesis imperfecta).
- Immune-suppressed subjects, immune-deficiency subjects (properly managed diabetes
mellitus is not an exclusion criterion).
- Concomitant oral or IV systemic corticosteroid therapy and/or other constant
anti-inflammatory therapies.
- Patients already receiving amiodarone as a treatment for atrial fibrillation or
ventricular arrhythmias.
- Disease of the left pleura, previous intervention in the left pleural space, or
chest deformity.
- Subjects with end-stage chronic-renal disease / dialysis.
- STS (Society of Thoracic Surgeons Score) risk score >5.5% for 30 day mortality.