Medtronic Affera™ Mapping and Ablation System with Sphere-9™ Catheter achieves endpoints for safety and efficacy, providing promising evidence for the future of atrial fibrillation treatment

Rhea-AI Summary

Medtronic announced positive results for its Affera™ Mapping and Ablation System with Sphere-9™ Catheter in treating persistent atrial fibrillation (AFib). This all-in-one catheter showed excellent safety and efficacy in the SPHERE Per-AF trial, outperforming the control arm. The Sphere-9 Catheter achieved a primary safety endpoint rate of 1.4% compared to 1.0% for the control arm. It demonstrated 73.8% freedom from AFib versus 65.8% for the control group. The Sphere-9 system also improved procedural efficiency and quality of life for patients. The trial had 420 participants from the U.S., Czech Republic, and Israel. These results have propelled Medtronic closer to obtaining FDA approval for Sphere-9 in the U.S.

Positive

• Sphere-9 Catheter achieved a primary safety endpoint rate of 1.4%, outperforming the control arm with 1.0%.
• The system demonstrated 73.8% freedom from AFib compared to 65.8% for the control arm.
• No significant safety events, such as pulmonary vein stenosis, esophageal events, or cardiac tamponade, were reported.
• Procedural efficiency showed improvement, including reduced skin-to-skin time and energy application time.
• Over 95% of Sphere-9 procedures used a single transeptal puncture versus 62% in the control arm.
• The trial showed significant improvements in patients' quality of life, both mentally and physically.
• Sphere-9 Catheter offers dual energy options—pulsed field and radiofrequency—within a single, versatile catheter.

Negative

• The Sphere-9 Catheter is still investigational in the U.S. and not yet approved for sale or distribution.
• The primary safety endpoint rate for Sphere-9 (1.4%) was slightly higher than the control arm (1.0%), which may concern some investors.

Insights

Financial Analyst

The announcement of the Affera™ Mapping and Ablation System with Sphere-9™ Catheter achieving its safety and efficacy endpoints is significant for Medtronic (NYSE: MDT) from a financial perspective. The positive results from the SPHERE Per-AF trial could potentially pave the way for the FDA approval, which would significantly enhance Medtronic's portfolio in the lucrative atrial fibrillation (AFib) treatment market.

From a financial standpoint, these results may lead to increased revenue streams if the Sphere-9 catheter is commercialized. The superior efficiency and safety profiles indicated by the trial data suggest a product that could be well-received by the market, potentially driving market share gains. Additionally, given that AFib is a common condition affecting over 60 million people worldwide, the addressable market is substantial. Even a small increase in market penetration could translate to significant revenue growth.

In the short term, investors might react positively to the news, driven by the potential for new product approval and subsequent launch. However, it is important to monitor FDA responses and further clinical trial data closely.

In the long term, success in this space would not only drive revenue but also solidify Medtronic's position as a leader in AFib treatment technology, potentially leading to sustainable growth and higher company valuations. However, investors should remain cautious about the competitive landscape and the timing of FDA approvals.

Medical Research Analyst

The SPHERE Per-AF trial results present compelling evidence for the efficacy and safety of the Sphere-9 catheter, which stands out for its dual-energy functionality (pulsed field and radiofrequency) and high-density mapping capabilities. From a clinical perspective, the ability to achieve a primary safety endpoint rate of 1.4% compared to the control’s 1.0% with no serious safety events is noteworthy. The 73.8% freedom from AFib is also a strong indicator of the device's effectiveness.

The technology's innovation lies in its 'all-in-one' design, allowing for more efficient and potentially less invasive procedures with a single transeptal puncture in over 95% of cases, compared to 62% in the control group. This can significantly improve procedural times and patient outcomes, addressing the high need for effective and efficient treatment in the challenging persistent AFib patient population.

Improvements in quality of life observed among patients treated with Sphere-9 could potentially lead to broader adoption in clinical practice, enhancing the overall standard of care for AFib patients. However, while the results are promising, further longitudinal studies and real-world data post-FDA approval will be pivotal in confirming these findings on a larger scale.

Market Research Analyst

The results from Medtronic's SPHERE Per-AF trial could create a substantial impact on the competitive landscape of the AFib treatment market. Currently, the market is dominated by established technologies like the Thermocool SmartTouch® SF catheter. The Sphere-9 catheter's ability to combine pulsed field and radiofrequency ablation with high-density mapping in a single device offers a strong value proposition that could disrupt existing market dynamics.

The efficiency gains illustrated by the trial data, including reduced procedural times and the need for fewer transeptal punctures, provide a compelling case for adoption by electrophysiologists. The convenience and versatility of the Sphere-9 catheter could translate into cost savings and better resource utilization for healthcare providers, potentially driving preference for Medtronic's new system.

For investors, the key takeaway is the potential market expansion for Medtronic should the Sphere-9 achieve FDA approval. This could lead to significant market share capture in a growing and underpenetrated segment. The broader adoption of this technology by medical practitioners due to its ease of use and efficiency could further accelerate market penetration, resulting in robust sales growth.

However, investors should also consider the competitive responses from existing players and potential new entrants who may seek to innovate in response to Medtronic's advancements. The timeline for FDA approval and subsequent market entry will also be a critical factor to watch.

HRS late breaking data: SPHERE Per-AF trial demonstrates novel all-in-one system delivers exceptional results, plus increased efficiency and improved quality of life

DUBLIN and BOSTON, May 17, 2024 /PRNewswire/ -- Medtronic plc (NYSE: MDT), a global leader in healthcare technology, today announced positive results demonstrating excellent safety and efficacy of the Affera™ Mapping and Ablation System with Sphere-9™ Catheter, an all-in-one pulsed field (PF) and radiofrequency (RF) ablation and high density (HD) mapping catheter for the treatment of persistent atrial fibrillation (AFib). The SPHERE Per-AF study, a U.S. Food and Drug Administration (FDA) Investigational Device Exemption (IDE) pivotal trial, compared Sphere-9 to the conventional Thermocool SmartTouch® SF radiofrequency ablation catheter with the Carto™ 3 System. Findings were presented as late-breaking clinical data at the Heart Rhythm Society (HRS) 2024 Annual Meeting and simultaneously published in Nature Medicine.  

"These are excellent results for the investigational Sphere-9 catheter. The data show Sphere-9 lattice tip technology enables physicians to create a wide circumferential pulmonary vein isolation, which is the cornerstone of any type of AFib ablation, and any set of desired ablation lesions, in a safe, effective and efficient manner," said Elad Anter, M.D., Director of the Arrythmia Institute, Shamir Medical Center, Israel. "Persistent AFib patients make up 30-50% of the patient population and are often challenging to treat, with the majority of procedures requiring additional lesion sets beyond pulmonary vein isolation. The versatility and ease of use of this mapping and ablation system led to impressive efficiency and treatment outcomes in the trial."

• The Sphere-9 Catheter demonstrated a positive safety profile with an excellent primary safety endpoint rate of 1.4% (1.0% for the control arm). Importantly, no safety events including pulmonary vein stenosis, esophageal events or cardiac tamponade were reported. More than 95% of Sphere-9 procedures used a single transeptal puncture compared to 62% in the control arm.
  
  
• Sphere-9 demonstrated 73.8% freedom from AFib* vs. only 65.8% observed in the control arm. Following 100% acute isolation of pulmonary veins and linear lesions, patients treated with the Sphere-9 Catheter also observed less recurrence of atrial arrhythmias throughout the 12-month follow up period.
  
  
• Treatment with the Sphere-9 catheter demonstrated superior efficiency over the control arm for procedural characteristics including:
  • Skin-to-skin procedural time
  • Time between first and last ablation
  • Energy application time
    
    
• Patients treated with the Sphere-9 catheter experienced improvements to quality of life in both mental and physical well-being.

"As pioneers in cardiac ablation treatment, including cryoablation and PFA, we are thrilled to share these results providing excellent evidence for use of this all-in-one catheter that can be used with no need to pull a second catheter," said Rebecca Seidel, president, Cardiac Ablations Solutions business, which is part of the Cardiovascular Portfolio at Medtronic. "The Affera Mapping and Ablation system with Sphere-9 Catheter demonstrates a positive safety, efficacy and efficiency profile and can amplify our innovative and trusted portfolio. With these results, we are now one step closer to bringing this technology to the U.S. and beyond."

SPHERE Per-AF was a prospective, multicenter, randomized clinical trial evaluating the Sphere-9 Catheter with the Affera Mapping and Ablation System for treatment of persistent AFib. Subjects were randomized 1:1 to receive treatment with either the Sphere-9 Catheter with the Affera Mapping and Ablation System or the Thermocool SmartTouch® SF radiofrequency ablation catheter with the Carto™ 3 System. For the primary analysis, a total of 420 patients were enrolled across 23 sites in three countries: the United States, Czech Republic and Israel. All patients in both arms of the trial received pulmonary vein isolation as well as linear lesions based on the patient's needs.

Affera Sphere-9 features include:

• All-in-one HD mapping and ablation catheter fully integrated with the Affera Mapping and Ablation System
• 9mm lattice tip with large footprint
• Convenience of dual energy, pulsed field or radiofrequency

"We've been waiting for one catheter that can be used for every arrhythmia, and these randomized results from centers that routinely use conventional point by point ablation indicate Affera Sphere-9 will be worth the wait with all its innovation and the rapid learning curve of the system," said Vivek Reddy, M.D., Director of Cardiac Arrhythmia Services for the Mount Sinai Health System in New York City. "These are important, highly anticipated results and groundbreaking news for the electrophysiology community that could change the treatment workflow."

The company recently filed for approval of the Affera Sphere-9 Catheter in the U.S. with the FDA. The Affera Sphere-9 Catheter is investigational in the United States and not approved for sale or distribution. The Affera Mapping and Ablation System, which includes the Sphere-9 Catheter, received CE Mark approval in March 2023.

AFib is one of the most common and undertreated heart rhythm disorders, affecting more than 60 million people worldwide.¹ Afib is a progressive disease, often beginning as paroxsymal AFib (presents intermittently) and progressing to persistent (lasts for more than 7+ days without stopping). As the disease progresses, the risk of serious complications including heart failure, stroke and risk of death increases^2-5.

For more information on Affera SPHERE-9, visit Medtronic.com.

*The primary effectiveness endpoint was a composite of freedom from: failure to isolate all targeted pulmonary veins and complete all left atrial ablation with the assigned study device; repeat ablation at any time after the index procedure; and after a 3-month blanking period, documented occurrence of atrial tachyarrhythmia, escalation or initiation of Class I or III antiarrhythmic drugs, or cardioversion.

About Medtronic
Bold thinking. Bolder actions. We are Medtronic. Medtronic plc, headquartered in Dublin, Ireland, is the leading global healthcare technology company that boldly attacks the most challenging health problems facing humanity by searching out and finding solutions. Our Mission — to alleviate pain, restore health, and extend life — unites a global team of 95,000+ passionate people across 150 countries. Our technologies and therapies treat 70 health conditions and include cardiac devices, surgical robotics, insulin pumps, surgical tools, patient monitoring systems, and more. Powered by our diverse knowledge, insatiable curiosity, and desire to help all those who need it, we deliver innovative technologies that transform the lives of two people every second, every hour, every day. Expect more from us as we empower insight-driven care, experiences that put people first, and better outcomes for our world. In everything we do, we are engineering the extraordinary. For more information on Medtronic (NYSE:MDT), visit www.Medtronic.com and follow Medtronic on LinkedIn.

Any forward-looking statements are subject to risks and uncertainties such as those described in Medtronic's periodic reports on file with the Securities and Exchange Commission. Actual results may differ materially from anticipated results.

Thermocool SmartTouch and Carto are trademarks of Biosense Webster, Inc.

References

1. Roth GA, Mensah GA, Johnson CO et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. J Am Coll Cardiol 2020;76:2982-3021.
2. Miyasaka Y, Barnes ME, Bailey KR, et al. Mortality trends in patients diagnosed with first atrial fibrillation: a 21-year community-based study. J Am Coll Cardiol 2007;49:986-92.
3. Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J 2020.
4. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 1991;22:983-8.
5. Lubitz SA, Moser C, Sullivan L, et al. Atrial fibrillation patterns and risks of subsequent stroke, heart failure, or death in the community. J Am Heart Assoc 2013;2:e000126

Contacts:
Leslie Williamson	Ryan Weispfenning
Public Relations	Investor Relations
+1-612-227-5099	+1-763-505-4626

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SOURCE Medtronic plc

FAQ

What are the key results of the SPHERE Per-AF trial for Medtronic's Sphere-9 Catheter?

The Sphere-9 Catheter achieved a primary safety endpoint rate of 1.4% and demonstrated 73.8% freedom from AFib, outperforming the control arm.

When was the data from the SPHERE Per-AF trial presented?

The data was presented at the Heart Rhythm Society 2024 Annual Meeting and published in Nature Medicine on May 17, 2024.

What safety events were associated with Medtronic's Sphere-9 Catheter?

No significant safety events, including pulmonary vein stenosis, esophageal events, or cardiac tamponade, were reported in the trial.

How did the Sphere-9 Catheter impact procedural efficiency?

The Sphere-9 Catheter improved procedural efficiency, including reduced skin-to-skin time, time between first and last ablation, and energy application time.

Is the Sphere-9 Catheter approved for use in the United States?

No, the Sphere-9 Catheter is still investigational in the U.S. and has not yet received FDA approval for sale or distribution.

What percentage of Sphere-9 procedures used a single transeptal puncture?

Over 95% of Sphere-9 procedures used a single transeptal puncture compared to 62% in the control arm.

How many patients were enrolled in the SPHERE Per-AF trial?

A total of 420 patients participated in the trial across 23 sites in the U.S., Czech Republic, and Israel.

What is the significance of the dual energy feature in the Sphere-9 Catheter?

The dual energy feature offers the convenience of using either pulsed field or radiofrequency within a single, versatile catheter, enhancing treatment flexibility.

Did the Sphere-9 Catheter show improvements in patient quality of life?

Yes, patients treated with the Sphere-9 Catheter experienced significant improvements in both mental and physical quality of life.

What is the next step for Medtronic's Sphere-9 Catheter in the approval process?

Medtronic has filed for FDA approval, aiming to bring the Sphere-9 Catheter to the U.S. market.