The Medtronic Sphere-360™ Pulse Field Ablation (PFA) catheter, a new paradigm in single-shot ablation, demonstrates impressive results in treating paroxysmal atrial fibrillation
- Positive clinical trial results for Sphere-360 catheter
- 81.8% freedom from atrial arrhythmias after one year of follow-up
- 100% freedom in the sub-group with optimized pulse configuration
- 96% sustained lesion durability in patients treated with the optimized pulse
- Efficient energy delivery and tissue-conformable lattice tip design
- Zero primary safety adverse events reported
- None.
Insights
The Sphere-360 catheter's high efficacy and safety profile demonstrated in the study is a significant advancement in the treatment of atrial fibrillation (AFib). The ability to achieve 81.8% freedom from atrial arrhythmias after one year and 100% in the subgroup with the optimized pulse configuration is noteworthy. This catheter's design aligns with the trend towards minimally invasive procedures, which are favored for their reduced recovery times and lower complication rates compared to traditional surgery.
In the context of AFib treatment, the durability of lesions is critical as it correlates with the long-term success of ablation procedures. The reported 96% sustained lesion durability at 75 days post-procedure suggests a promising outlook for long-term patient outcomes. Moreover, the absence of primary safety adverse events is a compelling factor that may influence the adoption of this technology by healthcare providers.
From a market perspective, Medtronic's innovation in the AFib treatment space with Sphere-360 could potentially disrupt the current standard of care, which predominantly relies on antiarrhythmic drug therapy and traditional ablation catheters. The integration with the Affera Mapping and Ablation System could be a differentiator, offering a streamlined workflow for electrophysiologists. This system could also lead to cost savings for healthcare systems by reducing procedure times and potentially lowering the rate of repeat procedures due to its high durability of lesions.
The demand for effective AFib treatments is growing alongside the increasing prevalence of the condition. Medtronic's position as a global leader in healthcare technology may be further solidified if the Sphere-360 catheter receives regulatory approval. However, it's important to note that the device is still investigational and not yet approved for sale. The long-term impact on Medtronic's market share and financial performance will depend on the outcomes of the regulatory process and subsequent market adoption.
AFib is associated with significant healthcare costs due to its chronic nature and the risk of serious complications. The introduction of an advanced catheter like Sphere-360 could potentially reduce the economic burden of AFib by improving treatment outcomes and reducing the need for repeat procedures. The single-shot, low-fluoroscopy feature of the catheter aligns with the ongoing push for cost-effective healthcare solutions.
However, the upfront costs of adopting new technologies like the Sphere-360 catheter and Affera Mapping and Ablation System must be weighed against the potential long-term savings. The economic analysis should consider not only the direct costs but also the indirect benefits such as reduced hospital stays, lower complication rates and improved quality of life for patients. The long-term cost-effectiveness will be a key factor in determining the success of this technology in the healthcare market.
EHRA late-breaking data: Results highlight efficacy, safety, and durability of the novel PFA catheter that is fully integrated with Affera™ Mapping and Ablation System
DUBLIN and
The Sphere-360 catheter was developed with the goal to simplify the atrial fibrillation procedure while enhancing efficiency and providing high durability of lesions. Its unique design includes a large, tissue-conformable lattice tip for efficient energy delivery, with no need to rotate the catheter multiple times in one location as the entire lattice tip delivers PF energy. Furthermore, the catheter is fully integrated with the Affera™ Mapping and Ablation System for complete visualization inside the heart and electroanatomical mapping, making it a true all-in-one single-shot catheter for mapping, ablation, and validation.
The Sphere-360 study, a prospective, single arm, multi-center trial performed in three European centers with a total of 85 patients, demonstrated
A sub-study of patients treated with the optimized pulse underwent remapping procedures;
The study also showed the catheter to have a highly favorable safety profile, with zero incidences of primary safety adverse events including esophageal events, pulmonary vein stenosis, phrenic nerve injury or cardiac tamponade.
"Electrophysiologists are seeking innovative catheter options to address the varied cardiac anatomies encountered in patients, and as the population with atrial fibrillation continues to rise, catheter versatility will become more important than ever to achieve the most favorable outcomes," said Vivek Reddy, M.D., Director of Cardiac Arrhythmia Services, Icahn School of Medicine at Mount Sinai and primary investigator of the Sphere-360 trial. "These results are very encouraging as they show the Sphere-360 catheter has the potential to be an important part of next generation AFib care."
The Sphere-360 PFA catheter includes the following:
- Uniform and efficient PF energy delivery through the entire 34mm conformable lattice tip
- Fully integrated with the Affera Mapping and Ablation System, enabling low to zero fluoroscopy procedure
- Seamlessly adjusts to various shapes to accommodate different PV anatomies
- Real-time local impedance information to assess catheter proximity to tissue
- Over-the-wire design for ease of positioning in the vein and streamlined workflow
- Compatible with a small 8.5Fr sheath
"We have a vision to continually innovate and bring the best technology to AFib patients around the world, driven by our unwavering commitment to maximizing the safety and efficacy of our products," said Khaldoun Tarakji, M.D., MPH, vice president, chief medical officer, Cardiac Ablation Solutions business, which is part of the Cardiovascular Portfolio at Medtronic. "We are thrilled that the Sphere-360 study results validate our dedication to this goal: an all-in-one single shot mapping and pulsed field ablation catheter, that is fully integrated with the Affera Mapping and Ablation System, with a unique design that can conform to any pulmonary vein anatomy and can be used with an 8.5Fr sheath, single transeptal access and zero exchange. All these features make the procedure efficient and outcomes more predictable. We can't wait for what's next."
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, meaning it can become worse over time and can increase the risk of serious complications including heart failure, stroke and increased risk of death.2-5 Antiarrhythmic drug (AAD) therapy has been the current standard first-line treatment but is ineffective at controlling AFib in approximately half of patients treated with drug therapy.6-8
Worldwide, the single-shot Sphere-360 catheter is investigational and not approved for sale or distribution. The Affera Mapping and Ablation System, which includes the focal Sphere-9™ Catheter and Affera Mapping System, received CE Mark approval in March 2023.
* Based on data on optimized pulse sub-group. Total cohort
About Medtronic
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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.
- 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.
- 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.
- 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.
Wolf PA , Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 1991;22:983-8.- 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
- Wazni OM, Dandamudi G, Sood N, et al. Cryoballoon Ablation as Initial Therapy for Atrial Fibrillation. N Engl J Med. January 28, 2021;384(4):316-324.
- Kuniss M, Pavlovic N, Velagic V, et al. Cryoballoon ablation vs. antiarrhythmic drugs: first-line therapy for patients with paroxysmal atrial fibrillation. Europace. March 17, 2021:euab029.
- Andrade JG, Wells GA, Deyell MW, et al. Cryoablation or Drug Therapy for Initial Treatment of Atrial Fibrillation. N Engl J Med. January 28, 2021;384(4):305-315.
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