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Erschienen in: Journal of Interventional Cardiac Electrophysiology 2/2019

16.08.2019 | REVIEW

Electrophysiology devices and the regulatory approval process within the U.S. FDA and abroad

verfasst von: Kimberly A. Selzman, Hetal Patel, Kenneth Cavanaugh

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 2/2019

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Abstract

Almost all electrophysiology (EP) devices need to obtain premarket approval before they can be commercially sold and available for use in the community. The US Food and Drug Administration (FDA) has different paths to market approval depending on the intended use and the associated risks of the device. The European Union and Japan have device approval processes that have many similarities as well as differences to the US regulatory system. This paper describes some of the history and background of the US device approval process with an emphasis on EP devices. It provides an overview of the different regulatory pathways in the USA that are currently being utilized and contrasts them to the procedures often used in the European Union and in Japan. It also touches on the impact of the twenty-first Century Cures Act and how the balance between premarket and postmarket regulatory oversight is continually being examined and refined.
Literatur
11.
Zurück zum Zitat Reddy VY, Doshi SK, Sievert H, Buchbinder M, Neuzil P, Huber K, et al. 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;127(6):720–9.CrossRef Reddy VY, Doshi SK, Sievert H, Buchbinder M, Neuzil P, Huber K, et al. 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;127(6):720–9.CrossRef
12.
Zurück zum Zitat Holmes DR Jr, Kar S, Price MJ, Whisenant B, Sievert H, Doshi SK, et al. Prospective randomized evaluation of the watchman left atrial appendage closure device in patients with atrial fibrillation versus long-term warfarin therapy: The Prevail trial. J Am Coll Cardiol. 2014;64(1):1–12.CrossRef Holmes DR Jr, Kar S, Price MJ, Whisenant B, Sievert H, Doshi SK, et al. Prospective randomized evaluation of the watchman left atrial appendage closure device in patients with atrial fibrillation versus long-term warfarin therapy: The Prevail trial. J Am Coll Cardiol. 2014;64(1):1–12.CrossRef
13.
Zurück zum Zitat Waksman R, Pendyala LK. Overview of the Food and Drug Administration circulatory system devices panel meetings on watchman left atrial appendage closure therapy. Am J Cardiol. 2015;115(3):378–84.CrossRef Waksman R, Pendyala LK. Overview of the Food and Drug Administration circulatory system devices panel meetings on watchman left atrial appendage closure therapy. Am J Cardiol. 2015;115(3):378–84.CrossRef
18.
Zurück zum Zitat Heist EK, Herre JM, Binkley PF, van Bakel AB, Porterfield JG, Porterfield LM, et al. Analysis of different device-based intrathoracic impedance vectors for detection of heart failure events (from the detect fluid early from intrathoracic impedance monitoring study). Am J Cardiol. 2014;114(8):1249–56.CrossRef Heist EK, Herre JM, Binkley PF, van Bakel AB, Porterfield JG, Porterfield LM, et al. Analysis of different device-based intrathoracic impedance vectors for detection of heart failure events (from the detect fluid early from intrathoracic impedance monitoring study). Am J Cardiol. 2014;114(8):1249–56.CrossRef
19.
Zurück zum Zitat Boehmer JP, Hariharan R, Devecchi FG, Smith AL, Molon G, Capucci A, et al. A multisensory algorithm predicts heart failure events in patients with implanted devices: results from the MultiSENSE study. JACC Heart Fail. 2017;5(3):216–25.CrossRef Boehmer JP, Hariharan R, Devecchi FG, Smith AL, Molon G, Capucci A, et al. A multisensory algorithm predicts heart failure events in patients with implanted devices: results from the MultiSENSE study. JACC Heart Fail. 2017;5(3):216–25.CrossRef
21.
Zurück zum Zitat Moss AJ, Hall WJ, Cannom DS, Klein H, Brown MW, Daubert JP, et al. Cardiac-resynchronization therapy for the prevention of heart failure events. N Engl J Med. 2009;361(14):1329–38.CrossRef Moss AJ, Hall WJ, Cannom DS, Klein H, Brown MW, Daubert JP, et al. Cardiac-resynchronization therapy for the prevention of heart failure events. N Engl J Med. 2009;361(14):1329–38.CrossRef
22.
Zurück zum Zitat Linde C, Abraham WT, Gold MR, Daubert C, REVERSE Study Group. Cardiac resynchronization therapy in asymptomatic or mildly symptomatic heart failure patients in relation to etiology: results from the REVERSE (resynchronization reVErses remodeling in systolic left vEntricular dysfunction) study. J Am Coll Cardiol. 2010;56(22):1826–31.CrossRef Linde C, Abraham WT, Gold MR, Daubert C, REVERSE Study Group. Cardiac resynchronization therapy in asymptomatic or mildly symptomatic heart failure patients in relation to etiology: results from the REVERSE (resynchronization reVErses remodeling in systolic left vEntricular dysfunction) study. J Am Coll Cardiol. 2010;56(22):1826–31.CrossRef
23.
Zurück zum Zitat Wilber DJ, Pappone C, Neuzil P, de Paola A, Marchlinski F, Natale A, et al. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial. JAMA. 2010;303(4):333–40.CrossRef Wilber DJ, Pappone C, Neuzil P, de Paola A, Marchlinski F, Natale A, et al. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial. JAMA. 2010;303(4):333–40.CrossRef
24.
Zurück zum Zitat Public Health Effectiveness of the FDA 510(k) Clearance process: measuring postmarket performance and other select topics: workshop report. National Academies Press (US); 2011. Public Health Effectiveness of the FDA 510(k) Clearance process: measuring postmarket performance and other select topics: workshop report. National Academies Press (US); 2011.
29.
Zurück zum Zitat Zuckerman DM, Brown P, Nissen SE. Medical device recalls and the FDA approval process. Arch Intern Med. 2011;171(11):1006–11.PubMed Zuckerman DM, Brown P, Nissen SE. Medical device recalls and the FDA approval process. Arch Intern Med. 2011;171(11):1006–11.PubMed
30.
Zurück zum Zitat Redberg RF, Dhruva SS. Medical device recalls: get it right the first time: comment on “medical device recalls and the FDA approval process”. Arch Intern Med. 2011;171(11):1011–2.CrossRef Redberg RF, Dhruva SS. Medical device recalls: get it right the first time: comment on “medical device recalls and the FDA approval process”. Arch Intern Med. 2011;171(11):1011–2.CrossRef
35.
Zurück zum Zitat Selzman KA, Fellman M, Farb A, de Del Castillo S, Zuckerman B. New technology in electrophysiology: FDA process and perspective. J Interv Card Electrophysiol. 2016;47(1):11–8.CrossRef Selzman KA, Fellman M, Farb A, de Del Castillo S, Zuckerman B. New technology in electrophysiology: FDA process and perspective. J Interv Card Electrophysiol. 2016;47(1):11–8.CrossRef
38.
Zurück zum Zitat Kesselheim AS, Hwang TJ. Breakthrough medical devices and the 21st century cures act. Ann Intern Med. 2016;164:500–2.CrossRef Kesselheim AS, Hwang TJ. Breakthrough medical devices and the 21st century cures act. Ann Intern Med. 2016;164:500–2.CrossRef
39.
Zurück zum Zitat Kesselheim AS, Avorn J. New “21st Century Cures” legislation: speed and ease vs science. JAMA. 2017;317(6):581–2.CrossRef Kesselheim AS, Avorn J. New “21st Century Cures” legislation: speed and ease vs science. JAMA. 2017;317(6):581–2.CrossRef
45.
Zurück zum Zitat Kramer DB, Xu S, Kesselheim AS. How does medical device regulation perform in the United States and the European Union? A systematic review. PLoS Med. 2012;9(7):e1001276.CrossRef Kramer DB, Xu S, Kesselheim AS. How does medical device regulation perform in the United States and the European Union? A systematic review. PLoS Med. 2012;9(7):e1001276.CrossRef
48.
Zurück zum Zitat Uchida T, Ikeno F, Ikeda K, Suzuki Y, Todaka K, Yokoi H, et al. Global cardiovascular device innovation: Japan-USA synergies: harmonization by doing (HBD) program, a consortium of regulatory agencies, medical device industry, and academic institutions. Circ J. 2013;77(7):1714–8.CrossRef Uchida T, Ikeno F, Ikeda K, Suzuki Y, Todaka K, Yokoi H, et al. Global cardiovascular device innovation: Japan-USA synergies: harmonization by doing (HBD) program, a consortium of regulatory agencies, medical device industry, and academic institutions. Circ J. 2013;77(7):1714–8.CrossRef
49.
Zurück zum Zitat Konishi A, Isobe S, Sato D. New regulatory framework for medical devices in Japan: current regulatory considerations regarding clinical studies. J Vasc Interv Radiol. 2018;29(5):657–60.CrossRef Konishi A, Isobe S, Sato D. New regulatory framework for medical devices in Japan: current regulatory considerations regarding clinical studies. J Vasc Interv Radiol. 2018;29(5):657–60.CrossRef
50.
Zurück zum Zitat Matsushita S, Tachibana K, Kondoh M. The clinical innovation network: a policy for promoting development of drugs and medical devices in Japan. Drug Discov Today. 2019;24(1):4–8.CrossRef Matsushita S, Tachibana K, Kondoh M. The clinical innovation network: a policy for promoting development of drugs and medical devices in Japan. Drug Discov Today. 2019;24(1):4–8.CrossRef
51.
Zurück zum Zitat Konishi A, Ho M, Shirai Y, Shirato H. First approval of improved medical device conditional on use-result survey in Japan: regulatory review of polymer-free drug-coated BioFreedom coronary stent. Circ J. 2018;82:1487–90.CrossRef Konishi A, Ho M, Shirai Y, Shirato H. First approval of improved medical device conditional on use-result survey in Japan: regulatory review of polymer-free drug-coated BioFreedom coronary stent. Circ J. 2018;82:1487–90.CrossRef
52.
Zurück zum Zitat Murakami M, Suzuki Y, Tominaga T. Rapid globalization of medical device clinical development programs in Japan: the case of drug-eluting stents. Circ J. 2018;82:636–43.CrossRef Murakami M, Suzuki Y, Tominaga T. Rapid globalization of medical device clinical development programs in Japan: the case of drug-eluting stents. Circ J. 2018;82:636–43.CrossRef
Metadaten
Titel
Electrophysiology devices and the regulatory approval process within the U.S. FDA and abroad
verfasst von
Kimberly A. Selzman
Hetal Patel
Kenneth Cavanaugh
Publikationsdatum
16.08.2019
Verlag
Springer US
Erschienen in
Journal of Interventional Cardiac Electrophysiology / Ausgabe 2/2019
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-019-00607-x

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