Defibrillation Testing During Implantable Cardioverter Defibrillator (ICD) Replacement (T-DEF)
Longitudinal Follow-up of Patients With Defibrillator Threshold Testing During Implantable Cardioverter Defibrillator (ICD) Replacement
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Implantable cardioverter defibrillators (ICD) are strongly recommended in patients with left ventricular systolic function ≤35% or selected patients with channelopathies and cardiomyopathies.
Defibrillation threshold testing (DFT) defines the minimal energy required to successfully terminate a ventricular arrhythmia by an ICD. It remains the gold standard to evaluate the electrical integrity of the device. However inherent complications of this procedure have been registered, such as refractory ventricular fibrillation, and the need for this practice during implant and/or replacement of ICD has recently been questioned.
If several studies have led to abandonment of the DFT during initial ICD implant, its interest during replacement is still controversial. Indeed, the leads essential for the device electrical integrity are older, more fragile, and the ICD replacement may damage it.
Device replacement is indicated when battery reaches the point of Elective Replacement Interval (ERI).
Patients over 18 years old with indication for replacement of defibrillator will be included. Patient's informations (comorbidities, medical history and events during hospitalization or follow-up) and device characteristics will be collected. Procedure will be realized under local or general anesthesia and prophylactic antibiotic will be administrated. Leads will be tested before and after the implantation of the new device. After connexion of the new implanted device to the leads a DFT will be performed. Protocol of DFT will be decided by the physician who will chose between induction of ventricular fibrillation or R-wave synchronized shock. Patients will be followed for 6 and 12 months from the date of defibrillator replacement.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Caroline Grimard, MD
- Phone Number: (+33) 01 46 41 50 23
- Email: grimard@inparys.com
Study Locations
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Centre-Val de Loire
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Chambray-lès-Tours, Centre-Val de Loire, France, 37170
- Hôpital Trousseau
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Grand Est
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Vandœuvre-lès-Nancy, Grand Est, France, 54500
- Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu-CHU de Nancy-Hôpitaux de Brabois
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Normandy
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Caen, Normandy, France, 14000
- CHU de Caen
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Occitanie
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Toulouse, Occitanie, France, 31400
- CHU de Toulouse-Hopital Rangueil
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Pays de la Loire Region
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Nantes, Pays de la Loire Region, France, 44277
- Hopital Prive du Confluent
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Provence-Alpes-Côte d'Azur Region
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Avignon, Provence-Alpes-Côte d'Azur Region, France, 84902
- Centre Hospitalier Henri Duffaut
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Île-de-France Region
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Neuilly-sur-Seine, Île-de-France Region, France, 92200
- CMC Ambroise Paré
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients with an ICD (VR or DR) or CRT-D undergoing generator replacement.
- Consent for participation
- Affiliation to the French social security system
Exclusion Criteria:
- Atrial Fibrillation without effective anti-coagulation treatments.
- Severe Aortic valve stenosis
- Stroke occurred in the previous month
- Hemodynamic instability contraindicating the high energy shock
- Contraindication for anesthesia
- Pregnant or breastfeeding women
- Communication difficulties or neuropsychiatric disorder
- Patients under protection of the adults (guardianship, curators or safeguard of justice)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Other: Defibrillation testing during ICD replacment
|
Under general or local anesthesia.
Induction of Ventricular Fibrillation or R-wave synchronized shock
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Rate of Defibrillator Electrical Integrity Dysfunction During Generator Replacement.
Time Frame: 4 hours
|
Number of Participants With Abnormal Shock Impedance Value.
|
4 hours
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Rate of Lead Malfunction
Time Frame: 12 months
|
Number of Participants With Abnormal Shock Impedance Value.
|
12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- 2019/08
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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