Better Mechanistic Understanding of and Risk Stratification for Ventricular Tachyarrhythmias Through ECGI (BREACH-ECGI)
This study aims to evaluate the electrophysiological properties of the heart conduction system in patients with (increased risk of) ventricular tachyarrhythmias (VTA) and sudden cardiac arrest, and in a control cohort. The electrophysiological properties will be measured with the relatively new technique ECG-Imaging (ECGI). Moreover, clinical data of subjects will be gathered.
By combining the data from the data gathering and the results of ECGI, the investigators hope to increase mechanistic understanding of and risk stratification for VTAs. The investigators aim to be able to identify patients at risk of an arrhythmic event, and aim for better treatment strategies in the future.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
ECGI combines electrical body-surface mapping with 256 electrodes placed on the thorax with a CT-scan obtaining the anatomy of the heart and torso, hereby able to reconstruct local electrograms, activation and recovery times. In recent research, ECGI provided numerous extra insights into normal cardiac electrophysiology, but also electrophysiological disorders and disease. The results strongly suggest that ECGI can play a pivotal role in further characterizing arrhythmia mechanisms, therefore could do so for VTAs, leading to diagnosis and treatment improvement. Moreover, ECGI seems to have the potential to detect arrhythmogenic substrate in individuals before their first event, offering the possibility to diagnose and treat patients before sudden cardiac arrest occurs.
In the BREACH-ECGI study:
ECGI will be used to noninvasively characterize the epicardial electrophysiological substrate and triggers of:
- Patients with (increased risk of) VTAs
- A control cohort. Results will be evaluated for increased mechanistic understanding and risk stratification.
Moreover, clinical data of subjects will be gathered. These data will be analyzed to determine their prognostic value in terms of arrhythmia risk
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Limburg
-
Hasselt, Limburg, Netherlands, 3500
- Jessa Hospital
-
Maastricht, Limburg, Netherlands, 6229HX
- Maastricht University Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
In order to be eligible to participate in this study, a subject must be ≥ 18 years old, have either a history of VTAs or be at risk of VTAs and have one of the following diagnoses:
- Ischemic cardiomyopathy
- Non-ischemic cardiomyopathy
- Non-structural heart disease
- Congenital heart disease (with a limitation to CCTGA and situs inversus)
Or: a subject must be ≥ 18 years old and have a structurally normal heart with a clinical indication for a cardiac CT.
Exclusion Criteria:
A potential subject who meets any of the following criteria will be excluded from participation in this study:
- A known strong reaction against electrode attachment or contrast agent.
- Any serious medical condition, which in the opinion of the investigator, may adversely affect the safety and/or effectiveness of the participant or the study.
- Pregnancy, nursing or planning to be pregnant.
- The subject has an estimated glomerular filtration rate (eGFR) of <30mL/min/1.73m2, using the MDRD calculation 14.
- Being unable to give informed consent.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Control
Control subjects receiving body-surface potential mapping (BSPM) and either a CT-scan or a CMR scan
|
A body surface potential mapping and a cardiac + low dose CT-scan
|
|
Experimental: Diseased
Diseased subjects receiving body-surface potential mapping (BSPM) and either a CT-scan or a CMR scan.
Outcome measures from these procedures will be compared to controls.
|
A body surface potential mapping and a cardiac + low dose CT-scan
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
ECG-Imaging outcome: epicardial potentials
Time Frame: 3 years
|
reconstructed epicardial potentials, represented in mV over time(s).
|
3 years
|
|
ECG-Imaging outcome: activation and repolarization maps
Time Frame: 3 years
|
Activation and repolarization maps.
Acivation and repolarization times are determined from the epicardial potentials, expressed in ms.
These are shown on a CT-derived or CMR-derived heart mesh.
The entire activation and repolarization of the epicardium of the heart can be visualized this way.
|
3 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
(Possible) Prognostic risk factors for recurrent ventricular arrhythmias
Time Frame: 6 years
|
Possible risk factors, found in the clinical data collection, expressed as odds/hazard ratio.
|
6 years
|
|
Recurrence of ventricular arrhythmias
Time Frame: 6 years
|
Documentation over the period of follow-up, if subjects had a recurrence of ventricular arrythmia(s), presented as number of events over a time period.
|
6 years
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
Additional Relevant MeSH Terms
- Pathologic Processes
- Heart Diseases
- Cardiovascular Diseases
- Congenital Abnormalities
- Death, Sudden
- Cardiac Conduction System Disease
- Cardiovascular Abnormalities
- Death
- Arrhythmias, Cardiac
- Heart Arrest
- Ventricular Fibrillation
- Tachycardia
- Tachycardia, Ventricular
- Heart Defects, Congenital
- Death, Sudden, Cardiac
Other Study ID Numbers
Other Study ID Numbers
- METC19-065
- NL69831.068.19 (Other Identifier: Toetsingonline)
- 300260 (Other Identifier: Raad van Bestuur)
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
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