- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02507986
Mobile Phones in Cryptogenic Stroke Patients Bringing Single Lead ECGs to Detect Atrial Fibrillation (MOBILE-AF)
Study Overview
Status
Intervention / Treatment
Detailed Description
Rationale: A standard work-up of stroke patients to identify a cause of stroke consists of Computed Tomography (CT), CT angiography of head and neck arteries, transthoracic echocardiography, 12-lead 10-seconds electrocardiogram (ECG), blood tests and 24-hour ECG monitoring. A stroke is called "cryptogenic" if no cause can be determined after standard work-up. Current detection of atrial fibrillation (AF) after stroke is 2.0%. Recent studies revealed that prolonged monitoring yields higher percentages of detected AF (12.0%). Devices used in these trials suffer from drawbacks. The investigators' hypothesis is that a new, smartphone compatible device, producing a single lead ECG (single lead ECG device), can be used for prolonged ECG monitoring in cryptogenic stroke patients.
Objective: The main objective of this study is to compare the incidence of detected AF in cryptogenic stroke patients by a single lead ECG device with the incidence of detected AF by a 7-Day Holter ECG.
Study design: A multicenter randomized trial. Study population: Cryptogenic stroke patients admitted to a hospital participating in the study. The calculated sample size is 200 (100 per arm).
Intervention: After inclusion, patients will be randomized to either a single lead ECG device or a 7-Day Holter Monitor.
Main study parameters/endpoints: The main endpoint will be the percentage of detected atrial fibrillation in both the single lead ECG device group and the 7-Day Holter group after one year.
Nature and extent of the burden and risks associated with participation, benefit and group relatedness: Both devices are battery powered and electrically safe. Patients face a 2-3% risk that AF is detected false-positively; this might lead to incorrect oral anticoagulation (OAC) prescription. However, a potential benefit of the investigators' study is that if AF is detected and treated with OAC, this significantly reduces the chance of recurrent stroke.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Herning, Denmark, 7400
- Regionshospitalet Midtjylland
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Zuid-Holland
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Delft, Zuid-Holland, Netherlands
- Reinier de Graaf Hospital
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Den Haag, Zuid-Holland, Netherlands, 2512 VA
- Medisch Centrum Haaglanden
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Den Haag, Zuid-Holland, Netherlands, 2597 AX
- Bronovo Ziekenhuis
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Gouda, Zuid-Holland, Netherlands, 2803 HH
- Groene Hart Ziekenhuis
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Leiden, Zuid-Holland, Netherlands, 2333 ZA
- Leiden University Medical Center
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Leiderdorp, Zuid-Holland, Netherlands, 2353 GA
- Alrijne Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Patients must have had an episode of symptomatic Transient ischemic attack (TIA) or episode of ischemic stroke.
- Ischemic stroke is defined as an episode of transient or neurological dysfunction caused by focal brain or retinal ischemia with recent infarction on imaging
- A TIA is defined as transient episode of neurologic dysfunction typically lasting less than one hour caused by focal brain or retinal ischemia without recent infarction on imaging.
Exclusion Criteria:
- Known etiology of TIA or ischemic stroke
- TIA or stroke caused by spinal ischemia
- TIA only presenting with non-localising symptoms
- Uncertainty about the diagnosis of TIA because of unclear clinical symptoms
- Myocardial infarction <6 months before stroke
- Coronary Artery Bypass Grafting <6 months before stroke
- Severe valvular heart disease
- Documented history of atrial fibrillation or atrial flutter
- Permanent indication for oral anticoagulation at enrolment
- Patient has permanent OAC contraindication
- Patient is included in another randomized trial
- Left ventricular aneurysm on echocardiography
- Thrombus on echocardiographyRenal dysfunction (creatinine clearance <30 mL/min/1.73m2)
- Patient has life expectancy of <1 year
- Patient is not willing to sign the informed consent form
- Patient is <18 years of age
- Patient is considered an incapacitated adult
- Patient is not in possession of a smartphone with Android Operating System (OS) or iOS.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Active Comparator: 7-Day Holter monitor
This arm will receive a 7-Day Holter monitor directly after randomization.
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The Holter is a conventional 7-Day Holter monitor.
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Experimental: Single lead ECG device
This arm will be asked to take a single lead ECG two times per day and in case of complaints with a single lead ECG device.
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The single lead ECG device is a smartphone compatible handheld device that produces a single lead ECG after 30 seconds of measurement.
It is non-invasive, electrically safe and easy to use.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
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Percentage of detected atrial fibrillation
Time Frame: 1 year of follow-up
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1 year of follow-up
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Secondary Outcome Measures
Outcome Measure |
Time Frame |
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Pro-Brain Natriuretic Peptide (Pro-BNP) levels in pg/mL
Time Frame: 24 hours after cryptogenic stroke
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24 hours after cryptogenic stroke
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Percentages of atrial ectopy detected on 7-Day Holter monitor
Time Frame: 7 days after cryptogenic stroke
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7 days after cryptogenic stroke
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Left atrial diameter in cm/m2
Time Frame: 24 hours after cryptogenic stroke
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24 hours after cryptogenic stroke
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Number of participants with a recurrent stroke or TIA as defined in the trial
Time Frame: Within one year after cryptogenic stroke
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Within one year after cryptogenic stroke
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Number of participants with a major bleeding
Time Frame: Within one year after cryptogenic stroke
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Within one year after cryptogenic stroke
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Left atrial volume in mL/m2
Time Frame: 24 hours after cryptogenic stroke
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24 hours after cryptogenic stroke
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Serge Trines, MD, PhD, Leiden University Medical Center
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- MOBILE-AF
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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