- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05565781
Smartwatch and External Holter Monitoring to Detect Atrial Fibrillation in Patients With Cryptogenic Stroke (SMARTTHUNDER)
September 30, 2022 updated by: Hospital Universitari Vall d'Hebron Research Institute
Impact of Non-invasive Remote Monitoring Via Wearable Technologies for Detection of Atrial Fibrillation in Patients With Cryptogenic Stroke
Stroke recurrence largely depends on the detection of the cause and the control of vascular risk factors, with occult atrial fibrillation (AF) being one of the most important.
Prolonged ambulatory cardiac monitoring is recommended for detecting occult AF.
Currently, there are non-invasive monitoring devices such as the textile Holter that have proven to be useful for monitoring for up to 30 days but not longer.
Another alternative is smartwatches, although they must be validated for use in the elderly population who have had a stroke.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
The primary objective is to demonstrate that the protocol of ambulatory cardiac monitoring with wearable devices for 12 months allows detection of a higher percentage of occult AF than monitoring for 30 days.
The secondary objectives will be to demonstrate the internal validity of smartwatches against insertable cardiac recorders for the detection of AF.
To evaluate the usability and adherence to the use of smartwatches in patients with stroke.
Detect predictors that can help detect long-term occult AF.
Determine the profile of vascular events in each group.
Detect predictors of vascular recurrence defined as stroke recurrence, incidence of cerebral hemorrhage, heart failure, myocardial infarction or vascular death.
Study Type
Interventional
Enrollment (Anticipated)
100
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Cataluña
-
Barcelona, Cataluña, Spain, 08035
- Recruiting
- Hospital Universitari Vall D'Hebron
-
Contact:
- Jorge Pagola, Neurologist
- Phone Number: 6364 932746000
- Email: jpagola@vhebron.net
-
Principal Investigator:
- Jorge Pagola, Neurologist
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
55 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Age greater to or equal to 55 years
- Patients with diagnosis of cryptogenic stroke after a basic study that included neuroimaging, extra/intracranial vascular evaluation, 24-hour monitoring, and echocardiogram
- Patients with acute cortical infarction with the presence of intracranial occlusion (preferably)
- Modified Rankin Scale (mRS) lower to 4
Exclusion Criteria:
- Diagnosis of lacunar infarction or transient ischemic attack (TIA)
- Diagnosis of stroke of known source: atherothrombotic due to moderate or severe symptomatic extra/intracranial stenosis, major cardioembolic cause (atrial fibrillation, anterior or apical ventricular akinesis, causal PFO, post-AMI, flutter or mitral stenosis), unusual cause (thrombophilia, arterial dissection symptomatic, toxic)
- Use of pacemakers
- Circumstances that may preclude the clinical follow-up or reduce the possibilities of obtaining data to achieve the objectives of the study and/or limit contact with the investigator (for example, transfer to a social health center)
- Unwillingness to the use of cardiac monitoring wearable devices
- Not understanding study procedures
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: SCREENING
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: ECG Smartwatch for up to 1 year
Cardiac monitoring with an ECG Smartwatch over 1 year after the acute phase of cryptogenic stroke.
Simultaneously, a continuous cardiac monitoring will be performed using an Insertable Cardiac Monitor (ICM)
|
Testing ECG smartwatch
Gold-standard cardiac monitor for comparison of testing device (ECG smartwatch)
|
ACTIVE_COMPARATOR: Holter monitoring for up to 1 year
Cardiac monitoring with an external holter device for 30 days after the acute phase of cryptogenic stroke and 15 additional days of extended use every 3 months up to 1 year
|
Regular cardiac monitor for diagnosis of atrial fibrillation
|
OTHER: Control group
Regular cardiac monitoring with an external holter device for 30 days after the acute phase of cryptogenic stroke
|
Regular cardiac monitor for diagnosis of atrial fibrillation
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Increased probability of detecting AF
Time Frame: Assessed throughout 1 year trial period
|
To identify and compare prevalence rates of AF detection for the purpose of determine the clinical relevance or not of a prolonged screening process for AF.
On the intervention group, patients will have a cardiac monitoring for up to 12 months.
If AF is detected by ECG smartwatch, the ICM data will be analyzed by a cardiologist team and provide an ECG report to investigators in order to confirmed ECG smartwatch result.
|
Assessed throughout 1 year trial period
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Identification of Atrial Fibrillation using a ECG smartwatch
Time Frame: Assessed throughout 1 year trial period
|
Episodes of atrial fibrillation detected by the ECG smartwatch will be compared to the gold-standard cardiac monitor
|
Assessed throughout 1 year trial period
|
Usability and adherence to ECG Smartwatch
Time Frame: Assessed throughout 1 year trial period
|
To evaluate the usability to the use of the ECG Smartwatch through the System usability scale (SUS) and self-reported of likes or dislikes encountered with wearable.
|
Assessed throughout 1 year trial period
|
Control of vascular risk factors (VRF)
Time Frame: Assessed at the end of the 1 and 2 year trial period
|
To describe and compare the percentage of adequate control of VRFs among patients in each study group.
VRFs metrics are defined according to the AHA Life Simple 7 factors.
Ideal metrics were defined as follows: (1) Smoking status: never or former smoker; (2) BMI: <25 kg/m2; (3) Physical activity: ≥150 min/wk of moderate-intensity physical activity; (4) Healthy diet: 4 or 5 fruits/vegetables per day; (5) Total cholesterol <200 mg/dL; (6) Blood pressure <120/80 mm Hg; (7) Fasting glucose <100 mg/dL.
|
Assessed at the end of the 1 and 2 year trial period
|
Vascular events incidence
Time Frame: Assessed at the end of the 1 and 2 year trial period
|
To describe the vascular events defined as recurrence of stroke, the incidence of cerebral hemorrhage, heart failure, myocardial infarction, or vascular death in each study group
|
Assessed at the end of the 1 and 2 year trial period
|
Predictors of vascular recurrence
Time Frame: Assessed at the end of the 1 and 2 year trial period
|
To identify predictors of vascular recurrence (recurrent stroke, cerebral hemorrhage, heart failure, myocardial infarction, or vascular death) in each study group.
Predictors of vascular recurrence included sociodemographic data such as age, sex and education level; BMI (kg/m2); history of diabetes mellitus; LDL-cholesterol and medications, such as the use of anti-hypertensive medications, lipid-lowering medications, and antiplatelet therapy.
Also clinical symptoms, neuroimagen and ECG parameters will be included in the analysis.
|
Assessed at the end of the 1 and 2 year trial period
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ACTUAL)
March 28, 2022
Primary Completion (ANTICIPATED)
April 1, 2023
Study Completion (ANTICIPATED)
April 1, 2024
Study Registration Dates
First Submitted
September 21, 2022
First Submitted That Met QC Criteria
September 30, 2022
First Posted (ACTUAL)
October 4, 2022
Study Record Updates
Last Update Posted (ACTUAL)
October 4, 2022
Last Update Submitted That Met QC Criteria
September 30, 2022
Last Verified
September 1, 2022
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- PI20/01210
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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