Treatment Registry of Arrhythmias, Complications and Electrocardiograms in Arrhythmogenic CardioMyopathies (TRACE-ACM)

June 30, 2026 updated by: Leonardo Calò, MD, Policlinico Casilino ASL RMB

Treatment Registry of Arrhythmias, Complications and Electrocardiograms in Arrhythmogenic CardioMyopathies: A Multicenter Retrospective Observational Study

TRACE-ACM is a multicenter, retrospective, observational study of patients with arrhythmogenic cardiomyopathy who received an implantable cardioverter-defibrillator (ICD) and had documented ventricular tachyarrhythmias. The study aims to describe the prevalence and type of ICD-related complications, characterize ventricular arrhythmias documented by ICD electrograms and/or ECG recordings, and explore associations between clinical, device-related, and treatment-related factors and arrhythmic outcomes.

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

Patients with arrhythmogenic cardiomyopathy will be identified at participating centers with expertise in the diagnosis and management of arrhythmogenic cardiomyopathies. De-identified retrospective data will be collected, including demographics, arrhythmogenic cardiomyopathy phenotype, genetic data, ICD type and indication, clinical follow-up, ICD therapies, antiarrhythmic and heart failure therapies, catheter ablation, and ECG/ICD electrogram documentation of ventricular tachyarrhythmias.

ICD-related complications will include implant-related complications such as hematoma, perforation, pneumothorax, upper-limb deep vein thrombosis, lead failure, and infection, as well as non-implant-related complications such as inappropriate shocks. Ventricular arrhythmias will be classified as monomorphic ventricular tachycardia, polymorphic ventricular tachycardia/ventricular fibrillation, or transition patterns between these arrhythmia types. When available, arrhythmia initiation will be analyzed using pre-specified ECG/EGM criteria including the origin of the beats preceding arrhythmia onset, R1-R2 and R2-R3 intervals, pause dependency, coupling interval, and prematurity index.

The study will also describe atrial arrhythmias and medical, interventional, and device-based therapies adopted in this population, and will explore their relationship with ventricular arrhythmia recurrences and ICD interventions.

Study Type

Observational

Enrollment (Estimated)

300

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population includes patients with arrhythmogenic cardiomyopathy followed at participating expert centers who underwent implantable cardioverter-defibrillator implantation and had documented sustained ventricular tachyarrhythmias. Eligible patients may have right-dominant arrhythmogenic right ventricular cardiomyopathy, biventricular arrhythmogenic cardiomyopathy, or left-dominant arrhythmogenic left ventricular cardiomyopathy. Patients must have periodic clinical and ICD follow-up, with arrhythmia onset available from ICD electrograms and/or ECG recordings suitable for centralized analysis. Patients with significant coronary artery disease, primary valvular or congenital heart disease, infiltrative or inflammatory cardiomyopathies, or prior cardiotoxic therapy exposure are excluded.

Description

Inclusion Criteria:

  • Diagnosis of arrhythmogenic cardiomyopathy, including right-dominant arrhythmogenic right ventricular cardiomyopathy, biventricular arrhythmogenic cardiomyopathy, or left-dominant arrhythmogenic left ventricular cardiomyopathy.
  • ICD implantation.
  • Documented sustained ventricular tachyarrhythmia, including polymorphic ventricular tachycardia, ventricular fibrillation, or monomorphic ventricular tachycardia.
  • Periodic clinical and ICD follow-up.
  • Arrhythmia onset available from ICD electrograms and/or ECG recordings.
  • ECG/EGM tracings available for analysis by the steering ECG committee.

Exclusion Criteria:

  • Incomplete ICD data or incomplete ICD follow-up.
  • Significant coronary artery disease, defined as coronary plaque greater than 50% at coronary angiography or coronary computed tomography angiography.
  • Primary valvular heart disease or congenital heart disease.
  • Infiltrative or inflammatory cardiomyopathies, including sarcoidosis or amyloidosis.
  • Previous exposure to therapies associated with cardiac toxicity, including chemotherapy.

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

Cohorts and Interventions

Group / Cohort
Patients with arrhythmogenic cardiomyopathy and ICD
Patients with arrhythmogenic cardiomyopathy, ICD implantation, and documented sustained ventricular tachyarrhythmias, with available ICD electrograms and/or ECG recordings suitable for analysis.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of participants with ICD-related complications
Time Frame: through study completion, an average of 1 year
Number of participants experiencing at least one ICD-related complication during follow-up, including implant-related complications such as hematoma, perforation, pneumothorax, upper-limb deep vein thrombosis, lead failure, and infection, and non-implant-related complications such as inappropriate shocks.
through study completion, an average of 1 year

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of ventricular tachyarrhythmia episodes by arrhythmia type
Time Frame: through study completion, an average of 1 year
Number of documented ventricular tachyarrhythmia episodes classified as monomorphic ventricular tachycardia, polymorphic ventricular tachycardia, ventricular fibrillation, or transition patterns between arrhythmia types.
through study completion, an average of 1 year
Number of ventricular arrhythmia episodes classified by initiation pattern
Time Frame: through study completion, an average of 1 year
Number of analyzable ventricular arrhythmia episodes classified according to pre-specified ECG or EGM initiation patterns, including type A and type B initiation, ventricular origin of preceding beats, pause dependency, coupling interval, and prematurity index.
through study completion, an average of 1 year
Number of ventricular arrhythmia recurrences
Time Frame: through study completion, an average of 1 year
Number of ventricular arrhythmia recurrences documented during follow-up after ICD implantation. Treatment exposure, including antiarrhythmic drug therapy, heart failure therapy, catheter ablation, and ICD programming strategy, will be recorded as baseline or follow-up clinical variables.
through study completion, an average of 1 year
Number of ventricular arrhythmia episodes by autonomic pattern
Time Frame: through study completion, an average of 1 year
Number of ventricular arrhythmia episodes classified according to available clinical circumstances suggestive of adrenergic or vagal predominance.
through study completion, an average of 1 year
Number of appropriate ICD interventions
Time Frame: through study completion, an average of 1 year
Number of appropriate ICD interventions, including antitachycardia pacing and appropriate ICD shocks, delivered for ventricular arrhythmias during follow-up.
through study completion, an average of 1 year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Policlinico Casilino ASL RMB

Investigators

  • Study Director: Luca Barca, MD, Policlinico Casilino, Rome
  • Study Director: Cinzia Crescenzi, MD, Policlinico Casilino, Rome
  • Study Director: Kristian Galanti, MD, Policlinico Casilino, Rome
  • Study Director: Alessandro Nudi, MD, Policlinico Casilino, Rome

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • 1. Corrado D, Anastasakis A, Basso C, et al. Proposed diagnostic criteria for arrhythmogenic cardiomyopathy: European Task Force consensus report. Int J Cardiol. 2024;395:131447. doi:10.1016/j.ijcard.2023.131447. 2. Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelines for ventricular arrhythmias and prevention of sudden cardiac death. Eur Heart J. 2022;43:3997-4126. doi:10.1093/eurheartj/ehac262. 3. Gasperetti A, James CA, Duru F, van Tintelen P, Calkins H. Arrhythmogenic right ventricular cardiomyopathy. Eur Heart J. 2026;ehag297. doi:10.1093/eurheartj/ehag297. 4. Arbelo E, Protonotarios A, Gimeno JR, et al. 2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J. 2023;44:3503-3626. 5. Towbin JA, McKenna WJ, Abrams DJ, et al. 2019 HRS expert consensus statement on arrhythmogenic cardiomyopathy. Heart Rhythm. 2019;16:e301-e372. doi:10.1016/j.hrthm.2019.05.007. 6. Christensen AH, Platonov PG, Svensson A, et al. Complications of implantable cardioverter-defibrillator treatment in arrhythmogenic right ventricular cardiomyopathy. Europace. 2022;24:306-312. 7. Migliore F, Pittorru R, De Lazzari M, et al. Third-generation subcutaneous ICD and intermuscular two-incision implantation in arrhythmogenic cardiomyopathy: 3-year follow-up. Int J Cardiol. 2023;382:33-39. 8. Belhassen B, Conte G, Steinberg C, et al. Mode and characteristics of arrhythmia initiation in idiopathic ventricular fibrillation: A THESIS substudy. JACC Clin Electrophysiol. 2024;10:1794-1809. 9. Gaine S, Rolland T, Asatryan B, et al. Long-term follow-up data on flecainide use as an antiarrhythmic in arrhythmogenic right ventricular cardiomyopathy. JACC Clin Electrophysiol. 2025;11:1159-1170. doi:10.1016/j.jacep.2025.02.023.

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 (Estimated)

July 1, 2026

Primary Completion (Estimated)

December 31, 2027

Study Completion (Estimated)

December 31, 2027

Study Registration Dates

First Submitted

June 23, 2026

First Submitted That Met QC Criteria

June 30, 2026

First Posted (Actual)

July 7, 2026

Study Record Updates

Last Update Posted (Actual)

July 7, 2026

Last Update Submitted That Met QC Criteria

June 30, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • TRACE-ACM-001

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be publicly shared because the study includes retrospective clinical, device, ECG/EGM, and genetic data subject to privacy, ethical, and institutional restrictions. Aggregate study results may be shared through scientific presentations and peer-reviewed publications.

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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