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Systematic Ambulatory ECG Monitoring Following TAVI (RECORDII)

Systematic Ambulatory ECG Monitoring Following TAVI: A Prospective Randomized Trial.

This multicenter, prospective, randomized superiority trial will evaluate whether systematic 14-day ambulatory ECG monitoring following hospital discharge after transcatheter aortic valve implantation (TAVI) reduces the risk of sudden death, symptomatic arrhythmic events, or stroke within 1 year compared with standard post-discharge care. Patients undergoing successful TAVI without permanent pacemaker implantation and presenting with at least one ECG conduction abnormality at hospital discharge will be randomized to receive either ambulatory ECG monitoring or standard follow-up. All participants will undergo routine clinical follow-up at 30 days and 1 year after TAVI.

Studienübersicht

Status

Noch keine Rekrutierung

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis. Despite advances in transcatheter heart valve technology and procedural techniques, conduction disturbances remain among the most frequent complications following TAVI. High-grade atrioventricular block, complete heart block, and new-onset bundle branch block may occur after the procedure and can lead to delayed permanent pacemaker implantation or life-threatening arrhythmic events. The increasing adoption of minimalist TAVI pathways with hospital discharge within 24-72 hours raises concerns that clinically significant arrhythmias may develop after discharge and remain undetected.

Ambulatory electrocardiographic (ECG) monitoring provides continuous rhythm surveillance during daily activities and enables the early detection of both symptomatic and asymptomatic bradyarrhythmias and tachyarrhythmias. Previous observational studies have demonstrated that clinically significant bradyarrhythmias occur in approximately 5-10% of patients during the first weeks after TAVI, particularly among those with baseline or new-onset conduction abnormalities. Ambulatory ECG monitoring has also identified previously unrecognized atrial fibrillation, allowing timely initiation of anticoagulation therapy in patients at high risk of thromboembolic events.

Although several prospective studies have evaluated ambulatory ECG monitoring after TAVI, most have been observational and were designed primarily to describe the incidence of post-procedural arrhythmias rather than to assess their impact on clinical outcomes. Preliminary evidence from the RECORD pilot study suggested that systematic ambulatory ECG monitoring after hospital discharge was associated with earlier identification and treatment of clinically significant arrhythmias and a reduction in the composite of sudden death, symptomatic arrhythmic events, and stroke during 1-year follow-up, with the greatest benefit observed among patients with conduction abnormalities at hospital discharge.

This randomized trial has been designed to provide definitive evidence regarding the clinical value of systematic ambulatory ECG monitoring after TAVI in patients at increased risk of post-procedural conduction disturbances. The study will evaluate whether early detection and management of clinically significant arrhythmias can improve clinical outcomes during the year following the procedure.

Studientyp

Interventionell

Einschreibung (Geschätzt)

754

Phase

  • Unzutreffend

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Studieren Sie die Kontaktsicherung

Studienorte

    • Quebec
      • Québec, Quebec, Kanada, G1Y 4G5
        • Institut universitaire de cardiologie et de pneumologie de Québec - UL
        • Kontakt:
        • Hauptermittler:
          • Josep Rodés-Cabau, MD, PhD
        • Unterermittler:
          • Francois Philippon, MD

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Beschreibung

Inclusion Criteria:

  • Age >18 years
  • Successful TAVI procedure.
  • Hospitalization discharge ≤72 hrs following the TAVI procedure.
  • Presence of at least 1 ECG abnormality at hospital discharge (QRS ≥120 ms OR PR ≥200 ms)

Exclusion Criteria:

  • Pacemaker implantation (pre- TAVI or during hospitalization after the procedure).
  • TAVI valve-in-valve procedure
  • Any complication or logistic reason precluding hospital discharge ≤72 hrs following the TAVI procedure.
  • Impossibility to obtain signed informed consent.

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Ambulatory ECG monitoring
Participants will undergo ambulatory ECG monitoring at hospital discharge following TAVI. Continuous ECG monitoring will be performed for 14 days using an ambulatory ECG monitoring device. Clinically significant bradyarrhythmias or tachyarrhythmias detected during monitoring will be reviewed and managed according to clinical practice, including appropriate therapeutic interventions when indicated.
Participants randomized to the intervention arm will undergo systematic ambulatory ECG monitoring at hospital discharge following the TAVI procedure. A wearable ambulatory ECG monitoring device will be applied for continuous rhythm monitoring during a 14-day period. The device will allow detection of clinically significant bradyarrhythmias and tachyarrhythmias. Detected arrhythmic events will be reviewed by the study team, and appropriate clinical management, including further evaluation or therapeutic intervention, will be performed according to the nature of the detected abnormality and standard clinical practice.
Kein Eingriff: Standard care (no ambulatory ECG monitoring device).
Participants will receive standard post-TAVI care without systematic ambulatory ECG monitoring at hospital discharge. Clinical follow-up will be performed according to routine practice.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Rate of the combined endpoint (sudden death, symptomatic arrhythmias or stroke)
Zeitfenster: Within the year following the TAVI procedure
Composite endpoint including sudden death, symptomatic arrhythmias, or stroke.
Within the year following the TAVI procedure

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Incidence of sudden death
Zeitfenster: 1 year after TAVI
Sudden death
1 year after TAVI
Incidence of symptomatic arrhythmias
Zeitfenster: 1 year after TAVI
All symptomatic arrhythmias events
1 year after TAVI
Incidence of stroke
Zeitfenster: 1 year after TAVI
All stroke events
1 year after TAVI
Incidence of PPI
Zeitfenster: 30 days after TAVI
Number of patients with PPI
30 days after TAVI
Incidence of PPI
Zeitfenster: 1 year after TAVI
Number of patients with PPI
1 year after TAVI
Incidence of the combined endpoint (sudden death, symptomatic arrhythmias or stroke) at 30 days
Zeitfenster: 30 days after TAVI
Composite endpoint including sudden death, symptomatic arrhythmias, or stroke.
30 days after TAVI
Incidence of sudden death
Zeitfenster: 30 days after TAVI
Sudden death
30 days after TAVI
Incidence of symptomatic arrhytmias
Zeitfenster: 30 days after TAVI
All symptomatic arrhythmias events
30 days after TAVI
Incidence of stroke
Zeitfenster: 30 days after TAVI
All stroke events
30 days after TAVI
Incidence of the combined endpoint (sudden death, symptomatic arrhythmias, stroke) according to patient sex
Zeitfenster: 1 year after TAVI
Composite endpoint including sudden death, symptomatic arrhythmias, or stroke, analyzed according to patient sex.
1 year after TAVI
Incidence of the combined endpoint of sudden death, symptomatic arrhythmias, or stroke) according to ECG abnormalities
Zeitfenster: 1 year after TAVI
Composite endpoint including sudden death, symptomatic arrhythmias, or stroke, analyzed according to ECG abnormality status (pre-existing versus new-onset after TAVI).
1 year after TAVI
Incidence of the combined endpoint according to baseline ECG abnormality type
Zeitfenster: 1 year after TAVI
Composite endpoint (sudden death, symptomatic arrhythmias, or stroke) analyzed according to the type of ECG abnormality present before TAVI.
1 year after TAVI
Incidence of sudden death according to baseline ECG abnormality type
Zeitfenster: 1 year after TAVI
Sudden death analyzed according to the type of ECG abnormality present before TAVI.
1 year after TAVI
Incidence of symptomatic arrhythmias according to baseline ECG abnormality type
Zeitfenster: 1 year after TAVI
Symptomatic arrhythmias according to the type of ECG abnormality present before TAVI.
1 year after TAVI
Incidence of stroke according to baseline ECG abnormality type
Zeitfenster: 1 year after TAVI
Stroke according to the type of ECG abnormality present before TAVI.
1 year after TAVI
Incidence of the combined endpoint according to discharge ECG abnormality type
Zeitfenster: 1 year after TAVI
Composite endpoint (sudden death, symptomatic arrhythmias, or stroke) according to the type of ECG abnormality present at hospital discharge.
1 year after TAVI
Incidence of sudden death according to discharge ECG abnormality type
Zeitfenster: 1 year after TAVI
Sudden death according to the type of ECG abnormality present at hospital discharge.
1 year after TAVI
Incidence of symptomatic arrhythmias according to discharge ECG abnormality type
Zeitfenster: 1 year after TAVI
Symptomatic arrhythmias according to the type of ECG abnormality present at hospital discharge.
1 year after TAVI
Incidence of stroke according to discharge ECG abnormality type
Zeitfenster: 1 year after TAVI
Stroke according to the type of ECG abnormality present at hospital discharge.
1 year after TAVI
Change in quality of life
Zeitfenster: Baseline to 1 year after TAVI
Quality of life assessed using the EQ-5D-5L questionnaire.
Baseline to 1 year after TAVI
Percentage of ventricular pacing
Zeitfenster: 1 year after TAVI
Ventricular pacing burden in participants with permanent pacemakers.
1 year after TAVI
Incidence of all-cause mortality
Zeitfenster: 30 days after TAVI
All-cause mortality
30 days after TAVI
Incidence of cardiovascular mortality
Zeitfenster: 30 days after TAVI
Cardiovascular mortality
30 days after TAVI
Incidence of all-cause mortality
Zeitfenster: 1 year after TAVI
All cause mortality
1 year after TAVI
Incidence of cardiovasculare mortality
Zeitfenster: 1 year after TAVI
Cardiovascular mortality
1 year after TAVI

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Ermittler

  • Hauptermittler: Josep Rodes-Cabau, MSc, Fondation IUCPQ

Publikationen und hilfreiche Links

Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.

Allgemeine Veröffentlichungen

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Geschätzt)

1. August 2026

Primärer Abschluss (Geschätzt)

1. Dezember 2028

Studienabschluss (Geschätzt)

1. Dezember 2028

Studienanmeldedaten

Zuerst eingereicht

21. Juli 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

27. Juli 2026

Zuerst gepostet (Tatsächlich)

31. Juli 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

31. Juli 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

27. Juli 2026

Zuletzt verifiziert

1. Juli 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • RECORDII- MP-10-2026-4441

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

UNENTSCHIEDEN

Beschreibung des IPD-Plans

A decision regarding IPD sharing has not yet been made. Following study completion, requests for access to de-identified individual participant data may be considered by the sponsor on a case-by-case basis, subject to ethical, legal, and institutional requirements.

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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