- ICH GCP
- Yhdysvaltain kliinisten tutkimusten rekisteri
- Kliininen tutkimus NCT05280093
HEAL-IST IDE -kokeilu
Epikardiaalista ja endokardiaalista sinussolmuketta säästävä ablaatiohoito sopimattoman sinustakykardian hoidossa
Inappropriate Sinus Tachycardia (IST) is a prevalent and debilitating condition in otherwise healthy younger patients, resulting in significant loss of quality of life, lacking effective treatment options or systematic clinical evidence to support a therapy. The primary objective of this clinical trial is to evaluate the safety and effectiveness of a hybrid sinus node sparing ablation procedure for the treatment of symptomatic drug refractory or drug intolerant IST.
Tutkimuksen yleiskatsaus
Tila
Interventio / Hoito
Opintotyyppi
Ilmoittautuminen (Todellinen)
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Opiskelupaikat
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Amsterdam, Alankomaat
- Amsterdam University Medical Center
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Maastricht, Alankomaat
- Maastricht University Medical Center
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Brussels, Belgia
- UZ Brussels
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Milan, Italia
- San Raffaele Hospital
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Warsaw, Puola
- Central Clinic Hospital
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Sheffield, Yhdistynyt kuningaskunta, S5 7AU
- Northern General Hospital
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Arkansas
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Jonesboro, Arkansas, Yhdysvallat, 72401
- St. Bernard
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California
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Loma Linda, California, Yhdysvallat, 92354
- Loma Linda University Health
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Redwood City, California, Yhdysvallat, 94063
- Stanford University
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Redwood City, California, Yhdysvallat, 94062
- Sequoia Hospital
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Connecticut
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Bridgeport, Connecticut, Yhdysvallat, 06606
- Saint Vincent's Medical Center
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District of Columbia
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Washington D.C., District of Columbia, Yhdysvallat, 20010
- Medstar Washington Hospital Center
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Florida
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Gainesville, Florida, Yhdysvallat, 32610
- University of Florida
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Miami, Florida, Yhdysvallat, 33143
- Baptist Health
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Sarasota, Florida, Yhdysvallat, 34239
- Sarasota Memorial Hospital
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Tampa, Florida, Yhdysvallat, 33607
- St. Joseph's Hospital / Baycare Health System
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Georgia
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Savannah, Georgia, Yhdysvallat, 31404
- Memorial Health University Medical Center
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Idaho
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Boise, Idaho, Yhdysvallat, 83706
- Saint Alphonsus Regional Medical Center
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Kansas
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Overland Park, Kansas, Yhdysvallat, 66211
- Kansas City Cardiac Arrhythmia Research LLC
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Minnesota
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Rochester, Minnesota, Yhdysvallat, 55905
- Mayo Clinic
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North Carolina
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Winston-Salem, North Carolina, Yhdysvallat, 27157
- Wake Forest University Health Sciences
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Ohio
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Cincinnati, Ohio, Yhdysvallat, 45219
- The Christ Hospital
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Cincinnati, Ohio, Yhdysvallat, 45202
- TriHealth, Inc.
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Texas
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Austin, Texas, Yhdysvallat, 78705
- Texas Cardiac Arrhythmia Research Foundation
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Utah
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Salt Lake City, Utah, Yhdysvallat, 84111
- Intermountain Healthcare
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Virginia
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Richmond, Virginia, Yhdysvallat, 23219
- Virginia Commonwealth University
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Washington
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Seattle, Washington, Yhdysvallat, 98122
- Swedish Medical Center
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
Inclusion Criteria:
- Age ≥ 18 years and ≤ 75 years at time of enrollment consent
- Subject has a diagnosis of IST
- Documentation of refractoriness (intolerance or failure) of a drug (e.g., rate control drugs such as beta-blockers/calcium channel blockers, ivabradine), and/or AADs
- Subject is willing and able to provide written informed consent
Exclusion Criteria:
- Subjects on whom cardiac surgery or single lung ventilation cannot be performed
- Subjects with indication for or existing ICDs/Pacemakers
- Presence of channelopathies
- Previous cardio-thoracic surgery
- Left Ventricular Ejection Fraction (LVEF) < 50%
- Body Mass Index (BMI) ≥ 35
- Presence of supraventricular or ventricular tachycardia
- Presence of Postural Orthostatic Sinus Tachycardia (POTS)
- Presence of congenital heart disease
- History suggestive of secondary cause of tachycardia such as pheochromocytoma, anemia, thyrotoxicosis, chronic fever of unknown origin, COPD, long-term bronchodilators use, severe asthma or carcinoid syndrome
- Subjects who have had a previous catheter ablation in the right atrium for IST or other disorders
- Life expectancy < 24 months
- Pregnant or planning to become pregnant during trial
- Subjects with substance abuse
- Subjects with previous weight loss surgery
- Subject is unwilling and/or unable to return for scheduled follow-up visits
- Current participation in another clinical investigation of a medical device or a drug, or recent participation in such a trial that may interfere with trial results
- Not competent to legally represent him or herself (e.g., requires a guardian or caretaker as a legal representative) and;
- Presence of other anatomic or comorbid conditions, or other medical, social, or psychological conditions that, in the investigator's opinion, could limit the subject's ability to participate in the clinical investigation or to comply with follow-up requirements, or impact the scientific soundness of the clinical investigation results
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Ei käytössä
- Inventiomalli: Yksittäinen ryhmätehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
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Kokeellinen: Hybrid sinus node sparing ablation procedure
Hybrid sinus node sparing ablation procedure using the ISOLATOR Synergy Surgical Ablation System |
Hybrid sinus node sparing ablation procedure using the ISOLATOR Synergy Surgical Ablation System |
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Primary Effectiveness Endpoint
Aikaikkuna: 12-months Post Procedure
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Freedom from IST at 12-months. Freedom from IST is defined as mean heart rate of ≤ 90bpm or at least a 15% reduction in mean heart rate as compared to baseline, in the absence of new or higher dosage of previously failed medications. |
12-months Post Procedure
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Primary Safety Endpoint
Aikaikkuna: 30-days Post Procedure
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Incidence of device or procedure-related major adverse events (MAEs) for subjects undergoing the hybrid sinus node sparing ablation procedure from the index procedure through 30-days post procedure |
30-days Post Procedure
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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6-Minute Walk Test
Aikaikkuna: 24-months Post Procedure
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Change in 6-Minute Walk Test (6-MWT) from baseline compared to 6-, 12- and 24-months post-procedure |
24-months Post Procedure
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Borg dyspnea score
Aikaikkuna: 24-months Post Procedure
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Change in Borg dyspnea severity of breathlessness and fatigue score from baseline compared to 6-, 12- and 24-months post-procedure. Borg dyspnea score will be assessed at each of the 6-MWT. |
24-months Post Procedure
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Self-Rating Anxiety Scale
Aikaikkuna: 24-months Post Procedure
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Change from baseline in psychological evaluation compared to 6-, 12- and 24-months post-procedure utilizing the Self-Rating Anxiety Scale (SAS) |
24-months Post Procedure
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IST symptom reduction
Aikaikkuna: 24-months Post Procedure
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IST symptom reduction at baseline to 6-, 12- and 24-months post-procedure |
24-months Post Procedure
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QoL - SF-12
Aikaikkuna: 24-months Post Procedure
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Change in QoL based on a Short Form Survey (SF-12) domain and component scores at baseline compared to 6-, 12- and 24-months post-procedure |
24-months Post Procedure
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Mean heart rate
Aikaikkuna: 24-months Post Procedure
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Change in mean heart rate at 6-, 12- and 24-months post-procedure compared to baseline, using 7-day continuous monitoring |
24-months Post Procedure
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Reduction in mean heart rate in the absence of rate control drugs
Aikaikkuna: 24-months Post Procedure
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Freedom from IST or at least 15% reduction in mean heart rate at 12- and 24-months compared to baseline, in the absence of rate control drugs (beta-blockers/calcium channel blockers, ivabradine) and/or AADs |
24-months Post Procedure
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Reduction in mean heart rate regardless of rate control drugs
Aikaikkuna: 24-months Post Procedure
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Freedom from IST or at least a 15% reduction in mean heart rate at 12- and 24-months compared to baseline, regardless of rate control drugs (beta-blockers/calcium channel blockers, ivabradine) and/or AADs |
24-months Post Procedure
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Device or procedure related Serious Adverse Events
Aikaikkuna: 12-months Post Procedure
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Device or procedure related Serious Adverse Events (SAEs) through 12-months |
12-months Post Procedure
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Improved heart rate variability - 7-day monitor
Aikaikkuna: 12-months Post Procedure
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Improved heart rate variability for subjects using 7-day continuous monitoring |
12-months Post Procedure
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Improved heart rate variability - Implantable loop recorder
Aikaikkuna: 12-months Post Procedure
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Improved heart rate variability and activity levels for subjects with implantable loop recorders (ILRs) |
12-months Post Procedure
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Health Economics
Aikaikkuna: 24-months Post Procedure
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Health Economics: ER visits and readmissions |
24-months Post Procedure
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Yhteistyökumppanit ja tutkijat
Sponsori
Tutkijat
- Päätutkija: Dhanunjaya Lakkireddy, MD, Kansas City Heart Rhythm Institute
- Päätutkija: Mark La Meir, MD, Universitair Ziekenhuis Brussel
- Päätutkija: Carlo de Asmundis, MD, Universitair Ziekenhuis Brussel
- Päätutkija: Thomas Beaver, MD, University of Florida
Julkaisuja ja hyödyllisiä linkkejä
Yleiset julkaisut
- Calkins H, Hindricks G, Cappato R, Kim YH, Saad EB, Aguinaga L, Akar JG, Badhwar V, Brugada J, Camm J, Chen PS, Chen SA, Chung MK, Nielsen JC, Curtis AB, Davies DW, Day JD, d'Avila A, de Groot NMSN, Di Biase L, Duytschaever M, Edgerton JR, Ellenbogen KA, Ellinor PT, Ernst S, Fenelon G, Gerstenfeld EP, Haines DE, Haissaguerre M, Helm RH, Hylek E, Jackman WM, Jalife J, Kalman JM, Kautzner J, Kottkamp H, Kuck KH, Kumagai K, Lee R, Lewalter T, Lindsay BD, Macle L, Mansour M, Marchlinski FE, Michaud GF, Nakagawa H, Natale A, Nattel S, Okumura K, Packer D, Pokushalov E, Reynolds MR, Sanders P, Scanavacca M, Schilling R, Tondo C, Tsao HM, Verma A, Wilber DJ, Yamane T. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm. 2017 Oct;14(10):e275-e444. doi: 10.1016/j.hrthm.2017.05.012. Epub 2017 May 12. No abstract available.
- Sheldon RS, Grubb BP 2nd, Olshansky B, Shen WK, Calkins H, Brignole M, Raj SR, Krahn AD, Morillo CA, Stewart JM, Sutton R, Sandroni P, Friday KJ, Hachul DT, Cohen MI, Lau DH, Mayuga KA, Moak JP, Sandhu RK, Kanjwal K. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015 Jun;12(6):e41-63. doi: 10.1016/j.hrthm.2015.03.029. Epub 2015 May 14. No abstract available.
- Olshansky B, Sullivan RM. Inappropriate sinus tachycardia. Europace. 2019 Feb 1;21(2):194-207. doi: 10.1093/europace/euy128.
- Pellegrini CN, Scheinman MM. Epidemiology and definition of inappropriate sinus tachycardia. J Interv Card Electrophysiol. 2016 Jun;46(1):29-32. doi: 10.1007/s10840-015-0039-8. Epub 2015 Aug 27.
- Khiabani AJ, Greenberg JW, Hansalia VH, Schuessler RB, Melby SJ, Damiano RJ Jr. Late Outcomes of Surgical Ablation for Inappropriate Sinus Tachycardia. Ann Thorac Surg. 2019 Oct;108(4):1162-1168. doi: 10.1016/j.athoracsur.2019.03.103. Epub 2019 May 8.
- de Asmundis C, Chierchia GB, Sieira J, Stroker E, Umbrain V, Poelaert J, Brugada P, La Meir M. Sinus Node Sparing Novel Hybrid Approach for Treatment of Inappropriate Sinus Tachycardia/Postural Orthostatic Sinus Tachycardia With New Electrophysiological Finding. Am J Cardiol. 2019 Jul 15;124(2):224-232. doi: 10.1016/j.amjcard.2019.04.019. Epub 2019 Apr 23.
- Nwazue VC, Paranjape SY, Black BK, Biaggioni I, Diedrich A, Dupont WD, Robertson D, Raj SR. Postural tachycardia syndrome and inappropriate sinus tachycardia: role of autonomic modulation and sinus node automaticity. J Am Heart Assoc. 2014 Apr 10;3(2):e000700. doi: 10.1161/JAHA.113.000700.
- Masumoto A, Takemoto M, Mito T, Tanaka A, Kawano Y, Kumeda H, Kang H, Matsuo A, Hida S, Okazaki T, Tayama KI, Yoshitake K, Kosuga K. Inappropriate Sinus Tachycardia Diagnosed and Treated as Depression Successfully Treated by Radiofrequency Catheter Ablation. Intern Med. 2017;56(5):523-526. doi: 10.2169/internalmedicine.56.7579. Epub 2017 Mar 1.
- Yasin OZ, Vaidya VR, Chacko SR, Asirvatham SJ. Inappropriate Sinus Tachycardia: Current Challenges and Future Directions. J Innov Card Rhythm Manag. 2018 Jul 15;9(7):3239-3243. doi: 10.19102/icrm.2018.090706. eCollection 2018 Jul. No abstract available.
- Cappato R, Castelvecchio S, Ricci C, Bianco E, Vitali-Serdoz L, Gnecchi-Ruscone T, Pittalis M, De Ambroggi L, Baruscotti M, Gaeta M, Furlanello F, Di Francesco D, Lupo PP. Clinical efficacy of ivabradine in patients with inappropriate sinus tachycardia: a prospective, randomized, placebo-controlled, double-blind, crossover evaluation. J Am Coll Cardiol. 2012 Oct 9;60(15):1323-9. doi: 10.1016/j.jacc.2012.06.031. Epub 2012 Sep 12.
- Kreisel D, Bailey M, Lindsay BD, Damiano RJ Jr. A minimally invasive surgical treatment for inappropriate sinus tachycardia. J Thorac Cardiovasc Surg. 2005 Aug;130(2):598-9. doi: 10.1016/j.jtcvs.2004.12.026. No abstract available.
- de Asmundis C, Chierchia GB, Lakkireddy D, Romeya A, Okum E, Gandhi G, Sieira J, Vloka M, Jones SD, Shah H, Winner M, Patel D, Whalen SP, Beaty EH, Kincaid EH, Lee A, Brodt C, Taylor BJ, Colombowala I, Romano M, Morady F, Stroker E, Overeinder I, Bala G, Van Meeteren J, Krauthammer Y, Koerber S, Shults C, Thomaides A, Badhwar N, Gopinathannair R, Shah A, Tummala R, Bello D, Hoff S, Almorad A, Frazier K, Brugada P, La Meir M. Sinus node sparing novel hybrid approach for treatment of inappropriate sinus tachycardia/postural sinus tachycardia: multicenter experience. J Interv Card Electrophysiol. 2022 Apr;63(3):531-544. doi: 10.1007/s10840-021-01044-5. Epub 2021 Aug 23.
- C. De Asmundis et al, "Thoracoscopic Ablation of Inappropriate Sinus Tachycardia and Postural Orthostatic Tachycardia Syndrome." Hands-On-Ablation, The Expert's Approach, Third Edition.
- Lakkireddy D, Garg J, DeAsmundis C, LaMeier M, Romeya A, Vanmeetren J, Park P, Tummala R, Koerber S, Vasamreddy C, Shah A, Shivamurthy P, Frazier K, Awasthi Y, Chierchia GB, Atkins D, Bommana S, Di Biase L, Al-Ahmad A, Natale A, Gopinathannair R. Sinus Node Sparing Hybrid Thoracoscopic Ablation Outcomes in Patients with Inappropriate Sinus Tachycardia (SUSRUTA-IST) Registry. Heart Rhythm. 2022 Jan;19(1):30-38. doi: 10.1016/j.hrthm.2021.07.010. Epub 2021 Jul 30.
- Broglio KR, Connor JT, Berry SM. Not too big, not too small: a goldilocks approach to sample size selection. J Biopharm Stat. 2014;24(3):685-705. doi: 10.1080/10543406.2014.888569.
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Tutkimustietojen päivitykset
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