Dual Energy Focal Ablation of Premature Ventricular Complexes (DUAL-PVC)
Dual Energy (RF/PF) Focal Ablation of Premature Ventricular Complexes: the DUAL-PVC Prospective Clinical Trial
The purpose of this research is to understand whether a dual-energy catheter ablation system that uses radiofrequency (RF) and pulsed-field (PF) energy can safely and effectively treat premature ventricular contractions (PVCs).
A tanulmány áttekintése
Állapot
Körülmények
Tanulmány típusa
Beiratkozás (Becsült)
Fázis
- Nem alkalmazható
Kapcsolatok és helyek
Tanulmányi kapcsolat
- Név: Konstantinos Siontis, MD
- Telefonszám: 507-255-0774
- E-mail: siontis.konstantinos@mayo.edu
Tanulmányi helyek
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Minnesota
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Rochester, Minnesota, Egyesült Államok, 55905
- Mayo Clinic
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Részvételi kritériumok
Jogosultsági kritériumok
Tanulmányozható életkorok
Egészséges önkénteseket fogad
Tanulmányozható nemek
Leírás
Inclusion Criteria:
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≥10% burden of the target PVC on ambulatory rhythm monitoring within 3 months prior to enrollment. The qualifying ambulatory monitor may be of any duration (1-30 days) per standard of care and may be distinct from the baseline 12-lead Holter required within 30 days before ablation
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Guideline-supported indication for first-time or redo catheter ablation of PVCs at the judgment of the electrophysiologist. Specifically:
- Patients with symptomatic PVCs for whom antiarrhythmic medications are ineffective, not tolerated, or not the patient's preference.
- Suspected or confirmed PVC-induced cardiomyopathy
- Enrollment of patients requiring a redo procedure will be capped at 30% of planned enrollment (n=18) if the target PVC is the same or similar to that targeted in previous procedure(s), per review of the study investigator
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Patients with and without known structural heart disease are eligible
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Ability to undergo study-directed cardiac MRI pre- and post-procedure
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Ability to undergo study-directed post-ablation coronary CT angiography
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Ability to provide written informed consent
Exclusion Criteria:
- LVEF <35%
- NYHA class IV
- Presence of multifocal PVCs (>=3 distinct morphologies) on available pre-baseline standard-of-care ambulatory monitor and ECG tracings per the review of the study team.
- PVCs attributable to a reversible or non-cardiac cause (e.g., electrolyte imbalance or active thyroid disease).
- History of sustained VT or VF.
- Current or recent (<4 weeks) decompensated heart failure.
- Active systemic infection.
- Contraindication to LGE-MRI or contrast CT.
- Known allergy to iodinated contrast dye that cannot be adequately managed with pre-medication protocol.
- Thrombocytopenia (platelet count <50,000/mm³) or known coagulopathy.
- Contraindication to systemic anticoagulation.
- Severe valvular disease requiring future intervention.
- Mechanical valve prosthesis.
- Pregnancy.
- Recent acute coronary syndrome (<6 months).
- Un-revascularized coronary artery disease.
- Presence of left ventricular assist device (LVAD) or transplanted heart.
- Presence of intracardiac thrombus.
- Current use of inotropes.
- Recent stroke or TIA (<6 months).
- Presence of a systemic illness likely to limit survival to <1 year.
- Patient enrollment in other clinical study that could conflict with the current investigation.
Tanulási terv
Hogyan készül a tanulmány?
Tervezési részletek
- Elsődleges cél: Kezelés
- Kiosztás: Véletlenszerűsített
- Beavatkozó modell: Párhuzamos hozzárendelés
- Maszkolás: Nincs (Open Label)
Fegyverek és beavatkozások
Résztvevő csoport / kar |
Beavatkozás / kezelés |
|---|---|
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Kísérleti: RF-PF Sequential Ablation
Participants are assigned to receive radiofrequency (RF) followed by pulsed-field (PF) at each selected treatment site. For each PF treatment, 24 PF bursts are delivered. Up to three stacked lesions may be performed at the same location. |
The THERMOCOOL SMARTTOUCH™ SF Bi-Directional Navigation Catheter is an irrigated, contact-force-sensing catheter used to map the heart and deliver radiofrequency (RF) or pulsed-field (PF) energy to selected treatment sites. The catheter is connected to the TRUPULSE™ Generator, which provides both energy types, and to the nGEN™ Pump, which controls saline irrigation. The system is used with the CARTO™ 3 electroanatomic mapping system and workstation with the VISITAG SURPOINT™ Module to display heart anatomy, catheter location, catheter-to-tissue contact, and treatment information during the procedure. |
|
Kísérleti: PF-Only Ablation
Participants are assigned to receive pulsed-field (PF) alone at each selected treatment site. For each PF treatment, 24 PF bursts are delivered. Up to three stacked lesions may be performed at the same location. |
The THERMOCOOL SMARTTOUCH™ SF Bi-Directional Navigation Catheter is an irrigated, contact-force-sensing catheter used to map the heart and deliver radiofrequency (RF) or pulsed-field (PF) energy to selected treatment sites. The catheter is connected to the TRUPULSE™ Generator, which provides both energy types, and to the nGEN™ Pump, which controls saline irrigation. The system is used with the CARTO™ 3 electroanatomic mapping system and workstation with the VISITAG SURPOINT™ Module to display heart anatomy, catheter location, catheter-to-tissue contact, and treatment information during the procedure. |
Mit mér a tanulmány?
Elsődleges eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
|
Number of Participants With Successful Delivery of Ablation Lesions Using the Dual-Energy THERMOCOOL SMARTTOUCH SF Catheter With the TRUPULSE Generator
Időkeret: During the index ablation procedure
|
Feasibility is defined as successful delivery of ablation energy at the targeted premature ventricular complex (PVC) site. Delivery counts as successful only if there is no study device deficiency or malfunction that prevents energy delivery, and no need to convert to a bailout ablation approach. |
During the index ablation procedure
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Másodlagos eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
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Acute procedural success
Időkeret: End of the ablation procedure
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Number of participants with elimination of the target premature ventricular contraction by the end of the procedure. |
End of the ablation procedure
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Participants with greater than 80% reduction in target PVC burden
Időkeret: 1 month, 6 months
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Number of participants with greater than 80% reduction from baseline in the burden of the target premature ventricular contraction on Holter monitoring. |
1 month, 6 months
|
|
Change in Short Form Health Survey (SF-36) score
Időkeret: Baseline, 1 month, 6 months
|
The 36-Item Short Form Health Survey (SF-36) is a participant-reported questionnaire that assesses health-related quality of life across eight domains: physical functioning, role limitations due to physical health, bodily pain, general health, vitality, social functioning, role limitations due to emotional problems, and mental health. Total scores range from 0 to 100. Higher scores indicate better health status. |
Baseline, 1 month, 6 months
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Change in EQ-5D score
Időkeret: Baseline, 1 month, 6 months
|
The EQ-5D is a participant-reported measure of health-related quality of life covering five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Responses across the five dimensions define the participant's health state. Higher scores indicate better health. |
Baseline, 1 month, 6 months
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Number of Participants With New Coronary Artery Stenosis on Coronary CT Angiography at 6 Months After Ablation
Időkeret: 6 months
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Total number of patients with new-onset coronary luminal stenosis found on CT coronary angiography |
6 months
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Total Procedure Time
Időkeret: From start to finish of index ablation procedure
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Total procedure time will be reported in minutes |
From start to finish of index ablation procedure
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Electrogram endpoints
Időkeret: Intraprocedure
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EGM amplitude changes after PF, RF, and RF-PF lesion delivery |
Intraprocedure
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Ablation Lesion Depth
Időkeret: 1 month and 6 months after ablation
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Maximum depth of the ablation lesion at the target premature ventricular complex (PVC) site. Depth is measured from the endocardial surface on late gadolinium enhancement (LGE) cardiac MRI. Only participants with an evaluable post-ablation MRI are analyzed. Reported in millimeters. |
1 month and 6 months after ablation
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Ablation Lesion Width
Időkeret: 1 month and 6 months after ablation
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Maximum width of the ablation lesion at the target PVC site, measured on LGE cardiac MRI. Only participants with an evaluable post-ablation MRI are analyzed. Reported in millimeters. |
1 month and 6 months after ablation
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Ablation Lesion Volume
Időkeret: 1 month and 6 months after ablation
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Total volume of the ablation lesion at the target PVC site, measured on LGE cardiac MRI. Only participants with an evaluable post-ablation MRI are analyzed. Reported in cubic centimeters. |
1 month and 6 months after ablation
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Number of Radiofrequency (RF) Lesions Delivered per Participant
Időkeret: During the index ablation procedure
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Total number of RF lesions delivered with the study catheter during the index procedure |
During the index ablation procedure
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Number of Pulsed-Field (PF) Lesions Delivered per Participant
Időkeret: During the index ablation procedure
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Total number of PF lesions delivered with the study catheter during the index procedure |
During the index ablation procedure
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Együttműködők és nyomozók
Szponzor
Nyomozók
- Kutatásvezető: Konstantinos Siontis, MD, Mayo Clinic
Tanulmányi rekorddátumok
Tanulmány főbb dátumok
Tanulmány kezdete (Becsült)
Elsődleges befejezés (Becsült)
A tanulmány befejezése (Becsült)
Tanulmányi regisztráció dátumai
Először benyújtva
Először nyújtották be, amely megfelel a minőségbiztosítási kritériumoknak
Első közzététel (Tényleges)
Tanulmányi rekordok frissítései
Utolsó frissítés közzétéve (Tényleges)
Az utolsó frissítés elküldve, amely megfelel a minőségbiztosítási kritériumoknak
Utolsó ellenőrzés
Több információ
A tanulmányhoz kapcsolódó kifejezések
További vonatkozó MeSH feltételek
Egyéb vizsgálati azonosító számok
- 25-013930
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Tervezi megosztani az egyéni résztvevői adatokat (IPD)?
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