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Spinal Cord Stimulation to Treat Post-operative Atrial Fibrillation (SCS-PAF)

5 aprile 2016 aggiornato da: Medtronic BRC
Patients will be randomized to control and spinal cord stimulation arm (SCS) to investigate the effect of SCS on the occurrence of post-operative atrial fibrillation in the five days after surgery.

Panoramica dello studio

Descrizione dettagliata

Pre market single center clinical research feasibility study. Non blinded randomized controlled study. 52 patients undergoing CABG procedure will be enrolled and randomized into two different group (26 person each): the Spinal Cord Stimulation (SCS) and the control group. The first group will be implanted before the CABG procedure with a temporary SCS lead (5 days) while the second one will not. The lead will be connected to an external stimulator.

The day of the CABG surgery, before the scheduled procedure, the patients in the treatment group will be implanted with the SCS lead. CABG procedure follows the SCS lead implantation. SCS will be switched off before surgery.

After the CABG procedure, all patients will be hospitalized for minimally five days at the end of which they will be discharged. The Primary Endpoint data will be collected from the day of CABG procedure (Day-0) until Day-5. SCS lead will be removed on Day-5.

1-week follow up visit will be performed one week after discharge. End-points will be evaluated at various time before, during and after surgery. In both groups arrhythmic episodes for primary and secondary endpoints will be recorded via a Holter monitor (recording 5 days continuously).

Tipo di studio

Interventistico

Iscrizione (Effettivo)

4

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

      • Enschede, Olanda, 7511 JX
        • Medisch Spectrum Twente (MST)

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  1. Patients which will be subjected to an OFF-pump CABG procedure
  2. More than 18 years of age
  3. Subject is able and willing to give informed consent.

Exclusion Criteria:

  1. Patients with known history of atrial arrhythmias.
  2. Patients who are not treated with β-blockers unless heart rate is too low for β-blockers assumption.
  3. Participation in another clinical trial which may affect the outcome within 3 months prior to day of procedure.
  4. Other surgical interventions (e.g. valve replacement) programmed in the same surgical session
  5. Resting pulse rate ≤45 beats / min as assessed before daily doses of β-blockage is administered.
  6. Hypotension (RR systolic <100 or RR diastolic <50).
  7. Conduction abnormalities on the ECG consisting of a 1st degree atrioventricular block or a complete bundle branch block.
  8. Subject is diagnosed with epilepsy or history of seizures.
  9. Coagulation abnormalities as determined by anticoagulation guidelines for neuroaxial procedures 2011.
  10. Patients not stabilized on an anti-arrhythmic drug regimen for the last 30 days.
  11. Patients with long QT syndrome.
  12. Patients with Brugada syndrome.
  13. Patients affected by Polyneuropathy (e.g. due to diabetes).
  14. Patients affected by pericarditis
  15. Patients who underwent procedures in the past, which are expected to have changed the innervation of the heart for example:

    • Ablation procedure
    • Cardiac surgery
  16. Pregnant patients or nursing (subjects who are of child bearing potential and are not on a reliable form of birth control will undergo a pregnancy test)
  17. Patients already implanted with cardiac devices
  18. Patients with existing implanted neurostimulators

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Altro: Conventional treatment
Non interventional group, patients that belong to this arm will receive the conventional treatment for CABG and they will wear the Holter for 5 days.
To measure primary endpoint and most of the secondary endpoints in all the patients enrolled in the study. The recording will start to before CABG procedure and will be stop at day 5.
Sperimentale: Spinal Cord Stimulation System
This group will receive the Spinal Cord Stimulation System and they will wear the Holter for 5 days.
To measure primary endpoint and most of the secondary endpoints in all the patients enrolled in the study. The recording will start to before CABG procedure and will be stop at day 5.
High frequency stimulation using a catheter placed in the lumen of the spine to inhibit sympathetic outflow to the heart
Altri nomi:
  • (Medtronic External Neurostimulator Model 37022; Medtronic 1x8 Standard LZ Lead Model 3877; Medtronic MultiLead Trialing Cable MLTC Model 355531)

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Atrial fibrillation
Lasso di tempo: 5 days after CABG
AT/AF will be defined as an episode with an atrial rate >175 bpm lasting ≥ 20 seconds.
5 days after CABG

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Medication
Lasso di tempo: 5 days after CABG
Description of integral medication related to AT/AF occurrence and pain in the treatment (SCS) and control group between start of anesthesia and 5 days after surgery.
5 days after CABG
Cardioversion
Lasso di tempo: 5 days after CABG
Description of number of cardioversion needed in the treatment (SCS) and control group between start of anesthesia and 5 days after surgery.
5 days after CABG
Hospitalizations Days
Lasso di tempo: 1 week after discharge
Description of hospitalizations longer than 5 days as required by the protocol and clinical practice in the treatment (SCS) and control group.
1 week after discharge
BP
Lasso di tempo: 5 days after CABG
Description of 1) intra arterial blood pressure as averaged over the first 24 hours after surgery and 2) arterial blood pressure as determined using a blood pressure cuff at a specific time on Day-2, Day-3, Day-4 and Day-5 after surgery in the treatment (SCS) and control group.
5 days after CABG
Description of the total number of AT/AF episodes in the treatment (SCS) and control group between start of anesthesia and 5 days after surgery.
Lasso di tempo: 5 days after CABG
AT/AF episodes
5 days after CABG
Description of burden of AT/AF episodes in the treatment (SCS) and control group between start of anesthesia and 5 days after surgery.
Lasso di tempo: 5 days after CABG
AT/AF burden
5 days after CABG
Premature atrial beats
Lasso di tempo: 5 days after CABG
Description of the amount of premature atrial beats in the treatment (SCS) and control group from the end of the procedure till Day-5 after surgery.
5 days after CABG
VT/VF episodes
Lasso di tempo: 5 days after CABG
Description of the total number of VT/VF episodes in the treatment (SCS) and control group between start of anesthesia and 5 days after surgery.
5 days after CABG
Burden VT/VF episodes
Lasso di tempo: 5 days after CABG
Description of the burden of VT/VF episodes in the treatment (SCS) and control group between start of anesthesia and 5 days after surgery.
5 days after CABG
HRV
Lasso di tempo: 5 days after CABG
Improvement LF/HF ratio of Heart Rate Variability (HRV) by SCS. SCS On and Off will be compared in each patients in the treatment (SCS) group before surgery and 5 days after surgery.
5 days after CABG
Pain on the VAS scale
Lasso di tempo: 5 days after CABG
Description of pain-score due to CABG surgery measured with a VAS score three times a from Day-1 till Day-5 after surgery in the treatment (SCS) and control group.
5 days after CABG
Bladder function
Lasso di tempo: 5 days after CABG
The extra time the bladder catheter will be kept in the patients after the first 2 days after surgery will be described in the treatment (SCS) and control group in order to assess bladder function.
5 days after CABG
HR
Lasso di tempo: 5 days after CABG
Description of 1) heart rate as averaged over the first 24 hours after surgery and 2) heart rate as determined using a blood pressure cuff at a specific time on Day-2, Day-3, Day-4 and Day-5 after surgery in the treatment (SCS) and control group.
5 days after CABG

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Investigatori

  • Investigatore principale: Jan Diephuis, PhD, Medisch Spectrum Twente

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 febbraio 2015

Completamento primario (Effettivo)

1 febbraio 2016

Completamento dello studio (Effettivo)

1 febbraio 2016

Date di iscrizione allo studio

Primo inviato

11 maggio 2015

Primo inviato che soddisfa i criteri di controllo qualità

19 agosto 2015

Primo Inserito (Stima)

20 agosto 2015

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Stima)

6 aprile 2016

Ultimo aggiornamento inviato che soddisfa i criteri QC

5 aprile 2016

Ultimo verificato

1 aprile 2016

Maggiori informazioni

Termini relativi a questo studio

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INDECISO

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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