Dynamic Voltage Mapping to Personalise the Ventricular Tachycardia Substrate (DYNAMITE-VT)
Ventricular tachycardia (VT) is a life-threatening heart rhythm disorder and one of the commonest causes of heart-related sudden death. It often affects people who have had a heart attack or other structural heart damage. VT occurs when abnormal electrical circuits develop within and around scar tissue in the heart.
People at risk are usually offered an implantable cardiac defibrillator (ICD), a device that can detect VT and deliver a lifesaving shock. While effective, these shocks can be sudden, painful and distressing. Medications such as amiodarone can also help, but they are often unsuitable for long-term use due to their potential side effects on the liver, lungs and thyroid gland.
An alternative is catheter ablation. Thin tubes (catheters) are threaded from a blood vessel in the groin to the heart, allowing the cardiologist to identify scar tissue and abnormal electrical circuits, which can be destroyed using heat, freezing or electrical energy.
Although ablation can help many patients, VT can return in up to one in three people after the procedure. This is because it can be difficult to precisely identify the scar and surrounding tissue that sustain the abnormal circuits, making it challenging to know exactly where to apply ablation treatment.
Dynamic Voltage Mapping, is a technique which the investigators believe can more accurately identify scar and the critical bordering tissue during ablation. Initial data collected suggests that the approach accurately predicts the VT circuit and helps guide ablation.
In this study, the investigators wish to recruit 40 participants undergoing VT ablation to determine how effective Dynamic Voltage Mapping is in real-world procedures.
調査の概要
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究場所
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Liverpool、イギリス、L14 3PE
- Liverpool Heart and Chest Hospital NHS Foundation Trust
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コンタクト:
- Vishal Luther, MRCP PhD ECES ECDS
- 電話番号:0151 600 1251
- メール:vishal.luther@lhch.nhs.uk
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コンタクト:
- Justin Chiong, MBChB MSc MRCP
- メール:justin.chiong@lhch.nhs.uk
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主任研究者:
- Vishal Luther, MRCP PhD ECES ECDS
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副調査官:
- Justin Chiong, MBChB MSc MRCP
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Scheduled for clinically indicated VT ablation (due to sustained VT episodes or ICD therapies).
- Willing and able to give informed consent for participation in the trial
- Male or female aged between 18-85
- Ischaemic and non-ischaemic cardiomyopathy
- ICD insitu
Exclusion Criteria:
- Unable or unwilling to consent
- NYHA Class IV (end stage heart failure)
- Metastatic cancer
- End stage renal disease
- Pregnant or breast feeding
- Severe frailty
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的:Dynamic Voltage Mapping Guided Ablation
Patients assigned to this group will have Dynamic Voltage Maps available for the operator to view during the procedure to help guide ablation.
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Dynamic Voltage Mapping uses electrical information collected from catheters positioned within the heart to create an individualised map of the heart, which the investigators hypothesise will better identify scar and surrounding tissue responsible for ventricular tachycardia.
他の名前:
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アクティブコンパレータ:Standard of Care Ablation
Patients assigned to this group will receive standard of care ablation, and operators will be blinded to Dynamic Voltage Maps created during the procedure.
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Standard catheter ablation of ventricular tachycardia, guided by operator preference
他の名前:
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Study Feasibility
時間枠:From enrolment to end of follow up (1 year after procedure)
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From enrolment to end of follow up (1 year after procedure)
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Procedural Time
時間枠:From start of procedure to end (skin-to-skin)
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Measured in minutes
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From start of procedure to end (skin-to-skin)
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Ablation time/number of lesions
時間枠:From start of procedure to end (skin-to-skin)
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Measured by number of ablation lesions applied
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From start of procedure to end (skin-to-skin)
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Acute VT non-inducibility
時間枠:From start of procedure to end (skin-to-skin)
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Ability to induce clinical VT at the end of the procedure
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From start of procedure to end (skin-to-skin)
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VT recurrence Rate
時間枠:From end of procedure to end of follow up (12 months)
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Number of sustained VT episodes/ICD shocks/therapies following procedure, recorded by implanted cardiac device
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From end of procedure to end of follow up (12 months)
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協力者と研究者
出版物と役立つリンク
一般刊行物
- Grade Santos J, Mills MT, Calvert P, Worthington N, Phenton C, Modi S, Ashrafi R, Todd D, Waktare J, Mahida S, Gupta D, Luther V. Delineating postinfarct ventricular tachycardia substrate with dynamic voltage mapping in areas of omnipolar vector disarray. Heart Rhythm O2. 2024 Feb 27;5(4):224-233. doi: 10.1016/j.hroo.2024.02.006. eCollection 2024 Apr.
- Khanra D, Calvert P, Hughes S, Waktare J, Modi S, Hall M, Todd D, Mahida S, Gupta D, Luther V. An approach to help differentiate postinfarct scar from borderzone tissue using Ripple Mapping during ventricular tachycardia ablation. J Cardiovasc Electrophysiol. 2023 Mar;34(3):664-672. doi: 10.1111/jce.15766. Epub 2023 Jan 12.
- Mills MT, Calvert P, Chiong J, Gupta D, Luther V. Dynamic Voltage Mapping of the Post-infarct Ventricular Tachycardia Substrate: A Practical Technique to Help Differentiate Scar from Borderzone Tissue. Arrhythm Electrophysiol Rev. 2024 Oct 14;13:e16. doi: 10.15420/aer.2024.26. eCollection 2024.
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
- 35371
- FS/CRTF/25/24865 (その他の助成金/資金番号:British Heart Foundation)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
IPD 共有時間枠
IPD 共有アクセス基準
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
- SAP
- ANALYTIC_CODE
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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