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

5 de abril de 2016 atualizado por: 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.

Visão geral do estudo

Status

Rescindido

Condições

Intervenção / Tratamento

Descrição detalhada

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 de estudo

Intervencional

Inscrição (Real)

4

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

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

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

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

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Outro: 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.
Experimental: 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
Outros nomes:
  • (Medtronic External Neurostimulator Model 37022; Medtronic 1x8 Standard LZ Lead Model 3877; Medtronic MultiLead Trialing Cable MLTC Model 355531)

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Atrial fibrillation
Prazo: 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

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Medication
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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.
Prazo: 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.
Prazo: 5 days after CABG
AT/AF burden
5 days after CABG
Premature atrial beats
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Investigadores

  • Investigador principal: Jan Diephuis, PhD, Medisch Spectrum Twente

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo

1 de fevereiro de 2015

Conclusão Primária (Real)

1 de fevereiro de 2016

Conclusão do estudo (Real)

1 de fevereiro de 2016

Datas de inscrição no estudo

Enviado pela primeira vez

11 de maio de 2015

Enviado pela primeira vez que atendeu aos critérios de CQ

19 de agosto de 2015

Primeira postagem (Estimativa)

20 de agosto de 2015

Atualizações de registro de estudo

Última Atualização Postada (Estimativa)

6 de abril de 2016

Última atualização enviada que atendeu aos critérios de controle de qualidade

5 de abril de 2016

Última verificação

1 de abril de 2016

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • SCS-PAF

Plano para dados de participantes individuais (IPD)

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INDECISO

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