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AV-node Stimulation Clinical Download Study to Reduce Ventricular Rate During AF (AVNS)

14 februari 2014 uppdaterad av: Medtronic BRC

Reduction of Ventricular Rate During Atrial Fibrillation by AV Node Stimulation" AVNS Download Study

The aim of this multi-center research study is to evaluate the performance (primary purpose) and safety of a new algorithm aimed at controlling ventricular rate (VR) during rapidly conducted atrial fibrillation (AF) by delivering AV node stimulation (AVNS) from the atrial lead placed at a septal position, and designed with the purpose of reducing inappropriate shocks. Additional purposes include the assessment of a possible application of AVNS aimed at allowing prolonged control of VR during AF and reducing AF symptoms, and evaluation of implantation data on selective placement of the atrial lead in postero-septal right atrium. About 37 patients will be followed for half a year.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

The aim of this multi-center research study is to evaluate the performance (primary purpose) and safety of a new algorithm aimed at controlling VR during rapidly conducted AF by delivering AVNS from the atrial lead placed at a septal position, and designed with the purpose of reducing inappropriate shocks. Additional purposes include the assessment of a possible application of AVNS aimed at allowing prolonged control of VR during AF and reducing AF symptoms, and evaluation of implantation data on selective placement of the atrial lead in postero-septal right atrium. About 37 patients will be followed for half a year.

Studietyp

Interventionell

Inskrivning (Faktisk)

45

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

      • Firenze, Italien, 50134
        • Institute of Internal Medicine and Cardiology, Firenze
      • Rome, Italien, I- 00186
        • Department of Cardiology, Ospedalis Giovanni Calibita Fatebenefratelli, Rome
      • Uppsala, Sverige, SE-751 85
        • Department of Cardiology, university hospital
      • Aachen, Tyskland, 52074
        • Klinikum Aachen

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • Patients with a documented history of paroxysmal or persistent AF are eligible to be enrolled in the study if one of the following criteria is met:
  • Indication for CRT implant according to current Guidelines (Heart Failure, NYHA III-IV class, symptomatic despite optimal stable medical therapy, left ventricular (LV) ejection fraction ≤35% and QRS≥120ms); OR
  • Indication for upgrading to CRT-D from a single chamber device; OR
  • Indication for upgrading to CRT-D from a dual chamber device with septal atrial lead or a dislodged atrial lead; OR
  • Indication for device replacement or surgical revision in patients already implanted with a CRT-D device and an atrial lead in the septal position or a dislodged atrial lead; OR
  • Patients already implanted with a ConsultaTM device and an atrial lead in the septal position, requiring electrical cardioversion.

Exclusion Criteria:

  • If any of the following criteria are met, patient cannot be enrolled in the study:
  • Permanent atrial fibrillation;
  • Patients who are not on anti-coagulant therapy;
  • Advanced AV block (II-III degree AV block);
  • Patients previously submitted to valvular surgery;
  • Patients previously submitted to AV or AF ablative procedures;
  • Age < 18 years;
  • Patient not disposed to sign the Informed Consent;
  • Participation in other studies which could potentially conflict with this study;

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: AVNS ON
Consulta downloaded with AVNS to provide high frequency bursting during fastly conducted AF. AVNS will be programmed on for five months. The feasibility and safety of the AVNS algorithm to reduce inappropriate shocks will be monitored.
Delaying the AV-node by stimulating the parasympathetic nerves innervating the AV-node with high frequency burst pacing during the refractory period of the ventricle using a standard atrial lead at a septal position.
Andra namn:
  • AVNS
  • AV-node stimulation
  • parasympathetic AV-node stimulation

Vad mäter studien?

Primära resultatmått

Resultatmått
Tidsram
To evaluate the performance of the investigational algorithm in reducing mean VR during AF, the relative reduction of VR during AVNS will be assessed in acute in-hospital tests, conducted preferably during either spontaneous or induced episodes of AF.
Tidsram: baseline and 1 month
baseline and 1 month

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
To evaluate the performance of the investigational algorithm in shock reduction.
Tidsram: baseline, 1 month, 3 months, 6 months
assessing the number of successful rate reduction interventions by AVNS during spontaneous episodes of AF occurring during follow-up, with rapid VR due to AF conducted in the VT/FVT/VF zone;
baseline, 1 month, 3 months, 6 months
To evaluate the safety of the investigational algorithm.
Tidsram: baseline, 1 month, 3 months, 6 months

To evaluate the safety of the investigational algorithm, assessing:

  • The rate of adverse device effects and serious adverse device effects related to the investigational algorithm;
  • The number of VT/VF or AT/AF episodes potentially induced or prolonged by the investigational algorithm.
baseline, 1 month, 3 months, 6 months
To gather data for further possible applications.
Tidsram: baseline, 1 month, 3 months, 6 months

To gather data for further possible applications of AVNS, assessing:

  • the performance of the investigational algorithm in decreasing mean VR and standard deviation directly after 30 seconds of AVNS as compared to 30 seconds directly before algorithm intervention (baseline: all patients; 1, 3 and 6 months follow-up: patients in AF only);
  • the performance of the investigational algorithm in combination with ventricular pacing in decreasing mean VR and standard deviation directly after 30 seconds of AVNS as compared to 30 seconds directly before algorithm intervention (baseline only).
baseline, 1 month, 3 months, 6 months
To collect data on selective placement of the atrial lead.
Tidsram: baseline, 1 month, 3 months, 6 months

evaluating:

  • electrical characteristics (impedance, threshold, sensing, FFRW) related to pacing and AVNS at implant (when applicable), baseline and follow-ups;
  • the percentage of atrial lead implantations with electrical characteristics suitable both for standard pacing and AVNS;
  • adverse events related to selective atrial lead placement at implant and in the follow-up;
  • mean duration of implant procedure and mean fluoroscopic time;
  • the presence of an implant learning curve.
baseline, 1 month, 3 months, 6 months

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Utredare

  • Huvudutredare: Stephano Bianchi, MD, Department of Cardiology, Hospital Rome, ospedalis giovanni calibita fatebenefratelli

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 november 2011

Primärt slutförande (Faktisk)

1 november 2013

Avslutad studie (Faktisk)

1 november 2013

Studieregistreringsdatum

Först inskickad

11 mars 2010

Först inskickad som uppfyllde QC-kriterierna

26 mars 2010

Första postat (Uppskatta)

30 mars 2010

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

17 februari 2014

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

14 februari 2014

Senast verifierad

1 februari 2014

Mer information

Termer relaterade till denna studie

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Kliniska prövningar på Förmaksflimmer

Kliniska prövningar på AVNS ON

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