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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT04206917
Other study ID # CL007
Secondary ID
Status Terminated
Phase N/A
First received
Last updated
Start date March 19, 2020
Est. completion date June 21, 2022

Study information

Verified date October 2022
Source Cardialen, Inc.
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Assess the clinical safety and feasibility of MultiPulse Therapy (MPT) electrical stimulation waveform sequence in terminating paroxysmal and persistent atrial fibrillation.


Description:

A prospective non-randomized feasibility study involving acute testing of MPT in subjects with paroxysmal and persistent AF during clinically indicated atrial fibrillation catheter ablation procedure. Subjects will be split into 2 cohorts depending on status at time of procedure. 1. In Atrial Fibrillation at time of procedure (Clinical AF) 2. In Normal Sinus Rhythm at time of procedure Subjects will be evaluated at the visits for the Clinically-Indicated Procedure per standard of care. A single follow-up at up to 30 days post-procedure is required to assess subjects for adverse events.


Recruitment information / eligibility

Status Terminated
Enrollment 30
Est. completion date June 21, 2022
Est. primary completion date June 21, 2022
Accepts healthy volunteers No
Gender All
Age group 18 Years to 80 Years
Eligibility Inclusion Criteria: 1. Male or female between 18 and 80 years of age 2. Willing and able to comply with the study protocol, provide a written informed consent 3. Currently indicated for atrial catheter ablation due to paroxysmal or early persistent atrial fibrillation 4. Current treatment and compliance with standard anticoagulation regimen, including uninterrupted OAC, with acceptable coagulation status, as determined by globally accepted risk stratification (CHA2DS2-VASc score) and the Principal Investigator Exclusion Criteria: 1. Life expectancy of 1 year or less 2. AF due to reversible causes (e.g., hyperthyroidism, valve disease) 3. History of DC Cardioversion which failed to convert to AF to Normal Sinus Rhythm 4. Currently in AF for more than 3 months continuously 5. Chronic, long-standing persistent, or permanent atrial fibrillation 6. Allergy or contraindication to anticoagulation therapy 7. Presence of intracardiac thrombus (confirmed with TEE or ICE) 8. Existing Left Atrial Appendage closure device 9. Severely Dilated Left Atrium >5cm 10. LVEF<20% 11. NYHA Class IV heart failure at the time of enrollment 12. History of embolic stroke, Transient Ischemic Attack (TIA) or other thromboembolic event within the preceding 3 months. 13. Known hyper-coagulable state that increases risk of thrombus 14. History of myocardial infarction or coronary revascularization within the preceding 3 months. 15. History of sustained ventricular arrhythmia or cardiac arrest 16. Presence of chronically implanted lead in the CS 17. Presence of ventricular assist device, including intra-aortic balloon pump 18. Documented bradycardia (<40 BPM) at the time of the study 19. Morbid obesity: BMI>39 kg/m2 20. Presence of any prosthetic cardiac valve 21. History of significant tricuspid valvular disease requiring surgery 22. Moderate to severe mitral valve regurgitation (>40% regurgitation fraction) 23. Cognitive or mental health status that would interfere with study participation and proper informed consent 24. Cardiovascular anatomical defects that would complicate placement of the stimulation leads required by the protocol, including congenital heart disease and cardiac vein anomalies per the Investigator's discretion 25. Pregnancy confirmed by test within 7 days of procedure. 26. Inability to pass catheters to heart due to vascular limitations 27. Cardiovascular surgery or intervention within 1 month prior to enrollment or planned for up to 1 month after enrollment (other than the planned treatment procedure) 28. No active endocarditis 29. Any other medical condition which may affect the outcome of this study or safety of the subject as determined by the investigator 30. History of hemodynamic compromise due to valvular heart disease 31. Unstable CAD as determined by the investigator 32. Severe proximal three-vessel or left main coronary artery disease without revascularization as determined by the investigators 33. History of Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Dysplasia, Congenital Heart Anomaly, Cardiac Amyloidosis or Cardiac Sarcoidosis 34. Any other condition which may affect the outcome of this study or safety of the subject as determined by the investigator

Study Design


Intervention

Device:
Multi Pulse Therapy
The Cardialen External Stimulation System (CESS) is the research delivery system for the proprietary Cardialen MultiPulse Therapy (MPT). The CESS is a custom designed and built research device. It is comprised of off-the-shelf commercial components (power supplies, waveform generators, laptop computer, monitor, rack, ECG system, leads, etc.) combined with a custom electrical circuit board and custom software.

Locations

Country Name City State
Australia Royal Adelaide Hospital Adelaide South Australia
Australia St. Andrews Adelaide South Australia
Australia The Prince Charles Hospital Chermside Queensland
Australia Gold Coast University Hospital Gold Coast Queensland
Australia Greenslopes Private Hospital Greenslopes Queensland
Australia Mulgrave Private Hospital Melbourne Victoria

Sponsors (3)

Lead Sponsor Collaborator
Cardialen, Inc. Avania, Iqvia Pty Ltd

Country where clinical trial is conducted

Australia, 

References & Publications (4)

Ambrosi CM, Ripplinger CM, Efimov IR, Fedorov VV. Termination of sustained atrial flutter and fibrillation using low-voltage multiple-shock therapy. Heart Rhythm. 2011 Jan;8(1):101-8. doi: 10.1016/j.hrthm.2010.10.018. Epub 2010 Oct 19. — View Citation

Efimov I, Ripplinger CM. Virtual electrode hypothesis of defibrillation. Heart Rhythm. 2006 Sep;3(9):1100-2. Epub 2006 Mar 10. — View Citation

Janardhan AH, Gutbrod SR, Li W, Lang D, Schuessler RB, Efimov IR. Multistage electrotherapy delivered through chronically-implanted leads terminates atrial fibrillation with lower energy than a single biphasic shock. J Am Coll Cardiol. 2014 Jan 7-14;63(1):40-8. doi: 10.1016/j.jacc.2013.07.098. Epub 2013 Sep 26. — View Citation

Li W, Janardhan AH, Fedorov VV, Sha Q, Schuessler RB, Efimov IR. Low-energy multistage atrial defibrillation therapy terminates atrial fibrillation with less energy than a single shock. Circ Arrhythm Electrophysiol. 2011 Dec;4(6):917-25. doi: 10.1161/CIRCEP.111.965830. Epub 2011 Oct 6. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary To define the safety of MPT for the treatment of atrial fibrillation in subjects Adverse Events from procedure and 30 day follow up. Study procedure and 30 day post procedure
Primary Translation Explore and enhance MPT parameters delivered in successful cases in a previous Cardialen AF study (CL001 / NCT02257112) Study procedure
Primary Translation Determine MPT parameters relationships at which MPT terminates AF Study procedure
Primary Translation Determine rate of conversion from AF to NSR after MPT delivery Study procedure
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