Catheter Ablation Versus Amiodarone for Shock Prophylaxis in Defibrillator Patients With Ventricular Tachycardia

NCT ID: NCT01097330

Last Updated: 2020-01-29

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-08-31

Study Completion Date

2012-03-31

Brief Summary

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Implantable Cardioverter Defibrillators (ICDs) provide a shock or pacing therapy to bring back a normal heart beat when a patient experiences a dangerous abnormal heart rhythm such as ventricular tachycardia (VT). ICDs are very successful in bringing back a normal heart beat when VT occurs, but they do not prevent further dangerous heart rhythms from occurring. This study is designed to determine the best way to manage patients who have an ICD and who continue to have episodes of VT. There are two methods for treatment the VT: 1) Ablation, and 2) Medication.

An ablation procedure involves placing a flexible catheter (insulated wire) in the groin area and threading it into the heart. After the doctor has located the affected area responsible for the VT, radiofrequency energy is delivered by the power generator through the catheter to the inside of the heart. The radiofrequency energy ablates (burns) a small area of the heart tissue thought to cause the VT.

A medication called Amiodarone is an "anti-arrhythmic" prescribed to prevent abnormal heart rhythms from recurring.

The purpose of this study is to compare these two different methods for treating VT. Treatment with ablation and amiodarone are both considered the standard of care for patients with VT but they have not been compared directly in a study like this before.

Detailed Description

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Conditions

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Defibrillators, Implantable Tachycardia, Ventricular

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Ablation

Catheter based radiofrequency ablation for ischemic ventricular tachycardia

Group Type ACTIVE_COMPARATOR

Ablation

Intervention Type PROCEDURE

Catheter based radiofrequency ablation for ischemic ventricular tachycardia scheduled to occur within 4 weeks after randomization

Amiodarone

amiodarone titrated to therapeutic levels as per standard of care and maintained on a dose of at least 200 mg (300 mg recommended) once a day for the duration of the study.

Group Type ACTIVE_COMPARATOR

Amiodarone

Intervention Type DRUG

Amiodarone titrated to therapeutic levels as per standard of care and maintained on a dose of at least 200 mg (300 mg recommended) once a day for the duration of the study

Interventions

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Ablation

Catheter based radiofrequency ablation for ischemic ventricular tachycardia scheduled to occur within 4 weeks after randomization

Intervention Type PROCEDURE

Amiodarone

Amiodarone titrated to therapeutic levels as per standard of care and maintained on a dose of at least 200 mg (300 mg recommended) once a day for the duration of the study

Intervention Type DRUG

Other Intervention Names

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VT ablation ischemic VT ablation catheter ablation radiofrequency ablation Cordarone

Eligibility Criteria

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Inclusion Criteria

* \> 18 and \< 85 years of age
* ICD implanted for primary prophylaxis against sudden cardiac death or ICD implanted for secondary prophylaxis against spontaneous or inducible sustained VT without any reversible causes
* Coronary artery disease (CAD) with prior myocardial infarction (MI)
* ICD or electrocardiogram (ECG) documentation of ventricular arrhythmia responsible for appropriate ICD therapy \[antitachycardia pacing (ATP) \& shocks\].

Exclusion Criteria

* Contraindication or allergy to contrast media, routine procedural medications or catheter materials
* Contraindication to an interventional procedure
* Current or previous (within 3 months) amiodarone therapy
* Atrial Fibrillation requiring antiarrhythmic drug therapy
* Contraindication to amiodarone therapy
* New York Heart Association (NYHA) functional class IV
* Myocardial infarction within the past 60 days
* Stroke within the past 90 days
* Unstable angina
* Hypertrophic cardiomyopathy, Non-ischemic dilated cardiomyopathy, Arrhythmogenic Right Ventricular Dysplasia, Brugada Syndrome, Catecholamine sensitive polymorphic VT or long QT syndrome
* Patients with active ischemia that are eligible for revascularization
* Life expectancy less than 6 months
* Incessant or multiple episodes of VT requiring immediate therapy with medications or ablation
* Untreated hypothyroidism or hyperthyroidism. Patients who are euthyroid on thyroid hormone replacement therapy are acceptable.
* Current enrollment in another investigational drug or device study.
* Presence of any other condition that the investigator feels would be problematic or would restrict or limit the participation of the patient for the entire study period.
* Absolute contra-indication to the use of heparin and or warfarin.
* Documented intra-atrial thrombus, ventricular thrombus (\< 6 months after detection of thrombus), tumor, or another abnormality which precludes catheter introduction.
* Females of childbearing potential who are not practicing protocol acceptable method of birth control.
Minimum Eligible Age

19 Years

Maximum Eligible Age

84 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Abbott Medical Devices

INDUSTRY

Sponsor Role collaborator

Hamilton Health Sciences Corporation

OTHER

Sponsor Role collaborator

Population Health Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Andrea Natale, M.D.

Role: PRINCIPAL_INVESTIGATOR

Texas Cardiac Arrhythmia Research Foundation

David J Callans, M.D.

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania

Carlos A. Morillo, M.D.

Role: PRINCIPAL_INVESTIGATOR

Population Health Research Institute, McMaster University

Girish M. Nair, M.D.

Role: PRINCIPAL_INVESTIGATOR

Population Health Research Institute, McMaster University

Locations

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Northwestern University

Chicago, Illinois, United States

Site Status

Mayo Clinic

Rochester, Minnesota, United States

Site Status

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Texas Cardiac Arrhythmia Research Foundation

Austin, Texas, United States

Site Status

University of Virginia Health System

Charlottesville, Virginia, United States

Site Status

Hamilton Health Sciences

Hamilton, Ontario, Canada

Site Status

Southlake Regional Health Centre

Newmarket, Ontario, Canada

Site Status

University of Ottawa Heart Institute

Ottawa, Ontario, Canada

Site Status

McGill University Health Center

Montreal, Quebec, Canada

Site Status

Institut Universitaire de Cardiologie et Pneumologie de Québec

Québec, , Canada

Site Status

Beijng Fuwai Heart Hospital

Beijing, , China

Site Status

Countries

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United States Canada China

Related Links

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http://www.phri.ca/

Population Health Research Institute

Other Identifiers

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CEASE-VT

Identifier Type: -

Identifier Source: org_study_id

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