Intramural Needle Ablation for Ablation of Recurrent Ventricular Tachycardia

NCT ID: NCT01791543

Last Updated: 2023-02-01

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

115 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-09-30

Study Completion Date

2022-05-27

Brief Summary

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The purpose of the study is to assess the effectiveness and safety of a new device called an Intramural Needle Ablation Catheter (INA catheter). The INA catheter is used for locating and ablating ventricular arrhythmias that have failed standard radiofrequency ablation. This approach is desirable because some people have ventricular arrhythmias that originate deep within the heart muscle where it is not abolished by ablation with standard catheters.

The investigators seek to determine whether the INA catheter can potentially help people who have ventricular arrhythmias that have failed standard radiofrequency ablation. The investigators also want to determine if it is likely to be safe, without excessive side effects.

Detailed Description

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Conditions

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Ventricular Tachycardia

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Intramural Needle Catheter Ablation

Ablation of Ventricular Tachycardia with Intramural Needle Ablation Catheter

Group Type EXPERIMENTAL

Intramural Needle Ablation Catheter

Intervention Type DEVICE

Interventions

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Intramural Needle Ablation Catheter

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

Monomorphic ventricular tachycardia (VT) or incessant ventricular arrhythmia (defined as \>20% of beats due to ventricular arrhythmia including unifocal premature ventricular contractions (PVCs ), couplets, nonsustained VT) that is causing a decline in left ventricular (LV) ejection fraction to less than 0.50.

Arrhythmia meets the following criteria:

1. Ventricular arrhythmia is recurrent and symptomatic
2. prior antiarrhythmic drug therapy has failed due to recurrent ventricular arrhythmia, toxicity, or intolerance

* Age 18 or older
* Left ventricular (LV) ejection fraction \> 0.10 as estimated by echocardiography or contrast ventriculography within the previous 90 days
* Failed prior VT or PVC ablation due to spontaneous recurrence of the arrhythmia or frequent PVCs.
* Able and willing to comply with all pre-, post-, and follow-up testing and requirements
* Signed Informed Consent

Exclusion Criteria

* Patients with idiopathic VT defined as VT that originates from a region without evidence of scar detected by MRI or voltage mapping in a patient without other evidence of heart disease that is not causing significant depression of ventricular function.
* Definite protruding left ventricular thrombus on pre-ablation echocardiography when LV ablation is required.
* Thrombotic myocardial infarction within the preceding two (2) months.
* Other disease process that is likely to limit survival to less than 12 months.
* Class IV heart failure, unless heart failure is due to frequent or incessant VT.
* Contraindication to heparin.
* Allergy to radiographic contrast dye.
* Severe aortic stenosis
* Severe mitral regurgitation with a flail mitral valve leaflet.
* Significant congenital anomaly or medical problem that in the opinion of the principal investigator would preclude enrollment into the study.
* Enrolled in another investigational study evaluating a drug or device.
* Unstable angina that is not due to frequent or incessant VT.
* Women who are pregnant.
* Thrombocytopenia (platelet count \< 50,000) or coagulopathy.
* Acute non-cardiovascular illness or systemic infection.
* Cardiogenic shock unless it is due to incessant VT
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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William Stevenson

OTHER

Sponsor Role lead

Responsible Party

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William Stevenson

Professor, Cardiovascular Medicine

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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William G. Stevenson, M.D.

Role: STUDY_DIRECTOR

Vanderbilt Heart and Vascular Institute

Usha Tedrow, M.D.

Role: PRINCIPAL_INVESTIGATOR

Brigham and Women's Hospital

Locations

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Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

Vanderbilt Heart and Vascular Institute

Nashville, Tennessee, United States

Site Status

Countries

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United States

References

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Sapp JL, Cooper JM, Zei P, Stevenson WG. Large radiofrequency ablation lesions can be created with a retractable infusion-needle catheter. J Cardiovasc Electrophysiol. 2006 Jun;17(6):657-61. doi: 10.1111/j.1540-8167.2006.00439.x.

Reference Type BACKGROUND
PMID: 16836718 (View on PubMed)

Sapp JL, Beeckler C, Pike R, Parkash R, Gray CJ, Zeppenfeld K, Kuriachan V, Stevenson WG. Initial human feasibility of infusion needle catheter ablation for refractory ventricular tachycardia. Circulation. 2013 Nov 19;128(21):2289-95. doi: 10.1161/CIRCULATIONAHA.113.003423. Epub 2013 Sep 13.

Reference Type BACKGROUND
PMID: 24036605 (View on PubMed)

Schaeffer B, Tanigawa S, Nakamura T, Muthalaly RG, Sapp J, John R, Ghidoli D, Pellegrini C, Tedrow U, Stevenson WG. Characteristics of myocardial tissue staining and lesion creation with an infusion-needle ablation catheter for the treatment of ventricular tachycardia in humans. Heart Rhythm. 2020 Mar;17(3):398-405. doi: 10.1016/j.hrthm.2019.10.007. Epub 2019 Oct 8.

Reference Type BACKGROUND
PMID: 31604127 (View on PubMed)

Stevenson WG, Tedrow UB, Reddy V, AbdelWahab A, Dukkipati S, John RM, Fujii A, Schaeffer B, Tanigawa S, Elsokkari I, Koruth J, Nakamura T, Naniwadekar A, Ghidoli D, Pellegrini C, Sapp JL. Infusion Needle Radiofrequency Ablation for Treatment of Refractory Ventricular Arrhythmias. J Am Coll Cardiol. 2019 Apr 2;73(12):1413-1425. doi: 10.1016/j.jacc.2018.12.070.

Reference Type RESULT
PMID: 30922472 (View on PubMed)

Tedrow UB, Kurata M, Kawamura I, Batnyam U, Dukkipati S, Nakamura T, Tanigawa S, Fuji A, Richardson TD, Kanagasundram AN, Koruth JS, John RM, Hasegawa K, Abdelwahab A, Sapp J, Reddy VY, Stevenson WG. Worldwide Experience With an Irrigated Needle Catheter for Ablation of Refractory Ventricular Arrhythmias: Final Report. JACC Clin Electrophysiol. 2023 Aug;9(8 Pt 2):1475-1486. doi: 10.1016/j.jacep.2023.05.014. Epub 2023 May 19.

Reference Type DERIVED
PMID: 37278684 (View on PubMed)

Dukkipati SR, Nakamura T, Nakajima I, Oates C, Narui R, Tanigawa S, Sljapic T, Whang W, Koruth JS, Choudry S, Schaeffer B, Fujii A, Tedrow UB, Sapp JL, Stevenson WG, Reddy VY. Intramural Needle Ablation for Refractory Premature Ventricular Contractions. Circ Arrhythm Electrophysiol. 2022 May;15(5):e010020. doi: 10.1161/CIRCEP.121.010020. Epub 2022 Apr 27.

Reference Type DERIVED
PMID: 35476455 (View on PubMed)

Qian PC, Oberfeld B, Schaeffer B, Nakamura T, John RM, Sapp JL, Stevenson WG, Tedrow UB. Frequency Content of Unipolar Electrograms May Predict Deep Intramural Excitable Substrate: Insights From Intramural Needle Catheter Ablation of Ventricular Tachycardia. JACC Clin Electrophysiol. 2020 Jul;6(7):760-769. doi: 10.1016/j.jacep.2020.03.003. Epub 2020 Apr 29.

Reference Type DERIVED
PMID: 32703556 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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2013P000304

Identifier Type: -

Identifier Source: org_study_id

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