DEtect Long-term Complications After icD rEplacement: a Multicenter Italian Registry

NCT ID: NCT02076789

Last Updated: 2015-01-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

800 participants

Study Classification

OBSERVATIONAL

Study Start Date

2013-03-31

Study Completion Date

2015-10-31

Brief Summary

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This study has been designed to prospectively estimate long term complication rates (12-months and 5-years) in patients undergoing Implantable Cardioverter Defibrillator (ICD) replacement, with and without a planned transvenous lead addition for replacement or upgrade to a device capable of additional therapies; the study also evaluates the predictors of complications, the patient's management before and during the replacement procedure in clinical practice and the estimated costs related to the use of health care resources.

Detailed Description

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Based on positive outcomes from numerous randomized, controlled trials, the implantable defibrillators have been included in the current European Society of Cardiology (ESC) and American College of Cardiology / American Heart Associations (ACC/AHA) guidelines as a standard of care in selected patients, and thus ICD use is currently increasing worldwide.

In the years after initial implantation, device replacement may become necessary for battery depletion or for upgrades to more complex multi-lead ICDs. The increase in generator or lead advisories and recalls contributes further to those patients considered for replacement.

The determination of procedural adverse events is complex, and requires monitoring of both short-term complications and long-term patient outcome.

Previous retrospective series have examined complications with ICD replacements. Moreover, the more recent REPLACE registry prospectively collected 6-month complication rates in patients undergoing pacemaker or ICD generator replacement at 72 private practice and academic sites in United States. This study examined a broad range of major and minor complications and found that ICD replacements were associated with a notable complication risk, particularly when a transvenous lead addition or revision was required.

Previous retrospective series have examined complications with ICD implantation in the Italian clinical practice, showing frequent interventions for system revision and demonstrating an association between adverse events and the complexity of the implanted device (i.e. Cardiac Resynchronization Therapy CRT-D versus single- or dual-chamber ICD). Moreover, it was shown that device replacement procedures are associated with significantly higher risk of infections.

Nonetheless, detailed data on the complications of ICD replacement in the current Italian clinical practice are unavailable.

This information would be particularly important because ICD replacement-related events may be associated not only with a worse clinical outcome, but also with incremental costs to the healthcare system.

The analysis of adverse events would permit to study new preventative strategies with significant clinical as well as financial benefits. Moreover, the quantification of the complication rate after ICD replacement would permit to estimate the actual long-term cost of ICD therapy, and to assess the impact of ICD longevity on the cost-effectiveness of the therapy.

This study has been designed to prospectively estimate long term complication rates (at 12-months and 5-years) in patients undergoing ICD generator replacement. The study also evaluates predictors of complications, patient's management before and during the replacement procedure in clinical practice and the estimated costs related to the use of health care resources.

All consecutive patients with standard indications to ICD generator replacement will be enrolled In this study. The decision to perform the generator replacement or to upgrade an existing device will be made according to the investigators' clinical assessment of their patient. The study do not mandate specific surgical or implantation techniques such as venous access, use of temporary pacemakers, or surgical site choices. Any commercially available generator or lead can be included.

Patients will be followed for a 60-month period with periodical in-hospital visits or remote ICD interrogations via remote patient monitoring (RPM) systems, according to the standard hospital practice and the physician's discretion.

Conditions

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Device Replacement Device Upgrade Long-term Postoperative Complications Resource Consumption and Associated Costs After Device Replacement/Upgrade

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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ICD generator replacement

Patients with standard indications to ICD generator replacement

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Patient implanted with a CardiacResynchronizationTherapy-Defibrillator or single chamber/dual chambers ICD device (any commercially available generator or lead can be included).
* Patient with standard indications to ICD generator replacement according to the investigators' clinical assessment.
* Patient must be able to attend all required follow-up visits at the study center.

Exclusion Criteria

* Patient is less than 18 years of age.
* Patient is unwilling or unable to sign an authorization to use and disclose health information or an Informed Consent.
* Patient life expectancy is less than 12 months.
* Patient is participating in another clinical study that may have an impact on the study endpoints.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mauro Biffi

OTHER

Sponsor Role lead

Responsible Party

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Mauro Biffi

Dirigente Medico di Cardiologia

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Ospedale di Venere

Carbonara di Bari, Bari, Italy

Site Status RECRUITING

A.O. "Papa Giovanni XXIII"

Bergamo, BG, Italy

Site Status RECRUITING

Ospedale di Bentivoglio

Bentivoglio, Bologna, Italy

Site Status RECRUITING

Ospedale SS. Annunziata

Cento, Ferrara, Italy

Site Status RECRUITING

Ospedale Casa Sollievo della Sofferenza

San Giovanni Rotondo, FG, Italy

Site Status RECRUITING

Ospedale "Maurizio Bufalini"

Cesena, Forlì, Italy

Site Status RECRUITING

Ospedale Maggiore

Lodi, LO, Italy

Site Status RECRUITING

Ospedale Civile S.Agostino-Estense

Baggiovara, Modena, Italy

Site Status RECRUITING

A.O.U.P. "Paolo Giaccone"

Palermo, PA, Italy

Site Status RECRUITING

Policlinico Universitario "Agostino Gemelli"

Rome, RM, Italy

Site Status RECRUITING

Ospedale Santa Maria alle Scotte

Siena, SI, Italy

Site Status RECRUITING

Casa di Cura "Villa Verde"

Taranto, TA, Italy

Site Status RECRUITING

Ospedale "San Donato"

Arezzo, , Italy

Site Status RECRUITING

Ospedale Maggiore

Bologna, , Italy

Site Status RECRUITING

Azienda Ospedaliera Universitaria , Policlinico Sant'Orsola

Bologna, , Italy

Site Status RECRUITING

Università Cattolica del Sacro Cuore

Campobasso, , Italy

Site Status RECRUITING

Ospedale Cuneo

Cuneo, , Italy

Site Status RECRUITING

Ospedale "San Giuseppe"

Empoli, , Italy

Site Status RECRUITING

A.O.S.Anna

Ferrara, , Italy

Site Status RECRUITING

Ospedale "Morgagni-Pierantoni"

Forlì, , Italy

Site Status RECRUITING

Ospedale "Padre Antero Micone" - Sestri Ponente

Genova, , Italy

Site Status RECRUITING

Ospedale della Misericordia

Grosseto, , Italy

Site Status RECRUITING

Clinica Mediterranea

Napoli, , Italy

Site Status RECRUITING

Ospedale Monaldi SUN

Napoli, , Italy

Site Status RECRUITING

A.O. Santa Maria della Misericordia

Perugia, , Italy

Site Status RECRUITING

Azienda Ospedali Riuniti Marche Nord

Pesaro, , Italy

Site Status RECRUITING

Ospedale "Santa Maria delle Croci"

Ravenna, , Italy

Site Status RECRUITING

Ospedale Santa Maria Nuova

Reggio Emilia, , Italy

Site Status RECRUITING

Ospedale degli Infermi

Rimini, , Italy

Site Status RECRUITING

Policlinico Casilino

Roma, , Italy

Site Status RECRUITING

A.O. San Giovanni di Dio e Ruggi di Aragona

Salerno, , Italy

Site Status RECRUITING

Ospedale Santa Maria di Cà Foncello

Treviso, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Mauro Biffi

Role: CONTACT

0039 051 636 3434

References

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Zoni-Berisso M, Martignani C, Ammendola E, Narducci ML, Caruso D, Miracapillo G, Notarstefano P, Carinci V, Pierantozzi A, Ciaramitaro G, Calo L, Zennaro M, Infusino T, Ferretti C, Sassone B, Licciardello G, Setti S, Terzaghi C, Malacrida M, Biffi M. Mortality after cardioverter-defibrillator replacement: Results of the DECODE survival score index. Heart Rhythm. 2021 Mar;18(3):411-418. doi: 10.1016/j.hrthm.2020.11.024. Epub 2020 Nov 27.

Reference Type DERIVED
PMID: 33249200 (View on PubMed)

Biffi M, Ammendola E, Menardi E, Parisi Q, Narducci ML, De Filippo P, Manzo M, Stabile G, Potenza DR, Zanon F, Quartieri F, Rillo M, Saporito D, Zaca V, Berisso MZ, Bertini M, Tumietto F, Malacrida M, Diemberger I. Real-life outcome of implantable cardioverter-defibrillator and cardiac resynchronization defibrillator replacement/upgrade in a contemporary population: observations from the multicentre DECODE registry. Europace. 2019 Oct 1;21(10):1527-1536. doi: 10.1093/europace/euz166.

Reference Type DERIVED
PMID: 31209482 (View on PubMed)

Zanon F, Martignani C, Ammendola E, Menardi E, Narducci ML, DE Filippo P, Santamaria M, Campana A, Stabile G, Potenza DR, Pastore G, Iori M, LA Rosa C, Biffi M. Device Longevity in a Contemporary Cohort of ICD/CRT-D Patients Undergoing Device Replacement. J Cardiovasc Electrophysiol. 2016 Jul;27(7):840-5. doi: 10.1111/jce.12990. Epub 2016 Jun 17.

Reference Type DERIVED
PMID: 27094359 (View on PubMed)

Diemberger I, Parisi Q, De Filippo P, Narducci ML, Zanon F, Potenza DR, Ciaramitaro G, Malacrida M, Boriani G, Biffi M. Detect Long-term Complications After ICD Replacement (DECODE): Rationale and Study Design of a Multicenter Italian Registry. Clin Cardiol. 2015 Oct;38(10):577-84. doi: 10.1002/clc.22440. Epub 2015 Aug 18.

Reference Type DERIVED
PMID: 26282191 (View on PubMed)

Other Identifiers

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72/2013/O/Oss

Identifier Type: -

Identifier Source: org_study_id

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