Renal Nerve Stimulation and Renal Denervation in Patients With Sympathetic Ventricular Arrhythmias

NCT ID: NCT02856373

Last Updated: 2020-05-06

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

9 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-03-03

Study Completion Date

2020-05-04

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Rationale:

Sympathetic activity plays an important role in the pathogenesis of ventricular tachyarrhythmia. Previous studies have shown evidence of significant heritable influences on individual responses to adrenergic stimulation. Catheter-based renal sympathetic denervation (RDN) is a novel treatment option for patients with resistant hypertension, proved to reduce local and whole-body sympathetic activity. The investigators hypothesize that percutaneous transluminal electrical stimulation of the sympathetic nerve bundles in the renal arteries will cause ventricular arrhythmias and renal denervation will suppress these arrhythmias in patients with sympathetic ventricular arrhythmias.

Objective:

This study will investigate the effects of renal nerve stimulation before and after percutaneous transluminal RDN on cardiac excitable properties including induction of ventricular tachy-arrhythmias before and after RDN in six studies, i.e. patients with catecholaminergic polymorphic ventricular tachycardia (CPVT), long QT syndrome and arrhythmogenic right ventricular cardiomyopathy (ARVC), sympathetically driven ventricular arrhythmias, hypertrophic cardiomyopathy (HCM), dilated non-ischemic cardiomyopathy (DCM) and ischemic cardiomyopathy (ICM). The aim of the six studies is to assess the anti-arrhythmic effects of RDN in patients with sympathetic ventricular tachy-arrhythmias.

Study design:

Investigator initiated, multi centre, six pretest-posttest design studies.

Study population:

Patients with recurrent sympathetically driven ventricular arrhythmia despite optimal pharmacological therapy. Patients should be diagnosed with CPVT and certain types of long QT syndrome, ARVC, HCM, DCM and ICM. Eligible patients will be in the age category of 18-85 year.

Intervention:

RDN will be performed according to routine clinical practice. Prior to the ablation procedure, catheter mapping of the renal arteries will be performed according to routine clinical practice. Clinical and biological responses to transluminal electrical renal nerve stimulation will be assessed before and after RDN.

Study endpoints:

* Main procedural study endpoint: Induction of ventricular arrhythmias in response to renal nerve stimulation prior to RDN and absence of renal nerves stimulation induced ventricular arrhythmias after RDN.
* Main clinical study endpoint: Development of ventricular arrhythmia during exercise stress testing performed 6 months after procedure.

Nature and extent of the burden and risks associated with participation, benefit and group relatedness:

In several studies, it was shown that RDN was safe. The intervention resulted in significantly better control of blood pressure with less medication, and beneficial changes in heart rate variability, autonomic sympathetic balance, renal arteriolar function, and a higher success of atrial fibrillation prevention. In case reports and case series, RDN had a favourable effect in patients with sympathetic drug refractory ventricular tachy-arrhythmias.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Arrhythmias, Cardiac

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

CPVT

catecholaminergic polymorphic ventricular tachycardia (CPVT) patients

Group Type OTHER

RNS and RDN

Intervention Type PROCEDURE

The patients will undergo electrical renal nerve stimulation and subsequently renal nerve denervation

long QT syndrome

long QT syndrome patients

Group Type OTHER

RNS and RDN

Intervention Type PROCEDURE

The patients will undergo electrical renal nerve stimulation and subsequently renal nerve denervation

ARVC

arrhythmogenic right ventricular cardiomyopathy (ARVC) patients

Group Type OTHER

RNS and RDN

Intervention Type PROCEDURE

The patients will undergo electrical renal nerve stimulation and subsequently renal nerve denervation

HCM

hypertrophic cardiomyopathy (HCM) patients

Group Type OTHER

RNS and RDN

Intervention Type PROCEDURE

The patients will undergo electrical renal nerve stimulation and subsequently renal nerve denervation

DCM

dilated non-ischemic cardiomyopathy (DCM) patients

Group Type OTHER

RNS and RDN

Intervention Type PROCEDURE

The patients will undergo electrical renal nerve stimulation and subsequently renal nerve denervation

ICM

ischemic cardiomyopathy (ICM) patients

Group Type OTHER

RNS and RDN

Intervention Type PROCEDURE

The patients will undergo electrical renal nerve stimulation and subsequently renal nerve denervation

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

RNS and RDN

The patients will undergo electrical renal nerve stimulation and subsequently renal nerve denervation

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. The patient is willing and able to comply with the protocol and has provided written informed consent.
2. The patient falls within the target group as stated in 4.1.
3. Patient is an acceptable candidate for RDN treatment
4. Patient is 18-85 years of age
5. Documentation of ventricular arrhythmia (ECG, rhythm strip or ICD interrogation)

Exclusion Criteria

1. Contraindication to anticoagulation therapy or heparin.
2. Previous selective cardiac sympathetic denervation or previous RDN procedure.
3. Acute coronary syndrome, cardiac surgery, PCI or stroke within 3 months prior to enrolment.
4. Untreated hypothyroidism or hyperthyroidism.
5. More than grade 1/3 valvular regurgitation and/or significant valve stenosis (moderate or severe).
6. Severe LV dysfunction (LVEF \<20% and/or grade 3/4 diastolic dysfunction).
7. Enrolment in another investigational drug or device study.
8. Woman currently pregnant or breastfeeding or not using reliable contraceptive measures during fertile age.
9. Mental or physical inability to participate in the study.
10. Planned cardiovascular intervention.
11. Life expectancy ≤ 12 months.
12. Renal artery stenosis \>50% of the arterial lumen, or renal artery lumen ≤3 mm.
13. Complex renal artery
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Diagram B.V.

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Arif Elvan, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Isala, department of Cardiology

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

A. Elvan

Zwolle, Overijssel, Netherlands

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Netherlands

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

9218

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Ventricular Tachycardia Mechanisms
NCT05478213 RECRUITING NA
Electrocardiographic Mapping and Imaging
NCT01394965 WITHDRAWN EARLY_PHASE1