Avoid Transvenous Leads in Appropriate Subjects

NCT ID: NCT02881255

Last Updated: 2022-05-31

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

COMPLETED

Clinical Phase

NA

Total Enrollment

544 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-02-22

Study Completion Date

2022-02-10

Brief Summary

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The purpose of the study is to compare standard, single chamber transvenous ICD to sub-cutaneous ICD in occurrence of perioperative and long term device related complications and failed appropriate clinical shocks and arrhythmic death.

Detailed Description

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Conditions

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Ventricular Arrhythmia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Subcutaneous ICD

Patient will receive a subcutaneous implantable cardioverter defibrillator (Boston Scientific EMBLEM)

Group Type OTHER

Implantable Cardioverter Defibrillator

Intervention Type DEVICE

Patients will be randomized to receive either a subcutaneous or transvenous ICD.

Transvenous ICD

Patient will receive a single-chamber, transvenous implantable cardioverter defibrillator (from any manufacturer) which as the capability for remote monitoring.

Group Type OTHER

Implantable Cardioverter Defibrillator

Intervention Type DEVICE

Patients will be randomized to receive either a subcutaneous or transvenous ICD.

Interventions

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Implantable Cardioverter Defibrillator

Patients will be randomized to receive either a subcutaneous or transvenous ICD.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Patient is ≥ 18 - 60 years old AND has a standard indication for ICD; OR
2. Patient is ≥ 18 years old AND has any one of the following present:

* An inherited arrhythmia syndrome (i.e. Long QT, Brugada, ARVC, hypertrophic or dilated cardiomyopathy, early repolarization syndrome, idiopathic ventricular fibrillation, etc.)
* Prior pacemaker or ICD removal for infection
* Need for hemodialysis
* Prior heart valve surgery (repair or replacement)
* Chronic obstructive pulmonary disease (with FEV1 \< 1.5 L)

Exclusion Criteria

* Mechanical tricuspid valve
* Fontan repair
* Presence of an intra-cardiac shunt
* Known lack of upper extremity venous access
* Need for cardiac pacing for bradycardia indication
* PR interval of \> 240 msec
* Patients with permanent pacemaker
* Clinical indication for biventricular pacing
* Patients unwilling to provide informed consent or comply with follow-up
* Pregnant at time of enrollment and implant
* Patients who currently have a ventricular assist device (i.e. LVAD)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Boston Scientific Corporation

INDUSTRY

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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Jeff Healey, MD

Role: PRINCIPAL_INVESTIGATOR

Population Health Research Institute

Blandine Mondesert, MD

Role: PRINCIPAL_INVESTIGATOR

Université de Montréal

Locations

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University of Calgary

Calgary, Alberta, Canada

Site Status

Mazankowski Alberta Heart Institute

Edmonton, Alberta, Canada

Site Status

St. Paul's Hospital

Vancouver, British Columbia, Canada

Site Status

Victoria Cardiac Arrhythmia Trials Inc.

Victoria, British Columbia, Canada

Site Status

Hamilton General Hospital

Hamilton, Ontario, Canada

Site Status

Southlake Regional Health Centre

Newmarket, Ontario, Canada

Site Status

University of Ottawa Heart Institute

Ottawa, Ontario, Canada

Site Status

St. Michael's Hospital

Toronto, Ontario, Canada

Site Status

Sunnybrook Health Sciences Centre

Toronto, Ontario, Canada

Site Status

Toronto General Hospital, University Health Network

Toronto, Ontario, Canada

Site Status

IUCPQ-Universite Laval

Laval, Quebec, Canada

Site Status

McGill University Health Centre

Montreal, Quebec, Canada

Site Status

Montreal Heart Institute

Montreal, Quebec, Canada

Site Status

Centre Hospitalier Universitaire de Sherbrooke (CHUS)

Sherbrooke, Quebec, Canada

Site Status

Countries

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Canada

References

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Mondesert B, Bashir J, Philippon F, Dubuc M, Amit G, Exner D, Joza J, Birnie DH, Lane C, Tsang B, Korley V, Spears D, Ling A, Djuric A, Crystal E, Hruczkowski T, Roux JF, Carroll S, Essebag V, Krahn AD, Healey JS. Rationale and design of the randomized prospective ATLAS study: Avoid Transvenous Leads in Appropriate Subjects. Am Heart J. 2019 Jan;207:1-9. doi: 10.1016/j.ahj.2018.09.008. Epub 2018 Oct 9.

Reference Type BACKGROUND
PMID: 30399474 (View on PubMed)

Carroll SL, Mondesert B, Krahn AD, Bashir JG, Fisher K, Nair K, Healey JS. Device-specific quality of life: results from the ATLAS trial-avoid transvenous leads in appropriate subjects. Eur J Cardiovasc Nurs. 2024 Dec 16;23(8):877-885. doi: 10.1093/eurjcn/zvae067.

Reference Type DERIVED
PMID: 38695087 (View on PubMed)

Healey JS, Krahn AD, Bashir J, Amit G, Philippon F, McIntyre WF, Tsang B, Joza J, Exner DV, Birnie DH, Sadek M, Leong DP, Sikkel M, Korley V, Sapp JL, Roux JF, Lee SF, Wong G, Djuric A, Spears D, Carroll S, Crystal E, Hruczkowski T, Connolly SJ, Mondesert B; ATLAS Investigators. Perioperative Safety and Early Patient and Device Outcomes Among Subcutaneous Versus Transvenous Implantable Cardioverter Defibrillator Implantations : A Randomized, Multicenter Trial. Ann Intern Med. 2022 Dec;175(12):1658-1665. doi: 10.7326/M22-1566. Epub 2022 Nov 8.

Reference Type DERIVED
PMID: 36343346 (View on PubMed)

Other Identifiers

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ATLAS S-ICD

Identifier Type: -

Identifier Source: org_study_id

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