Monitoring of Arrhythmias in Patients Treated With Antipsychotics

NCT ID: NCT04575103

Last Updated: 2021-02-21

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

Clinical Phase

NA

Total Enrollment

600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-01

Study Completion Date

2024-12-31

Brief Summary

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Antipsychotics may be associated to life-threatening arrhythmias and sudden cardiac death. This is the fist study to estimated the arrhythmic burden using long-term monitoring by implantable loop recorder in patients treated with antipsychotics.

Detailed Description

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Aims and objectives To estimate frequency of potential malign arrhythmias and cardiovascular outcome in a population with patients treated with antipsychotic drugs compared to healthy controls.

Background Life expectancy is about 20 years shorter for patients with mental illness compared to the general population. Increasing evidence suggest that antipsychotic drugs can cause cardiac arrhythmias and hence sudden death. However, the evidence as well as the incidence of rhythm disturbances in patients treated with antipsychotic drugs is insufficient reported. Prolonged monitoring with external portable monitors is difficult for practical and technical reasons. In addition, long-term consistent and structured timing of clinical visits is often a challenge in this vulnerable patient group. In recent years, patients who have been suspected of rarely occurring arrhythmias, have been offered long-term monitoring using an 'implantable loop recorder' (ILR). However, no study has evaluated the arrhythmic burden in patients treated with antipsychotic drugs using ILR.

Methods and materials The study is a national joint project between departments of psychiatry and cardiology across Denmark. After written informed consent and a baseline evaluation including echocardiography, ecg and biochemistry, an ILR will be implanted. During follow-up, arrhythmias will be monitored at regular clinical visits. Cardiovascular endpoints will be monitored using Danish national registries.

Expected outcome and perspectives The present study is the first to reveal arrhythmias among patients treated with antipsychotics using consistent long-term monitoring. The results will give valuable insights into possible mechanism of the observed early death and risk of sudden death in patients treated with antipsychotics.

Conditions

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Death, Sudden, Cardiac Arrythmia Antipsychotics and Neuroleptics Toxicity

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Antipsychotics

Patients treated with antipsychotics as provided by their psychiatrist in order to treat disease best possible and in accordance with guidelines.

Group Type ACTIVE_COMPARATOR

Antipsychotic

Intervention Type DRUG

Antipsychotic treatment \>0.5 DDD

Control

Healthy controls, not treated with antipsychotics.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Antipsychotic

Antipsychotic treatment \>0.5 DDD

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patients with SMI defined according to ICD-10 as:

* F20.0-F20.9 schizophrenia
* F22.0-F22.9 paranoid psychosis
* F25.0-F25.9 schizo-affective psychosis
* F28 other non-organic psychosis
* F29 non-organic psychosis unspecified
* F31.0-F31.9 bipolar affective disorder.
* Patients treated with or initiating antipsychotics with ≥ 0.5 daily defined dosage
* \>18 years old and \<50 years.

Exclusion Criteria

* Patients not capable to understand the aim of the study as judged by investigator.
* Current in treatment with methadone.
* Left ventricular hypertrophy (echocardiographic septal thickness ≥1.3 cm for women and ≥1.4 cm for men, or LVM/BSA ≥109 g/m2 for women or ≥132 g/m2 for men).
* Heart failure (echocardiographic LVEF \<35%).
* Ischemic heart disease (patient reported coronary bypass grafting or percutaneous coronary intervention.
* Congenital cardiovascular disease (patient reported).
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Rigshospitalet, Denmark

OTHER

Sponsor Role collaborator

Bispebjerg Hospital

OTHER

Sponsor Role collaborator

Nordsjaellands Hospital

OTHER

Sponsor Role collaborator

University Hospital, Gentofte, Copenhagen

OTHER

Sponsor Role collaborator

Zealand University Hospital

OTHER

Sponsor Role collaborator

Odense University Hospital

OTHER

Sponsor Role collaborator

Aarhus University Hospital

OTHER

Sponsor Role collaborator

Aalborg University Hospital

OTHER

Sponsor Role collaborator

Herlev and Gentofte Hospital

OTHER

Sponsor Role lead

Responsible Party

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Casper N. Bang

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Casper Bang, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Cardiology, Bispebjerg and Frederiksberg Hospital, Copenhagen University, Denmark

Locations

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Department of Psychiatry, Region of Southern Denmark

Aabenraa, , Denmark

Site Status NOT_YET_RECRUITING

Cardiology, Aalborg Universitetshospital

Aalborg, , Denmark

Site Status NOT_YET_RECRUITING

Psychiatry, Aalborg University Hospital

Aalborg, , Denmark

Site Status NOT_YET_RECRUITING

Aarhus Universitetshospital, Skejby, Department of Cardiology

Aarhus, , Denmark

Site Status NOT_YET_RECRUITING

Department of Psychiatry, Aarhus University

Aarhus, , Denmark

Site Status NOT_YET_RECRUITING

Bispebjerg Hospital, Department of Cardiology

Copenhagen, , Denmark

Site Status RECRUITING

Copenhagen Center of Psychiatry (Rigshospitalet)

Copenhagen, , Denmark

Site Status NOT_YET_RECRUITING

Mental Health Center Amager

Copenhagen, , Denmark

Site Status RECRUITING

Rigshospitalet, Department of Cardiology

Copenhagen, , Denmark

Site Status NOT_YET_RECRUITING

Mental Health Center Frederiksberg

Frederiksberg, , Denmark

Site Status NOT_YET_RECRUITING

Gentofte-Herlev Hospital, Department of Cardiology

Gentofte Municipality, , Denmark

Site Status NOT_YET_RECRUITING

Mental Health Center Glostrup

Glostrup Municipality, , Denmark

Site Status NOT_YET_RECRUITING

Mental Health Center Copenhagen

Hellerup, , Denmark

Site Status NOT_YET_RECRUITING

North Zealand Hospital, Department of Cardiology

Hillerød, , Denmark

Site Status NOT_YET_RECRUITING

North Zealand Hospital, Department of Psychiatry

Hillerød, , Denmark

Site Status NOT_YET_RECRUITING

Odense University Hospital, Department of Cardiology

Odense, , Denmark

Site Status NOT_YET_RECRUITING

Zealand University Hospital, Department of Cardiology

Roskilde, , Denmark

Site Status NOT_YET_RECRUITING

Psychiatric Research Unit, Region of Zealand

Slagelse, , Denmark

Site Status NOT_YET_RECRUITING

Countries

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Denmark

Central Contacts

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Casper N Bang, MD, PhD

Role: CONTACT

+4538635000

Gunnar H Gislason, MD, PhD

Role: CONTACT

Facility Contacts

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Mikkel Højlund, MD

Role: primary

Jacob M Larsen, MD

Role: primary

René E Nielsen, MD, PhD

Role: primary

Henrik K Jensen, DMSc, PhD

Role: primary

Ole Mors, MD, PhD

Role: primary

Søren Højberg, MD, PhD

Role: primary

Anders Fink-Jensen, MD, DMSc

Role: primary

Julie Nordgaard, MD, PhD

Role: primary

Role: backup

Berit Philbert, MD, PhD

Role: primary

Runa I Munker, MD

Role: primary

Tommi B Lindhardt, MD, PhD

Role: primary

Casper B Westergaard, MD

Role: primary

Role: backup

Merete Nordentoft, MD, DMSc

Role: primary

Michael D Jacobsen, MD

Role: primary

Charlotte Hechmann, MD

Role: primary

Stine O Poulsen, MD

Role: primary

Thomas M Mechior, MD, PhD

Role: primary

Erik Simonsen, MD, PhD

Role: primary

Other Identifiers

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A0001

Identifier Type: -

Identifier Source: org_study_id

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