Novel ICD Arrhythmia Detection Algorithm

NCT ID: NCT04981496

Last Updated: 2023-12-01

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

ACTIVE_NOT_RECRUITING

Total Enrollment

90 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-07-06

Study Completion Date

2024-05-01

Brief Summary

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Implantable cardioverter defibrillators (ICD) are used to treat life-threatening heart rhythm disturbances (arrhythmias).

They have been proven to reduce the risk of sudden cardiac death; however, there are limitations with current ICDs. Firstly, they may deliver inappropriate therapies (therapies delivered in the absence of life-threatening arrhythmias). Secondly, slower life-threatening arrhythmias may be left untreated because current programming recommendations, designed to minimise inappropriate therapies, rely predominantly on heart rates. Therefore, there is considerable potential to make ICDs safer with more sophisticated ICD algorithms.

In this research study the investigators will collect data from participants with newly implanted or existing ICDs whilst they are in induced or spontaneously occurring abnormal rhythms. The data will come from sensors placed on the skin that can measure blood flow or electrical properties of the body. In addition, in 20 participants, the investigators will also collect further data from a small loop recorder implanted under the skin.

The investigators will use this data to help develop and validate new methods of reliably identifying life-threatening arrhythmias so that future ICDs deliver therapies when only needed.

The research is funded by the British Heart Foundation, and will take place at Hammersmith Hospital over 3 years. The investigators aim to recruit 100 patients in total.

Detailed Description

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This novel arrhythmia detection algorithm will incorporate a haemodynamic sensor and extra bipolar electrogram with an aim to outperform current commercially used arrhythmia detection algorithms that rely primarily on heart rate.

Conditions

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ICD Implantable Defibrillator User Cardiomyopathies

Keywords

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ICD arrhythmia algorithm haemodynamic sensor bipolar electrogram

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Study Groups

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Simulated Arrhythmias

Simulate ventricular and/or atrial tachycardia via VVI or AAI pacing an ICD with an implantable loop recorder implant (or a surface bipolar electrogram) and haemodynamics.

Observational Study during Clinical and Simulated arrhythmias in patients with ICDs

Intervention Type OTHER

Observational Study during Clinical and Simulated arrhythmias in patients with ICDs

Clinical Arrhythmias

Genuine clinical VT (acute presentation), RV lead fracture/noise or sinus tachycardia on exercise whilst recording haemodynamics and a surface bipolar electrogram.

Observational Study during Clinical and Simulated arrhythmias in patients with ICDs

Intervention Type OTHER

Observational Study during Clinical and Simulated arrhythmias in patients with ICDs

Interventions

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Observational Study during Clinical and Simulated arrhythmias in patients with ICDs

Observational Study during Clinical and Simulated arrhythmias in patients with ICDs

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Study A and B

1. Patients referred for conventional defibrillator implantation or generator change.
2. Adults (age \> 18 years)
3. Willing to take part and able to give consent.

Study C

1. Patients with defibrillators who are undergoing a VT ablation.
2. Adults (age \> 18 years)
3. Willing to take part and able to give consent.

Study D

1. Patients with defibrillators already implanted who are able to exercise and raise their heart rate substantially
2. Adults (age \> 18 years)
3. Willing to take part and able to give consent.

Study E

1. Patients with a defibrillator already implanted admitted with atrial arrhythmias, ventricular tachycardia or RV lead fracture.
2. Adults (age \> 18 years)
3. Willing to take part and able to give consent.

Exclusion Criteria

1. Unable to give consent.
2. Children (age \< 18 years)
3. Pregnant women.


1. Intracardiac thrombus
2. AF without regular anticoagulation
3. Severe aortic stenosis
4. Severe ischaemic heart disease
5. Decompensated heart failure


1. Recent heart attack or stroke (within the last month)
2. Thromboembolic event undergoing active treatment
3. Severe aortic stenosis
4. Severe ischaemic heart disease
5. Hypertrophic obstructive cardiomyopathy
6. Uncontrolled ventricular arrhythmias
7. Physically unable to exercise, for example due to arthritis.
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Imperial College London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Hammersmith Hospital

London, , United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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FS/20/11/34750

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

20HH5882

Identifier Type: -

Identifier Source: org_study_id