IDE-ALERTS Continued Access Study (ALERTS-CAS)
Primary Purpose
Acute Coronary Syndrome
Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
AngelMed Guardian System
Sponsored by

About this trial
This is an interventional diagnostic trial for Acute Coronary Syndrome
Eligibility Criteria
Inclusion Criteria (all must be true):
- Subject previously participated in the ALERTS study and currently has either a Guardian System IMD plus IS-1 lead or IS-1 lead still in place and hasn't developed exclusion criteria.
- Subject (men or women) is at least 21 years of age.
Women of childbearing age must have a negative pregnancy test or confirmation of one of the following:
- Post-menopause or amenorrhoeic during the past year
- Surgical sterilization
- Use of effective contraceptive method
Exclusion Criteria:
- In the investigator's opinion, subject lacks ability to respond appropriately to alarms, e.g., illiteracy, poor memory or cognitive function, dementia or other condition affecting memory function, etc.
- Known compromised tissue at the site of lead implantation in the apex of the right ventricle, e.g., prior infarct affecting the RV apex location.
- A permanent pacemaker or ICD is already in place or the patient is indicated for ICD or pacemaker implantation based on the guidelines published by the American College of Cardiology as Class I and IIa recommendations. Class IIb recommendations are at the investigator's discretion.
- Subject cannot feel the IMD vibration when placed on top of the skin on the left pectoral side of the chest.
- Subject has recurrent or persistent atrial fibrillation.
- Subject has recurrent or persistent non-sinus cardiac rhythm, second- or third-degree atrioventricular blocks, QRS duration greater than 120 ms, Benign Early Repolarization (BER), Brugada Syndrome, (LBB, BBB, RBB) or Rate Induced BBB.
- Subject has left ventricular hypertrophy evidenced by EKG criteria.
Subject has any condition preventing the subcutaneous implantation of the Guardian System in a left pectoral pouch, such as:
- superior vena cava thrombosis,
- subcutaneous tissue deemed inappropriate for the procedure
- prior central venous access via portacath, Hickman, Groshong, or similar placed in a left pectoral location or left side PICC line.
- Extremely heavy alcohol consumption (participates in binge drinking that leads to alcohol intoxication) or has history of alcohol or illicit drug abuse within past 5 years.
- Evidence of unresolved infection (fever > 38o C and/or leukocytosis > 15,000).
- History of bleeding disorders or severe coagulopathy (platelets < 100,000 plts/ml; APTT or PT > 1.3 x reference range).
- Subject has had a hemorrhagic stroke or transient ischemic attack (TIA) in the past 6 months.
- Subject has other severe diseases, such as cancer or refractory congestive heart failure, associated with limitation of life expectancy (less than 1 year), which may lead to inadequate compliance to the protocol or confusing data interpretation.
- Subject has clinical conditions such as heart diseases, difficult-to-control blood pressure, difficult-to-control insulin-dependent diabetes or serious prior infections attributed to the diabetes, or others that, at the investigator's discretion, could seriously affect the subject's current clinical condition during study procedures.
- Subject has current participation or previous participation in another drug or device study in the past 30 days that conflicts with this study as determined by the study sponsor.
- Gastro-intestinal hemorrhage in the past 6 months.
- Subject has any situation in which the use of aspirin is contraindicated for at least 6 months.
- Subject has epilepsy
- Subject has known severe allergies, e.g., peanut, bee sting.
Sites / Locations
- Orange County Heart Institute and Research Center
Arms of the Study
Arm 1
Arm Type
Other
Arm Label
AngelMed Guardian System
Arm Description
All eligible subjects will have the AngelMed Guardian System implanted with alerting features turned ON; receive an external device which provides additional alerting; and receive training on system use.
Outcomes
Primary Outcome Measures
Rate of Serious Adverse Events (SAE)
Annual rate of SAEs related to the device or procedure
Secondary Outcome Measures
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04316481
Brief Title
IDE-ALERTS Continued Access Study
Acronym
ALERTS-CAS
Official Title
ALERTS Continued Access Study- IDE G060259 Supplement
Study Type
Interventional
2. Study Status
Record Verification Date
June 2022
Overall Recruitment Status
Terminated
Why Stopped
FDA Approval was received for the Model AMSG3-E IMD and therefore commercial implants could be started. There was no longer any need to implant under the CAS. CAS patients were transitioned to commercial patients.
Study Start Date
September 22, 2020 (Actual)
Primary Completion Date
January 20, 2022 (Actual)
Study Completion Date
January 20, 2022 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Angel Medical Systems
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
No
5. Study Description
Brief Summary
This Continued Access IDE Study includes a subset of former ALERTS trial (NCT00781118) patients and provides performance data for a refined Guardian implantable medical device (AMSG3-E) with a new battery designed to extend device longevity.
Detailed Description
This Continued Access IDE Study is a prospective, non-randomized, multi-center (up to 25 sites) study designed to provide performance assessment of a refined Guardian implantable medical device (AMSG3-E) through controlled access of a replacement Guardian System to a subset of former ALERTS patients while waiting for FDA approval of the AMSG3-E. The AMSG3-E contains a drop-in replacement battery designed to extend the life of the implant to potentially exceed the previous 3-years implant life. Eligible patients will include those that exited the ALERTS study and chose to leave the device and/or lead in place. Eligible patients must also continue to meet ALERTS inclusion criteria and not have developed any exclusion criteria since exiting the ALERTS study.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Coronary Syndrome
7. Study Design
Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
Continued Access
Masking
None (Open Label)
Allocation
N/A
Enrollment
17 (Actual)
8. Arms, Groups, and Interventions
Arm Title
AngelMed Guardian System
Arm Type
Other
Arm Description
All eligible subjects will have the AngelMed Guardian System implanted with alerting features turned ON; receive an external device which provides additional alerting; and receive training on system use.
Intervention Type
Device
Intervention Name(s)
AngelMed Guardian System
Intervention Description
The AngelMed Guardian System detects potential ongoing ACS events, characterized by sustained ST segment changes, and alerts the patient to seek medical attention for those potential ACS events. The Guardian System is indicated as an adjunct to patient recognized symptoms.
Primary Outcome Measure Information:
Title
Rate of Serious Adverse Events (SAE)
Description
Annual rate of SAEs related to the device or procedure
Time Frame
5 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria (all must be true):
Subject previously participated in the ALERTS study and currently has either a Guardian System IMD plus IS-1 lead or IS-1 lead still in place and hasn't developed exclusion criteria.
Subject (men or women) is at least 21 years of age.
Women of childbearing age must have a negative pregnancy test or confirmation of one of the following:
Post-menopause or amenorrhoeic during the past year
Surgical sterilization
Use of effective contraceptive method
Exclusion Criteria:
In the investigator's opinion, subject lacks ability to respond appropriately to alarms, e.g., illiteracy, poor memory or cognitive function, dementia or other condition affecting memory function, etc.
Known compromised tissue at the site of lead implantation in the apex of the right ventricle, e.g., prior infarct affecting the RV apex location.
A permanent pacemaker or ICD is already in place or the patient is indicated for ICD or pacemaker implantation based on the guidelines published by the American College of Cardiology as Class I and IIa recommendations. Class IIb recommendations are at the investigator's discretion.
Subject cannot feel the IMD vibration when placed on top of the skin on the left pectoral side of the chest.
Subject has recurrent or persistent atrial fibrillation.
Subject has recurrent or persistent non-sinus cardiac rhythm, second- or third-degree atrioventricular blocks, QRS duration greater than 120 ms, Benign Early Repolarization (BER), Brugada Syndrome, (LBB, BBB, RBB) or Rate Induced BBB.
Subject has left ventricular hypertrophy evidenced by EKG criteria.
Subject has any condition preventing the subcutaneous implantation of the Guardian System in a left pectoral pouch, such as:
superior vena cava thrombosis,
subcutaneous tissue deemed inappropriate for the procedure
prior central venous access via portacath, Hickman, Groshong, or similar placed in a left pectoral location or left side PICC line.
Extremely heavy alcohol consumption (participates in binge drinking that leads to alcohol intoxication) or has history of alcohol or illicit drug abuse within past 5 years.
Evidence of unresolved infection (fever > 38o C and/or leukocytosis > 15,000).
History of bleeding disorders or severe coagulopathy (platelets < 100,000 plts/ml; APTT or PT > 1.3 x reference range).
Subject has had a hemorrhagic stroke or transient ischemic attack (TIA) in the past 6 months.
Subject has other severe diseases, such as cancer or refractory congestive heart failure, associated with limitation of life expectancy (less than 1 year), which may lead to inadequate compliance to the protocol or confusing data interpretation.
Subject has clinical conditions such as heart diseases, difficult-to-control blood pressure, difficult-to-control insulin-dependent diabetes or serious prior infections attributed to the diabetes, or others that, at the investigator's discretion, could seriously affect the subject's current clinical condition during study procedures.
Subject has current participation or previous participation in another drug or device study in the past 30 days that conflicts with this study as determined by the study sponsor.
Gastro-intestinal hemorrhage in the past 6 months.
Subject has any situation in which the use of aspirin is contraindicated for at least 6 months.
Subject has epilepsy
Subject has known severe allergies, e.g., peanut, bee sting.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mitchell W Krucoff, MD
Organizational Affiliation
Duke University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Orange County Heart Institute and Research Center
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
30842028
Citation
Gibson CM, Holmes D, Mikdadi G, Presser D, Wohns D, Yee MK, Kaplan A, Ciuffo A, Eberly AL 3rd, Iteld B, Krucoff MW. Implantable Cardiac Alert System for Early Recognition of ST-Segment Elevation Myocardial Infarction. J Am Coll Cardiol. 2019 Apr 23;73(15):1919-1927. doi: 10.1016/j.jacc.2019.01.014. Epub 2019 Mar 3.
Results Reference
result
PubMed Identifier
31623762
Citation
Holmes DR Jr, Krucoff MW, Mullin C, Mikdadi G, Presser D, Wohns D, Kaplan A, Ciuffo A, Eberly AL 3rd, Iteld B, Fischell DR, Fischell T, Keenan D, John MS, Gibson CM. Implanted Monitor Alerting to Reduce Treatment Delay in Patients With Acute Coronary Syndrome Events. J Am Coll Cardiol. 2019 Oct 22;74(16):2047-2055. doi: 10.1016/j.jacc.2019.07.084.
Results Reference
result
PubMed Identifier
32021496
Citation
Kazmi SHA, Datta S, Chi G, Nafee T, Yee M, Kalia A, Sharfaei S, Shojaei F, Mirwais S, Gibson CM. The AngelMed Guardian(R) System in the Detection of Coronary Artery Occlusion: Current Perspectives. Med Devices (Auckl). 2020 Jan 7;13:1-12. doi: 10.2147/MDER.S219865. eCollection 2020.
Results Reference
result
Links:
URL
https://www.accessdata.fda.gov/cdrh_docs/pdf15/P150009B.pdf
Description
SSED
Learn more about this trial
IDE-ALERTS Continued Access Study
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