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ExtraVascular Implantable Cardiac Defibrillator Continued Access Study (EV ICD CA)

Primary Purpose

Tachycardia, Ventricular Arrythmia

Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Defibrillation using the Extravascular ICD
Sponsored by
Medtronic
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Tachycardia

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patient has a Class I or IIa indication for implantation of an ICD according to the ACC/AHA/HRS Guidelines.[1]
  2. Patient is willing and able to sign and date the Informed Consent Form for their participation in the study.
  3. Patient is at least 18 years of age and meets age requirements per local law.
  4. Patient is geographically stable and willing and able to comply with the study procedures and visits for the duration of the follow-up.

Exclusion Criteria:

  1. Patient has indications for bradycardia pacing[2] or Cardiac Resynchronization Therapy (CRT)[3] (Class I, IIa, or IIb indication).
  2. Patients with an existing pacemaker, ICD, or CRT device or leads.
  3. Patients with these medical interventions are excluded from participation in the study:

    • Prior sternotomy
    • Any prior medical condition or procedure that leads to adhesions in the anterior mediastinal space (i.e., prior mediastinal instrumentation, mediastinitis)
    • Prior abdominal surgery in the epigastric region
    • Planned sternotomy
    • Prior chest radiotherapy

    Or any other prior/planned medical intervention not listed that precludes their participation in the opinion of the Investigator.

  4. Patients with these medical conditions or anatomies are excluded from participation in the study:

    • Hiatal hernia that distorts mediastinal anatomy
    • Marked sternal abnormality (e.g., pectus excavatum that impedes the substernal tunneling path or procedure)
    • Decompensated heart failure
    • COPD with oxygen dependence
    • Gross hepatosplenomegaly

    Or any other known medical condition or anatomy type not listed that precludes their participation in the opinion of the Investigator.

  5. Patients with a medical condition that precludes them from undergoing defibrillation testing:

    • Severe aortic stenosis
    • Current Intracardiac LA or LV thrombus
    • Severe proximal three-vessel or left main coronary artery disease without revascularization
    • Hemodynamic instability
    • Unstable angina
    • Recent stroke or transient ischemic attack (within the last 6 months)
    • Known inadequate external defibrillation
    • LVEF < 20%
    • LVEDD >70 mm

    Or any other known medical condition not listed that precludes their participation in the opinion of the Investigator.

  6. Patient with any evidence of active infection or undergoing treatment for an infection.
  7. Patient is contraindicated from temporary suspension of oral/systemic anticoagulation.
  8. Patient with current implantation of neurostimulator or any other chronically implanted device that delivers current in the body.
  9. Patient meets ACC/AHA/HRS or ESC clinical guideline Class III criteria for an ICD (e.g., life expectancy of less than 12 months).
  10. Patient is enrolled or planning to enroll in a concurrent clinical study that may confound the results of this study, without documented pre-approval from a Medtronic study manager.
  11. Patient with any exclusion criteria as required by local law (e.g., age or other).
  12. Pregnant women or breastfeeding women, or women of childbearing potential and who are not on a reliable form of birth regulation method or abstinence*

(*If required by local law, women of child-bearing potential must undergo a pregnancy test within seven days prior to EV ICD Continued Access Study procedures)

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Experimental

    Arm Description

    Patients will be implanted with an Extravascular ICD and undergo requisite electrical testing.

    Outcomes

    Primary Outcome Measures

    Complications
    EV ICD system and/or procedure related adverse events

    Secondary Outcome Measures

    Full Information

    First Posted
    August 26, 2021
    Last Updated
    September 6, 2022
    Sponsor
    Medtronic
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05049720
    Brief Title
    ExtraVascular Implantable Cardiac Defibrillator Continued Access Study
    Acronym
    EV ICD CA
    Official Title
    ExtraVascular Implantable Cardiac Defibrillator Continued Access Study
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2022
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    The NCT posting for the study has been transferred to NCT04060680
    Study Start Date
    September 2022 (Anticipated)
    Primary Completion Date
    July 28, 2023 (Anticipated)
    Study Completion Date
    July 28, 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Medtronic

    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 study is designed to provide continued access to the Extravascular Implantable Cardioverter Defibrillator (EV ICD) System.
    Detailed Description
    The study will enroll subjects who are indicated to receive an implantable defibrillator who meet all of the inclusion criteria and none of the exclusion criteria. Subjects will receive an investigational Extravascular Implantable Cardioverter Defibrillator (EV ICD) system, in which a lead is placed outside of the heart and veins to deliver defibrillation therapy. Subjects will be followed every 6 months following system implantation.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Tachycardia, Ventricular Arrythmia

    7. Study Design

    Primary Purpose
    Other
    Study Phase
    Not Applicable
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Experimental
    Arm Type
    Experimental
    Arm Description
    Patients will be implanted with an Extravascular ICD and undergo requisite electrical testing.
    Intervention Type
    Device
    Intervention Name(s)
    Defibrillation using the Extravascular ICD
    Intervention Description
    VT/VF induction attempted for defibrillation testing, as well as requisite electrical testing.
    Primary Outcome Measure Information:
    Title
    Complications
    Description
    EV ICD system and/or procedure related adverse events
    Time Frame
    Through study completion, an average of 18 months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Patient has a Class I or IIa indication for implantation of an ICD according to the ACC/AHA/HRS Guidelines.[1] Patient is willing and able to sign and date the Informed Consent Form for their participation in the study. Patient is at least 18 years of age and meets age requirements per local law. Patient is geographically stable and willing and able to comply with the study procedures and visits for the duration of the follow-up. Exclusion Criteria: Patient has indications for bradycardia pacing[2] or Cardiac Resynchronization Therapy (CRT)[3] (Class I, IIa, or IIb indication). Patients with an existing pacemaker, ICD, or CRT device or leads. Patients with these medical interventions are excluded from participation in the study: Prior sternotomy Any prior medical condition or procedure that leads to adhesions in the anterior mediastinal space (i.e., prior mediastinal instrumentation, mediastinitis) Prior abdominal surgery in the epigastric region Planned sternotomy Prior chest radiotherapy Or any other prior/planned medical intervention not listed that precludes their participation in the opinion of the Investigator. Patients with these medical conditions or anatomies are excluded from participation in the study: Hiatal hernia that distorts mediastinal anatomy Marked sternal abnormality (e.g., pectus excavatum that impedes the substernal tunneling path or procedure) Decompensated heart failure COPD with oxygen dependence Gross hepatosplenomegaly Or any other known medical condition or anatomy type not listed that precludes their participation in the opinion of the Investigator. Patients with a medical condition that precludes them from undergoing defibrillation testing: Severe aortic stenosis Current Intracardiac LA or LV thrombus Severe proximal three-vessel or left main coronary artery disease without revascularization Hemodynamic instability Unstable angina Recent stroke or transient ischemic attack (within the last 6 months) Known inadequate external defibrillation LVEF < 20% LVEDD >70 mm Or any other known medical condition not listed that precludes their participation in the opinion of the Investigator. Patient with any evidence of active infection or undergoing treatment for an infection. Patient is contraindicated from temporary suspension of oral/systemic anticoagulation. Patient with current implantation of neurostimulator or any other chronically implanted device that delivers current in the body. Patient meets ACC/AHA/HRS or ESC clinical guideline Class III criteria for an ICD (e.g., life expectancy of less than 12 months). Patient is enrolled or planning to enroll in a concurrent clinical study that may confound the results of this study, without documented pre-approval from a Medtronic study manager. Patient with any exclusion criteria as required by local law (e.g., age or other). Pregnant women or breastfeeding women, or women of childbearing potential and who are not on a reliable form of birth regulation method or abstinence* (*If required by local law, women of child-bearing potential must undergo a pregnancy test within seven days prior to EV ICD Continued Access Study procedures)

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    Citations:
    PubMed Identifier
    29097296
    Citation
    Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, Deal BJ, Dickfeld T, Field ME, Fonarow GC, Gillis AM, Granger CB, Hammill SC, Hlatky MA, Joglar JA, Kay GN, Matlock DD, Myerburg RJ, Page RL. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2018 Oct 2;72(14):e91-e220. doi: 10.1016/j.jacc.2017.10.054. Epub 2018 Aug 16. No abstract available. Erratum In: J Am Coll Cardiol. 2018 Oct 2;72(14):1760.
    Results Reference
    background
    PubMed Identifier
    26607062
    Citation
    Wilkoff BL, Fauchier L, Stiles MK, Morillo CA, Al-Khatib SM, Almendral J, Aguinaga L, Berger RD, Cuesta A, Daubert JP, Dubner S, Ellenbogen KA, Mark Estes NA 3rd, Fenelon G, Garcia FC, Gasparini M, Haines DE, Healey JS, Hurtwitz JL, Keegan R, Kolb C, Kuck KH, Marinskis G, Martinelli M, McGuire M, Molina LG, Okumura K, Proclemer A, Russo AM, Singh JP, Swerdlow CD, Teo WS, Uribe W, Viskin S, Wang CC, Zhang S. 2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing. Heart Rhythm. 2016 Feb;13(2):e50-86. doi: 10.1016/j.hrthm.2015.11.018. Epub 2015 Dec 1. No abstract available.
    Results Reference
    background
    PubMed Identifier
    30412709
    Citation
    Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR, Goldschlager NF, Hamilton RM, Joglar JA, Kim RJ, Lee R, Marine JE, McLeod CJ, Oken KR, Patton KK, Pellegrini CN, Selzman KA, Thompson A, Varosy PD. 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2019 Aug 20;74(7):e51-e156. doi: 10.1016/j.jacc.2018.10.044. Epub 2018 Nov 6. No abstract available. Erratum In: J Am Coll Cardiol. 2019 Aug 20;74(7):1016-1018.
    Results Reference
    background

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