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Catheter Ablation Versus Amiodarone for Shock Prophylaxis in Defibrillator Patients With Ventricular Tachycardia (CEASE-VT)

Primary Purpose

Defibrillators, Implantable, Tachycardia, Ventricular

Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Ablation
Amiodarone
Sponsored by
Population Health Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Defibrillators, Implantable focused on measuring Defibrillators, Implantable, Tachycardia, Ventricular, Catheter Ablation, Amiodarone

Eligibility Criteria

19 Years - 84 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria - Patients must meet all of the following criteria:

  • > 18 and < 85 years of age
  • ICD implanted for primary prophylaxis against sudden cardiac death or ICD implanted for secondary prophylaxis against spontaneous or inducible sustained VT without any reversible causes
  • Coronary artery disease (CAD) with prior myocardial infarction (MI)
  • ICD or electrocardiogram (ECG) documentation of ventricular arrhythmia responsible for appropriate ICD therapy [antitachycardia pacing (ATP) & shocks].

Exclusion Criteria - Patients should not have any of the following criteria:

  • Contraindication or allergy to contrast media, routine procedural medications or catheter materials
  • Contraindication to an interventional procedure
  • Current or previous (within 3 months) amiodarone therapy
  • Atrial Fibrillation requiring antiarrhythmic drug therapy
  • Contraindication to amiodarone therapy
  • New York Heart Association (NYHA) functional class IV
  • Myocardial infarction within the past 60 days
  • Stroke within the past 90 days
  • Unstable angina
  • Hypertrophic cardiomyopathy, Non-ischemic dilated cardiomyopathy, Arrhythmogenic Right Ventricular Dysplasia, Brugada Syndrome, Catecholamine sensitive polymorphic VT or long QT syndrome
  • Patients with active ischemia that are eligible for revascularization
  • Life expectancy less than 6 months
  • Incessant or multiple episodes of VT requiring immediate therapy with medications or ablation
  • Untreated hypothyroidism or hyperthyroidism. Patients who are euthyroid on thyroid hormone replacement therapy are acceptable.
  • Current enrollment in another investigational drug or device study.
  • Presence of any other condition that the investigator feels would be problematic or would restrict or limit the participation of the patient for the entire study period.
  • Absolute contra-indication to the use of heparin and or warfarin.
  • Documented intra-atrial thrombus, ventricular thrombus (< 6 months after detection of thrombus), tumor, or another abnormality which precludes catheter introduction.
  • Females of childbearing potential who are not practicing protocol acceptable method of birth control.

Sites / Locations

  • Northwestern University
  • Mayo Clinic
  • Hospital of the University of Pennsylvania
  • Texas Cardiac Arrhythmia Research Foundation
  • University of Virginia Health System
  • Hamilton Health Sciences
  • Southlake Regional Health Centre
  • University of Ottawa Heart Institute
  • McGill University Health Center
  • Institut Universitaire de Cardiologie et Pneumologie de Québec
  • Beijng Fuwai Heart Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Ablation

Amiodarone

Arm Description

Catheter based radiofrequency ablation for ischemic ventricular tachycardia

amiodarone titrated to therapeutic levels as per standard of care and maintained on a dose of at least 200 mg (300 mg recommended) once a day for the duration of the study.

Outcomes

Primary Outcome Measures

Number of Participants With Appropriate ICD Therapy, Slow VT or Sudden Cardiac Death
Number of participants with a composite outcome of any of: Appropriate Implantable Cardioverter Defibrillator (ICD) therapy [Including antitachycardia pacing (ATP) and shocks] Slow ventricular tachycardia (VT) below ICD detection threshold leading to hospitalization or necessitates antiarrhythmic medications and/or catheter ablation Sudden Cardiac Death

Secondary Outcome Measures

Number of Participants With (a) Ablation or Amiodarone Complications, (b) Inappropriate Shocks From ICD, or (c) Need for Concomitant Use of Sotalol, Dofetilide, Azimilide or Class 1 Antiarrhythmic Agents in Either Arm of the Trial.
Number of Participants with (a) Ablation or Amiodarone Complications, (b) Inappropriate Shocks from ICD, or (c) Need for Concomitant use of Sotalol, Dofetilide, Azimilide or Class 1 Antiarrhythmic agents in either arm of the trial.
Quality of Life Score
Quality of life score in each treatment arm using the EQ-5D Visual Analogue Scale (VAS) (euroqol.org). The EQ-5D VAS is a patient reported scale from 0 to 100 on which the patient rates how good or bad their health is today with 100 being the best health they can imagine and 0 being the worst health they can imagine.

Full Information

First Posted
March 31, 2010
Last Updated
January 17, 2020
Sponsor
Population Health Research Institute
Collaborators
Abbott Medical Devices, Hamilton Health Sciences Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT01097330
Brief Title
Catheter Ablation Versus Amiodarone for Shock Prophylaxis in Defibrillator Patients With Ventricular Tachycardia
Acronym
CEASE-VT
Official Title
Catheter Ablation Versus Amiodarone for Shock Prophylaxis in Defibrillator Patients With Ventricular Tachycardia: A Multi-center Randomized Trial
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Terminated
Why Stopped
Anticipated non-feasibility of recruitment objectives
Study Start Date
August 2010 (Actual)
Primary Completion Date
March 2012 (Actual)
Study Completion Date
March 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Population Health Research Institute
Collaborators
Abbott Medical Devices, Hamilton Health Sciences Corporation

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Implantable Cardioverter Defibrillators (ICDs) provide a shock or pacing therapy to bring back a normal heart beat when a patient experiences a dangerous abnormal heart rhythm such as ventricular tachycardia (VT). ICDs are very successful in bringing back a normal heart beat when VT occurs, but they do not prevent further dangerous heart rhythms from occurring. This study is designed to determine the best way to manage patients who have an ICD and who continue to have episodes of VT. There are two methods for treatment the VT: 1) Ablation, and 2) Medication. An ablation procedure involves placing a flexible catheter (insulated wire) in the groin area and threading it into the heart. After the doctor has located the affected area responsible for the VT, radiofrequency energy is delivered by the power generator through the catheter to the inside of the heart. The radiofrequency energy ablates (burns) a small area of the heart tissue thought to cause the VT. A medication called Amiodarone is an "anti-arrhythmic" prescribed to prevent abnormal heart rhythms from recurring. The purpose of this study is to compare these two different methods for treating VT. Treatment with ablation and amiodarone are both considered the standard of care for patients with VT but they have not been compared directly in a study like this before.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Defibrillators, Implantable, Tachycardia, Ventricular
Keywords
Defibrillators, Implantable, Tachycardia, Ventricular, Catheter Ablation, Amiodarone

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ablation
Arm Type
Active Comparator
Arm Description
Catheter based radiofrequency ablation for ischemic ventricular tachycardia
Arm Title
Amiodarone
Arm Type
Active Comparator
Arm Description
amiodarone titrated to therapeutic levels as per standard of care and maintained on a dose of at least 200 mg (300 mg recommended) once a day for the duration of the study.
Intervention Type
Procedure
Intervention Name(s)
Ablation
Other Intervention Name(s)
VT ablation, ischemic VT ablation, catheter ablation, radiofrequency ablation
Intervention Description
Catheter based radiofrequency ablation for ischemic ventricular tachycardia scheduled to occur within 4 weeks after randomization
Intervention Type
Drug
Intervention Name(s)
Amiodarone
Other Intervention Name(s)
Cordarone
Intervention Description
Amiodarone titrated to therapeutic levels as per standard of care and maintained on a dose of at least 200 mg (300 mg recommended) once a day for the duration of the study
Primary Outcome Measure Information:
Title
Number of Participants With Appropriate ICD Therapy, Slow VT or Sudden Cardiac Death
Description
Number of participants with a composite outcome of any of: Appropriate Implantable Cardioverter Defibrillator (ICD) therapy [Including antitachycardia pacing (ATP) and shocks] Slow ventricular tachycardia (VT) below ICD detection threshold leading to hospitalization or necessitates antiarrhythmic medications and/or catheter ablation Sudden Cardiac Death
Time Frame
From 30 days following randomization until final follow-up visit
Secondary Outcome Measure Information:
Title
Number of Participants With (a) Ablation or Amiodarone Complications, (b) Inappropriate Shocks From ICD, or (c) Need for Concomitant Use of Sotalol, Dofetilide, Azimilide or Class 1 Antiarrhythmic Agents in Either Arm of the Trial.
Description
Number of Participants with (a) Ablation or Amiodarone Complications, (b) Inappropriate Shocks from ICD, or (c) Need for Concomitant use of Sotalol, Dofetilide, Azimilide or Class 1 Antiarrhythmic agents in either arm of the trial.
Time Frame
from randomization until final follow-up
Title
Quality of Life Score
Description
Quality of life score in each treatment arm using the EQ-5D Visual Analogue Scale (VAS) (euroqol.org). The EQ-5D VAS is a patient reported scale from 0 to 100 on which the patient rates how good or bad their health is today with 100 being the best health they can imagine and 0 being the worst health they can imagine.
Time Frame
At 6 months follow-up

10. Eligibility

Sex
All
Minimum Age & Unit of Time
19 Years
Maximum Age & Unit of Time
84 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria - Patients must meet all of the following criteria: > 18 and < 85 years of age ICD implanted for primary prophylaxis against sudden cardiac death or ICD implanted for secondary prophylaxis against spontaneous or inducible sustained VT without any reversible causes Coronary artery disease (CAD) with prior myocardial infarction (MI) ICD or electrocardiogram (ECG) documentation of ventricular arrhythmia responsible for appropriate ICD therapy [antitachycardia pacing (ATP) & shocks]. Exclusion Criteria - Patients should not have any of the following criteria: Contraindication or allergy to contrast media, routine procedural medications or catheter materials Contraindication to an interventional procedure Current or previous (within 3 months) amiodarone therapy Atrial Fibrillation requiring antiarrhythmic drug therapy Contraindication to amiodarone therapy New York Heart Association (NYHA) functional class IV Myocardial infarction within the past 60 days Stroke within the past 90 days Unstable angina Hypertrophic cardiomyopathy, Non-ischemic dilated cardiomyopathy, Arrhythmogenic Right Ventricular Dysplasia, Brugada Syndrome, Catecholamine sensitive polymorphic VT or long QT syndrome Patients with active ischemia that are eligible for revascularization Life expectancy less than 6 months Incessant or multiple episodes of VT requiring immediate therapy with medications or ablation Untreated hypothyroidism or hyperthyroidism. Patients who are euthyroid on thyroid hormone replacement therapy are acceptable. Current enrollment in another investigational drug or device study. Presence of any other condition that the investigator feels would be problematic or would restrict or limit the participation of the patient for the entire study period. Absolute contra-indication to the use of heparin and or warfarin. Documented intra-atrial thrombus, ventricular thrombus (< 6 months after detection of thrombus), tumor, or another abnormality which precludes catheter introduction. Females of childbearing potential who are not practicing protocol acceptable method of birth control.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Andrea Natale, M.D.
Organizational Affiliation
Texas Cardiac Arrhythmia Research Foundation
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
David J Callans, M.D.
Organizational Affiliation
University of Pennsylvania
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Carlos A. Morillo, M.D.
Organizational Affiliation
Population Health Research Institute, McMaster University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Girish M. Nair, M.D.
Organizational Affiliation
Population Health Research Institute, McMaster University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Hospital of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Texas Cardiac Arrhythmia Research Foundation
City
Austin
State/Province
Texas
ZIP/Postal Code
78705
Country
United States
Facility Name
University of Virginia Health System
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States
Facility Name
Hamilton Health Sciences
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8L 2X2
Country
Canada
Facility Name
Southlake Regional Health Centre
City
Newmarket
State/Province
Ontario
ZIP/Postal Code
L3Y 2P9
Country
Canada
Facility Name
University of Ottawa Heart Institute
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1Y 4W7
Country
Canada
Facility Name
McGill University Health Center
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H3G 1A4
Country
Canada
Facility Name
Institut Universitaire de Cardiologie et Pneumologie de Québec
City
Quebec
ZIP/Postal Code
G1V 4G5
Country
Canada
Facility Name
Beijng Fuwai Heart Hospital
City
Beijing
ZIP/Postal Code
100037
Country
China

12. IPD Sharing Statement

Links:
URL
http://www.phri.ca/
Description
Population Health Research Institute

Learn more about this trial

Catheter Ablation Versus Amiodarone for Shock Prophylaxis in Defibrillator Patients With Ventricular Tachycardia

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