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MultiPulse Therapy (MPT) for AF (US)

Primary Purpose

Atrial Fibrillation, Paroxysmal Atrial Fibrillation, Persistent Atrial Fibrillation

Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Multi Pulse Therapy as delivered from the Cardialen External Stimulation System
Sponsored by
Cardialen, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional device feasibility trial for Atrial Fibrillation

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female between 18 and 80 years of age
  2. Willing and able to comply with the study protocol, provide a written informed consent
  3. Currently indicated for atrial catheter ablation due to paroxysmal or early persistent atrial fibrillation
  4. Current treatment and compliance with standard anticoagulation regimen, including uninterrupted OAC, with acceptable coagulation status, as determined by the Principal Investigator

Exclusion Criteria:

The subject must not meet any of the following exclusion criteria:

  1. Life expectancy of 1 year or less
  2. AF due to reversible causes (e.g., hyperthyroidism, valve disease)
  3. History of DC Cardioversion which failed to convert to AF to Normal Sinus Rhythm
  4. Currently in AF for more than 3 months continuously
  5. Chronic, long-standing persistent, or permanent atrial fibrillation
  6. Allergy or contraindication to anticoagulation therapy
  7. Presence of intracardiac thrombus (confirmed with TEE or ICE)
  8. Existing Left Atrial Appendage closure device
  9. Severely Dilated Left Atrium >5cm
  10. LVEF<35%
  11. NYHA Class III or IV heart failure at the time of enrollment
  12. History of embolic stroke, Transient Ischemic Attack (TIA) or other thromboembolic event within the preceding 3 months.
  13. Known hyper-coagulable state that increases risk of thrombus
  14. History of myocardial infarction or coronary revascularization within the preceding 3 months.
  15. History of sustained ventricular arrhythmia or cardiac arrest
  16. Presence of chronically implanted lead in the CS
  17. Presence of ventricular assist device, including intra-aortic balloon pump
  18. Documented bradycardia (<40 BPM) at the time of the study
  19. Morbid obesity: BMI>39 kg/m2
  20. Presence of any prosthetic cardiac valve
  21. History of significant tricuspid valvular disease requiring surgery
  22. Moderate to severe mitral valve regurgitation (>40% regurgitation fraction)
  23. Cognitive or mental health status that would interfere with study participation and proper informed consent
  24. Cardiovascular anatomical defects that would complicate placement of the stimulation leads required by the protocol, including congenital heart disease and cardiac vein anomalies per the Investigator's discretion
  25. Pregnancy confirmed by test within 7 days of procedure.
  26. Inability to pass catheters to heart due to vascular limitations
  27. Cardiovascular surgery or intervention within 1 month prior to enrollment or planned for up to 1 month after enrollment (other than the planned treatment procedure)
  28. Active endocarditis
  29. Any other medical condition which may affect the outcome of this study or safety of the subject as determined by the investigator
  30. History of hemodynamic compromise due to valvular heart disease
  31. Unstable CAD as determined by the investigator
  32. Severe proximal three-vessel or left main coronary artery disease without revascularization as determined by the investigator
  33. History of Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Dysplasia, Congenital Heart Anomaly, Cardiac Amyloidosis or Cardiac Sarcoidosis

Sites / Locations

  • Minneapolis Veterans Administration Hospital
  • The Ohio State University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Multi Pulse Therapy as delivered from the Cardialen External Stimulation System

Arm Description

Subjects will have AF induced and the Cardialen External Stimulation System (CESS) device will deliver electrical stimulation to terminate the arrhythmia.

Outcomes

Primary Outcome Measures

The safety of MPT for the treatment of atrial fibrillation in subjects
Reported Adverse Events following MPT delivery
The safety of MPT for the treatment of atrial fibrillation in subjects
Reported Adverse Events following MPT delivery
Enhanced ability of MPT to stop atrial fibrillation
Compare voltages at which MPT successfully terminated AF against a previous Cardialen AF study (CL001 / NCT02257112)
Ability of MPT to stop atrial fibrillation
Determine rate of conversion from AF to NSR

Secondary Outcome Measures

Full Information

First Posted
August 17, 2021
Last Updated
October 7, 2022
Sponsor
Cardialen, Inc.
Collaborators
Iqvia Pty Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT05055921
Brief Title
MultiPulse Therapy (MPT) for AF (US)
Official Title
A Clinical Feasibility Study to Evaluate the Safety and Performance of Low-Energy Therapy in Patients With Atrial Fibrillation (US)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Terminated
Why Stopped
Sponsor ceased operations
Study Start Date
February 28, 2022 (Actual)
Primary Completion Date
October 1, 2022 (Actual)
Study Completion Date
October 1, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cardialen, Inc.
Collaborators
Iqvia Pty Ltd

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
Assess the clinical safety and feasibility of MultiPulse Therapy (MPT) electrical stimulation waveform sequence in terminating paroxysmal and persistent atrial fibrillation.
Detailed Description
A prospective non-randomized feasibility study involving acute testing of MPT in subjects with paroxysmal and persistent AF during clinically indicated atrial fibrillation catheter ablation procedure. Subjects will be split into 2 cohorts depending on status at time of procedure. In Atrial Fibrillation at time of procedure (Clinical AF) In Normal Sinus Rhythm at time of procedure Subjects will be evaluated at the visits for the Clinically-Indicated Procedure per standard of care. A single follow-up at up to 30 days post-procedure is required to assess subjects for adverse events.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Atrial Fibrillation, Paroxysmal Atrial Fibrillation, Persistent Atrial Fibrillation

7. Study Design

Primary Purpose
Device Feasibility
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
Multi-Pulse Therapy as delivered from the Cardialen External Stimulation System (CESS)
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Multi Pulse Therapy as delivered from the Cardialen External Stimulation System
Arm Type
Experimental
Arm Description
Subjects will have AF induced and the Cardialen External Stimulation System (CESS) device will deliver electrical stimulation to terminate the arrhythmia.
Intervention Type
Device
Intervention Name(s)
Multi Pulse Therapy as delivered from the Cardialen External Stimulation System
Intervention Description
The Cardialen External Stimulation System (CESS) is the research delivery system for the proprietary Cardialen MultiPulse Therapy (MPT). The CESS is a custom designed and built research device. It is comprised of off-the-shelf commercial components (power supplies, waveform generators, laptop computer, monitor, rack, ECG system, leads, etc.) combined with a custom electrical circuit board and custom software. Other Names: Unpinning Termination Therapy Multi-stage therapy Multi-stage electrotherapy MultiPulse Therapy
Primary Outcome Measure Information:
Title
The safety of MPT for the treatment of atrial fibrillation in subjects
Description
Reported Adverse Events following MPT delivery
Time Frame
Acutely at the time of the study procedure
Title
The safety of MPT for the treatment of atrial fibrillation in subjects
Description
Reported Adverse Events following MPT delivery
Time Frame
At 30 day post procedure
Title
Enhanced ability of MPT to stop atrial fibrillation
Description
Compare voltages at which MPT successfully terminated AF against a previous Cardialen AF study (CL001 / NCT02257112)
Time Frame
Acutely following MPT delivery
Title
Ability of MPT to stop atrial fibrillation
Description
Determine rate of conversion from AF to NSR
Time Frame
Acutely following MPT delivery

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female between 18 and 80 years of age Willing and able to comply with the study protocol, provide a written informed consent Currently indicated for atrial catheter ablation due to paroxysmal or early persistent atrial fibrillation Current treatment and compliance with standard anticoagulation regimen, including uninterrupted OAC, with acceptable coagulation status, as determined by the Principal Investigator Exclusion Criteria: The subject must not meet any of the following exclusion criteria: Life expectancy of 1 year or less AF due to reversible causes (e.g., hyperthyroidism, valve disease) History of DC Cardioversion which failed to convert to AF to Normal Sinus Rhythm Currently in AF for more than 3 months continuously Chronic, long-standing persistent, or permanent atrial fibrillation Allergy or contraindication to anticoagulation therapy Presence of intracardiac thrombus (confirmed with TEE or ICE) Existing Left Atrial Appendage closure device Severely Dilated Left Atrium >5cm LVEF<35% NYHA Class III or IV heart failure at the time of enrollment History of embolic stroke, Transient Ischemic Attack (TIA) or other thromboembolic event within the preceding 3 months. Known hyper-coagulable state that increases risk of thrombus History of myocardial infarction or coronary revascularization within the preceding 3 months. History of sustained ventricular arrhythmia or cardiac arrest Presence of chronically implanted lead in the CS Presence of ventricular assist device, including intra-aortic balloon pump Documented bradycardia (<40 BPM) at the time of the study Morbid obesity: BMI>39 kg/m2 Presence of any prosthetic cardiac valve History of significant tricuspid valvular disease requiring surgery Moderate to severe mitral valve regurgitation (>40% regurgitation fraction) Cognitive or mental health status that would interfere with study participation and proper informed consent Cardiovascular anatomical defects that would complicate placement of the stimulation leads required by the protocol, including congenital heart disease and cardiac vein anomalies per the Investigator's discretion Pregnancy confirmed by test within 7 days of procedure. Inability to pass catheters to heart due to vascular limitations Cardiovascular surgery or intervention within 1 month prior to enrollment or planned for up to 1 month after enrollment (other than the planned treatment procedure) Active endocarditis Any other medical condition which may affect the outcome of this study or safety of the subject as determined by the investigator History of hemodynamic compromise due to valvular heart disease Unstable CAD as determined by the investigator Severe proximal three-vessel or left main coronary artery disease without revascularization as determined by the investigator History of Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Dysplasia, Congenital Heart Anomaly, Cardiac Amyloidosis or Cardiac Sarcoidosis
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John D Hummel, MD
Organizational Affiliation
Ohio State University (OSU) Wexner Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Minneapolis Veterans Administration Hospital
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55417
Country
United States
Facility Name
The Ohio State University
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
24076284
Citation
Janardhan AH, Gutbrod SR, Li W, Lang D, Schuessler RB, Efimov IR. Multistage electrotherapy delivered through chronically-implanted leads terminates atrial fibrillation with lower energy than a single biphasic shock. J Am Coll Cardiol. 2014 Jan 7-14;63(1):40-8. doi: 10.1016/j.jacc.2013.07.098. Epub 2013 Sep 26.
Results Reference
background
PubMed Identifier
21980076
Citation
Li W, Janardhan AH, Fedorov VV, Sha Q, Schuessler RB, Efimov IR. Low-energy multistage atrial defibrillation therapy terminates atrial fibrillation with less energy than a single shock. Circ Arrhythm Electrophysiol. 2011 Dec;4(6):917-25. doi: 10.1161/CIRCEP.111.965830. Epub 2011 Oct 6.
Results Reference
background
PubMed Identifier
16945810
Citation
Efimov I, Ripplinger CM. Virtual electrode hypothesis of defibrillation. Heart Rhythm. 2006 Sep;3(9):1100-2. doi: 10.1016/j.hrthm.2006.03.005. Epub 2006 Mar 10. No abstract available.
Results Reference
background
PubMed Identifier
20969974
Citation
Ambrosi CM, Ripplinger CM, Efimov IR, Fedorov VV. Termination of sustained atrial flutter and fibrillation using low-voltage multiple-shock therapy. Heart Rhythm. 2011 Jan;8(1):101-8. doi: 10.1016/j.hrthm.2010.10.018. Epub 2010 Oct 19.
Results Reference
background

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MultiPulse Therapy (MPT) for AF (US)

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