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MultiPulse Therapy (MPT) for AF

Primary Purpose

Atrial Fibrillation, Paroxysmal, Atrial Fibrillation, Persistent, Atrial Fibrillation

Status
Terminated
Phase
Not Applicable
Locations
Australia
Study Type
Interventional
Intervention
Multi Pulse Therapy
Sponsored by
Cardialen, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional device feasibility trial for Atrial Fibrillation, Paroxysmal

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 globally accepted risk stratification (CHA2DS2-VASc score) and the Principal Investigator

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<20%
  11. NYHA Class 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. No 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 investigators
  33. History of Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Dysplasia, Congenital Heart Anomaly, Cardiac Amyloidosis or Cardiac Sarcoidosis
  34. Any other condition which may affect the outcome of this study or safety of the subject as determined by the investigator

Sites / Locations

  • The Prince Charles Hospital
  • Gold Coast University Hospital
  • Greenslopes Private Hospital
  • Royal Adelaide Hospital
  • St. Andrews
  • Mulgrave Private Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Multi Pulse Therapy

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

To define the safety of MPT for the treatment of atrial fibrillation in subjects
Adverse Events from procedure and 30 day follow up.
Translation
Explore and enhance MPT parameters delivered in successful cases in a previous Cardialen AF study (CL001 / NCT02257112)
Translation
Determine MPT parameters relationships at which MPT terminates AF
Translation
Determine rate of conversion from AF to NSR after MPT delivery

Secondary Outcome Measures

Full Information

First Posted
October 23, 2019
Last Updated
October 7, 2022
Sponsor
Cardialen, Inc.
Collaborators
Iqvia Pty Ltd, Avania
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1. Study Identification

Unique Protocol Identification Number
NCT04206917
Brief Title
MultiPulse Therapy (MPT) for AF
Official Title
A Clinical Feasibility Study to Evaluate the Safety and Performance of Low-Energy Therapy in Patients With Atrial Fibrillation Energy Therapy in Patients With Atrial Fibrillation
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Terminated
Why Stopped
Sponsor ceasing operations
Study Start Date
March 19, 2020 (Actual)
Primary Completion Date
June 21, 2022 (Actual)
Study Completion Date
June 21, 2022 (Actual)

3. Sponsor/Collaborators

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

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
Product Manufactured in and Exported from the U.S.
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
Cardialen External Stimulation System (CESS) V1.0
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Multi Pulse Therapy
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
Other Intervention Name(s)
Unpinning Termination Therapy, Multi-stage therapy, Multi-stage electrotherapy, MultiPulse Therapy
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.
Primary Outcome Measure Information:
Title
To define the safety of MPT for the treatment of atrial fibrillation in subjects
Description
Adverse Events from procedure and 30 day follow up.
Time Frame
Study procedure and 30 day post procedure
Title
Translation
Description
Explore and enhance MPT parameters delivered in successful cases in a previous Cardialen AF study (CL001 / NCT02257112)
Time Frame
Study procedure
Title
Translation
Description
Determine MPT parameters relationships at which MPT terminates AF
Time Frame
Study procedure
Title
Translation
Description
Determine rate of conversion from AF to NSR after MPT delivery
Time Frame
Study procedure

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 globally accepted risk stratification (CHA2DS2-VASc score) and the Principal Investigator 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<20% NYHA Class 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) No 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 investigators History of Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Dysplasia, Congenital Heart Anomaly, Cardiac Amyloidosis or Cardiac Sarcoidosis Any other condition which may affect the outcome of this study or safety of the subject as determined by the investigator
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
PRASHANTHAN Sanders, MD
Organizational Affiliation
Royal Adelaide Hospital - Adelaide Medical School
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Prince Charles Hospital
City
Chermside
State/Province
Queensland
Country
Australia
Facility Name
Gold Coast University Hospital
City
Gold Coast
State/Province
Queensland
Country
Australia
Facility Name
Greenslopes Private Hospital
City
Greenslopes
State/Province
Queensland
ZIP/Postal Code
4120
Country
Australia
Facility Name
Royal Adelaide Hospital
City
Adelaide
State/Province
South Australia
ZIP/Postal Code
5000
Country
Australia
Facility Name
St. Andrews
City
Adelaide
State/Province
South Australia
Country
Australia
Facility Name
Mulgrave Private Hospital
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3170
Country
Australia

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

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