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REVEAL AF: Incidence of AF in High Risk Patients

Primary Purpose

Atrial Fibrillation

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
REVEAL Implantable Cardiac Monitor
Sponsored by
Medtronic Cardiac Rhythm and Heart Failure
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional screening trial for Atrial Fibrillation

Eligibility Criteria

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

Inclusion Criteria:

  • Patient meets the approved indications to receive the Reveal ICM
  • Patient is suspected, based on symptomatology and/or demographics, of having atrial fibrillation or at high risk of having AF, as determined by the clinical investigator
  • Patient has a Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, prior Stroke or transient ischemic attack (TIA) or thromboembolism (doubled) (CHADS2) score ≥ 3 OR has a CHADS2 score = 2 with at least one of the following documented: renal impairment (GFR 30-60 ml/min), sleep apnea, coronary artery disease, or chronic obstructive pulmonary disease. Note: stroke/TIA criterion as part of the CHADS2 score for this trial is limited to either an ischemic stroke or TIA, which occurred more than one year prior to enrollment.
  • Patient is 18 years of age or older
  • Patient has a life expectancy of 18 months or more
  • Patient, or legally authorized representative, is willing to sign and date the consent form
  • Patient is willing and able to be remotely monitored (i.e., eligible for enrollment into the Medtronic CareLink Network)

Exclusion Criteria:

  • Patient has a documented history of AF or atrial flutter
  • Patient had an ischemic stroke or TIA within past year prior to enrollment
  • Patient has a history of a hemorrhagic stroke
  • Patient is currently implanted with an implantable pulse generator (IPG), implantable cardioverter defibrillator (ICD), cardiac resynchronization therapy pacemaker (CRT-P), or cardiac resynchronization therapy defibrillator (CRT-D) device
  • New York Heart Association (NYHA) Class IV Heart Failure patient
  • Patient had heart surgery within previous 90 days prior to enrollment
  • Patient had a myocardial infarction (MI) within the previous 90 days prior to enrollment
  • Patient is taking chronic immuno-suppressant therapy
  • Patient is taking an anti-arrhythmic drug
  • Patient is contraindicated for long term anticoagulation medication
  • Patient is taking a long-term anticoagulation medication
  • Any concomitant condition which, in the opinion of the investigator, would not allow safe participation in the study (e.g., drug addiction, alcohol abuse, emotional / psychological diagnosis)
  • Patient is enrolled in another study that could confound the results of this study, without documented pre-approval from Medtronic study manager
  • Patient has a creatinine clearance <30 ml/min or is on dialysis

Sites / Locations

  • Phoenix Heart, PLLC
  • Cardiovascular Consultants Heart Center
  • Desert Heart Rhythm Consultants
  • Healdsburg Cardiology
  • Nanticoke Cardiology
  • Bradenton Cardiology
  • The Cardiac & Vascular Institute
  • Cardiac Clinic
  • Northside Hospital
  • North Georgia Heart Foundation
  • Premier HealthCare
  • Cardiovascular Consultants PC (Munster IN)
  • The University Kansas Medical Center Research Institute Inc
  • Cardiovascular Consultants of Kansas
  • Delmarva Heart Research Foundation Inc
  • Minneapolis Heart Institute Foundation
  • Minneapolis VA Health Care System
  • Jackson Heart Clinic
  • Saint Louis University Hospital
  • Cox Medical Center South
  • Glacier View Research Institute Cardiology
  • CHI Health Cardiology (Bergen)
  • Englewood Hospital & Medical Center
  • Hackensack University Medical Center
  • The Valley Hospital
  • Lourdes Cardiology Services
  • Icahn School of Medicine at Mount Sinai
  • New York-Presbyterian Hospital/Columbia University Medical Center
  • Caromont Regional Medical Center
  • Saint Elizabeth Youngstown Hospital
  • Oklahoma Heart Hospital Research Foundation
  • Salem Cardiovascular Associates
  • The Heart Care Group PC (Allentown PA)
  • Lankenau Institute for Medical Research
  • South County Cardiology
  • Selcuk A. Tombul, D.O., F.A.C.C.
  • The Stern Cardiovascular Foundation
  • Sutherland Cardiology Clinic
  • Turkey Creek Medical Center
  • Baylor Heart & Vascular Hospital
  • Baylor Research Institute (Plano TX)
  • Woodlands North Houston Heart and Vein Center
  • ProHealth Care
  • LKH - Universitätsklinikum Graz
  • Allgemein öffentliches Krankenhaus der Elisabethinen Linz
  • Klinikum Coburg GmbH
  • Universitätsklinikum Düsseldorf
  • Universitätsmedizin Göttingen Georg-August-Universität
  • Asklepios Klinik Sankt Georg
  • Klinikum Lünen St.-Marien-Hospital GmbH - Akademisches Lehrkrankenhaus der Westfälischen Wilhelms-Un
  • Eberhard Karls Universität Tübingen - Universitätsklinikum Tübingen
  • Azienda Ospedaliera San Gerardo
  • Ospedale classificato ed equiparato Sacro Cuore - Don Calabria
  • Ospedale civile di Ciriè
  • Catharina Ziekenhuis
  • St. Antonius Ziekenhuis
  • University Medical Centre Ljubljana
  • Hospital Universitari de Tarragona Joan XXIII

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

REVEAL Implantable Cardiac Monitor

Arm Description

Outcomes

Primary Outcome Measures

18 Month Incidence Rate of Atrial Fibrillation (AF) Lasting Six or More Minutes
Incidence of adjudicated AF lasting six or more minutes at 18 months. Each arrhythmic episode detected by the patient's Reveal device will be reviewed to determine if it is 1) an actual atrial fibrillation episode, and (2) is at least 6 minutes in duration. The first such episode per patient occurring within 18 months will be utilized to determine the 18 month incidence rate.

Secondary Outcome Measures

Predictors of the Incidence of AF
AF will be defined as in the primary outcome. Baseline characteristics including demographics, medical history, and biomarkers at enrollment will be tested for their association with a patient's risk of developing AF.
Actions Taken in Response to Awareness of AF
Clinical actions taken in response to clinician awareness of a patient's AF onset or progression will be summarized

Full Information

First Posted
November 12, 2012
Last Updated
March 29, 2018
Sponsor
Medtronic Cardiac Rhythm and Heart Failure
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1. Study Identification

Unique Protocol Identification Number
NCT01727297
Brief Title
REVEAL AF: Incidence of AF in High Risk Patients
Official Title
REVEAL AF: Incidence of AF in High Risk Patients
Study Type
Interventional

2. Study Status

Record Verification Date
March 2018
Overall Recruitment Status
Completed
Study Start Date
November 13, 2012 (Actual)
Primary Completion Date
January 13, 2017 (Actual)
Study Completion Date
January 30, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medtronic Cardiac Rhythm and Heart Failure

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is to determine, through continuous monitoring with the Reveal implantable cardiac monitor (ICM), the incidence of atrial fibrillation (AF) in patients suspected to be at high risk for having AF and to understand how physicians manage these patients after AF has been detected. This study will also seek to identify what patient characteristics are most predictive of developing AF.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
REVEAL Implantable Cardiac Monitor
Arm Type
Other
Intervention Type
Device
Intervention Name(s)
REVEAL Implantable Cardiac Monitor
Primary Outcome Measure Information:
Title
18 Month Incidence Rate of Atrial Fibrillation (AF) Lasting Six or More Minutes
Description
Incidence of adjudicated AF lasting six or more minutes at 18 months. Each arrhythmic episode detected by the patient's Reveal device will be reviewed to determine if it is 1) an actual atrial fibrillation episode, and (2) is at least 6 minutes in duration. The first such episode per patient occurring within 18 months will be utilized to determine the 18 month incidence rate.
Time Frame
Implant to 18 months post device insertion
Secondary Outcome Measure Information:
Title
Predictors of the Incidence of AF
Description
AF will be defined as in the primary outcome. Baseline characteristics including demographics, medical history, and biomarkers at enrollment will be tested for their association with a patient's risk of developing AF.
Time Frame
Time from implant to date of last stored available device data (maximum of 30 months)
Title
Actions Taken in Response to Awareness of AF
Description
Clinical actions taken in response to clinician awareness of a patient's AF onset or progression will be summarized
Time Frame
Time from first identified episode of AF to study exit (maximum of 30 months)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient meets the approved indications to receive the Reveal ICM Patient is suspected, based on symptomatology and/or demographics, of having atrial fibrillation or at high risk of having AF, as determined by the clinical investigator Patient has a Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, prior Stroke or transient ischemic attack (TIA) or thromboembolism (doubled) (CHADS2) score ≥ 3 OR has a CHADS2 score = 2 with at least one of the following documented: renal impairment (GFR 30-60 ml/min), sleep apnea, coronary artery disease, or chronic obstructive pulmonary disease. Note: stroke/TIA criterion as part of the CHADS2 score for this trial is limited to either an ischemic stroke or TIA, which occurred more than one year prior to enrollment. Patient is 18 years of age or older Patient has a life expectancy of 18 months or more Patient, or legally authorized representative, is willing to sign and date the consent form Patient is willing and able to be remotely monitored (i.e., eligible for enrollment into the Medtronic CareLink Network) Exclusion Criteria: Patient has a documented history of AF or atrial flutter Patient had an ischemic stroke or TIA within past year prior to enrollment Patient has a history of a hemorrhagic stroke Patient is currently implanted with an implantable pulse generator (IPG), implantable cardioverter defibrillator (ICD), cardiac resynchronization therapy pacemaker (CRT-P), or cardiac resynchronization therapy defibrillator (CRT-D) device New York Heart Association (NYHA) Class IV Heart Failure patient Patient had heart surgery within previous 90 days prior to enrollment Patient had a myocardial infarction (MI) within the previous 90 days prior to enrollment Patient is taking chronic immuno-suppressant therapy Patient is taking an anti-arrhythmic drug Patient is contraindicated for long term anticoagulation medication Patient is taking a long-term anticoagulation medication Any concomitant condition which, in the opinion of the investigator, would not allow safe participation in the study (e.g., drug addiction, alcohol abuse, emotional / psychological diagnosis) Patient is enrolled in another study that could confound the results of this study, without documented pre-approval from Medtronic study manager Patient has a creatinine clearance <30 ml/min or is on dialysis
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James A Reiffel, MD
Organizational Affiliation
Columbia University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Phoenix Heart, PLLC
City
Glendale
State/Province
Arizona
ZIP/Postal Code
85306-1870
Country
United States
Facility Name
Cardiovascular Consultants Heart Center
City
Fresno
State/Province
California
ZIP/Postal Code
93720-3235
Country
United States
Facility Name
Desert Heart Rhythm Consultants
City
Palm Springs
State/Province
California
ZIP/Postal Code
92262
Country
United States
Facility Name
Healdsburg Cardiology
City
Windsor
State/Province
California
ZIP/Postal Code
95492
Country
United States
Facility Name
Nanticoke Cardiology
City
Seaford
State/Province
Delaware
ZIP/Postal Code
19973
Country
United States
Facility Name
Bradenton Cardiology
City
Bradenton
State/Province
Florida
ZIP/Postal Code
34205-8805
Country
United States
Facility Name
The Cardiac & Vascular Institute
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32605-4218
Country
United States
Facility Name
Cardiac Clinic
City
Kissimmee
State/Province
Florida
ZIP/Postal Code
34741
Country
United States
Facility Name
Northside Hospital
City
Saint Petersburg
State/Province
Florida
ZIP/Postal Code
33709
Country
United States
Facility Name
North Georgia Heart Foundation
City
Gainesville
State/Province
Georgia
ZIP/Postal Code
30501-3427
Country
United States
Facility Name
Premier HealthCare
City
Bloomington
State/Province
Indiana
ZIP/Postal Code
47403-3239
Country
United States
Facility Name
Cardiovascular Consultants PC (Munster IN)
City
Munster
State/Province
Indiana
ZIP/Postal Code
46321-4054
Country
United States
Facility Name
The University Kansas Medical Center Research Institute Inc
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160-8500
Country
United States
Facility Name
Cardiovascular Consultants of Kansas
City
Wichita
State/Province
Kansas
ZIP/Postal Code
67226
Country
United States
Facility Name
Delmarva Heart Research Foundation Inc
City
Salisbury
State/Province
Maryland
ZIP/Postal Code
21804-6951
Country
United States
Facility Name
Minneapolis Heart Institute Foundation
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55407-1195
Country
United States
Facility Name
Minneapolis VA Health Care System
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55417-2309
Country
United States
Facility Name
Jackson Heart Clinic
City
Jackson
State/Province
Mississippi
ZIP/Postal Code
39216-4634
Country
United States
Facility Name
Saint Louis University Hospital
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110-2539
Country
United States
Facility Name
Cox Medical Center South
City
Springfield
State/Province
Missouri
ZIP/Postal Code
65807-5251
Country
United States
Facility Name
Glacier View Research Institute Cardiology
City
Kalispell
State/Province
Montana
ZIP/Postal Code
59901
Country
United States
Facility Name
CHI Health Cardiology (Bergen)
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68124-2319
Country
United States
Facility Name
Englewood Hospital & Medical Center
City
Englewood
State/Province
New Jersey
ZIP/Postal Code
07631-1808
Country
United States
Facility Name
Hackensack University Medical Center
City
Hackensack
State/Province
New Jersey
ZIP/Postal Code
07601
Country
United States
Facility Name
The Valley Hospital
City
Ridgewood
State/Province
New Jersey
ZIP/Postal Code
07450-2726
Country
United States
Facility Name
Lourdes Cardiology Services
City
Voorhees
State/Province
New Jersey
ZIP/Postal Code
08043
Country
United States
Facility Name
Icahn School of Medicine at Mount Sinai
City
New York
State/Province
New York
ZIP/Postal Code
10029-6574
Country
United States
Facility Name
New York-Presbyterian Hospital/Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032-3725
Country
United States
Facility Name
Caromont Regional Medical Center
City
Gastonia
State/Province
North Carolina
ZIP/Postal Code
28054-2140
Country
United States
Facility Name
Saint Elizabeth Youngstown Hospital
City
Youngstown
State/Province
Ohio
ZIP/Postal Code
44504-1006
Country
United States
Facility Name
Oklahoma Heart Hospital Research Foundation
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73120
Country
United States
Facility Name
Salem Cardiovascular Associates
City
Salem
State/Province
Oregon
ZIP/Postal Code
97302
Country
United States
Facility Name
The Heart Care Group PC (Allentown PA)
City
Allentown
State/Province
Pennsylvania
ZIP/Postal Code
18103-6202
Country
United States
Facility Name
Lankenau Institute for Medical Research
City
Wynnewood
State/Province
Pennsylvania
ZIP/Postal Code
19096-3450
Country
United States
Facility Name
South County Cardiology
City
Wakefield
State/Province
Rhode Island
ZIP/Postal Code
02879-4253
Country
United States
Facility Name
Selcuk A. Tombul, D.O., F.A.C.C.
City
Chattanooga
State/Province
Tennessee
ZIP/Postal Code
37404
Country
United States
Facility Name
The Stern Cardiovascular Foundation
City
Germantown
State/Province
Tennessee
ZIP/Postal Code
38138-1727
Country
United States
Facility Name
Sutherland Cardiology Clinic
City
Germantown
State/Province
Tennessee
ZIP/Postal Code
38138-1760
Country
United States
Facility Name
Turkey Creek Medical Center
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37934
Country
United States
Facility Name
Baylor Heart & Vascular Hospital
City
Dallas
State/Province
Texas
ZIP/Postal Code
75226-1301
Country
United States
Facility Name
Baylor Research Institute (Plano TX)
City
Plano
State/Province
Texas
ZIP/Postal Code
75093-3691
Country
United States
Facility Name
Woodlands North Houston Heart and Vein Center
City
The Woodlands
State/Province
Texas
ZIP/Postal Code
77384-4167
Country
United States
Facility Name
ProHealth Care
City
Waukesha
State/Province
Wisconsin
ZIP/Postal Code
53188
Country
United States
Facility Name
LKH - Universitätsklinikum Graz
City
Graz
ZIP/Postal Code
8036
Country
Austria
Facility Name
Allgemein öffentliches Krankenhaus der Elisabethinen Linz
City
Linz
ZIP/Postal Code
4010
Country
Austria
Facility Name
Klinikum Coburg GmbH
City
Coburg
ZIP/Postal Code
96450
Country
Germany
Facility Name
Universitätsklinikum Düsseldorf
City
Düsseldorf
ZIP/Postal Code
40225
Country
Germany
Facility Name
Universitätsmedizin Göttingen Georg-August-Universität
City
Gottingen
ZIP/Postal Code
37075
Country
Germany
Facility Name
Asklepios Klinik Sankt Georg
City
Hamburg
ZIP/Postal Code
20099
Country
Germany
Facility Name
Klinikum Lünen St.-Marien-Hospital GmbH - Akademisches Lehrkrankenhaus der Westfälischen Wilhelms-Un
City
Lünen
ZIP/Postal Code
44534
Country
Germany
Facility Name
Eberhard Karls Universität Tübingen - Universitätsklinikum Tübingen
City
Tübingen
ZIP/Postal Code
72076
Country
Germany
Facility Name
Azienda Ospedaliera San Gerardo
City
Monza
ZIP/Postal Code
20090
Country
Italy
Facility Name
Ospedale classificato ed equiparato Sacro Cuore - Don Calabria
City
Negrar
ZIP/Postal Code
37024
Country
Italy
Facility Name
Ospedale civile di Ciriè
City
Torino
ZIP/Postal Code
10073
Country
Italy
Facility Name
Catharina Ziekenhuis
City
Eindhoven
ZIP/Postal Code
5623 EJ
Country
Netherlands
Facility Name
St. Antonius Ziekenhuis
City
Nieuwegein
ZIP/Postal Code
3430 EM
Country
Netherlands
Facility Name
University Medical Centre Ljubljana
City
Ljubljana
ZIP/Postal Code
1000
Country
Slovenia
Facility Name
Hospital Universitari de Tarragona Joan XXIII
City
Tarragona
ZIP/Postal Code
43007
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
31862084
Citation
Reiffel JA, Verma A, Kowey PR, Halperin JL, Gersh BJ, Elkind MSV, Ziegler PD, Kaplon RE, Sherfesee L, Wachter R; REVEAL AF Investigators. Rhythm monitoring strategies in patients at high risk for atrial fibrillation and stroke: A comparative analysis from the REVEAL AF study. Am Heart J. 2020 Jan;219:128-136. doi: 10.1016/j.ahj.2019.07.016.
Results Reference
derived
PubMed Identifier
28842973
Citation
Reiffel JA, Verma A, Kowey PR, Halperin JL, Gersh BJ, Wachter R, Pouliot E, Ziegler PD; REVEAL AF Investigators. Incidence of Previously Undiagnosed Atrial Fibrillation Using Insertable Cardiac Monitors in a High-Risk Population: The REVEAL AF Study. JAMA Cardiol. 2017 Oct 1;2(10):1120-1127. doi: 10.1001/jamacardio.2017.3180.
Results Reference
derived

Learn more about this trial

REVEAL AF: Incidence of AF in High Risk Patients

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