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The Effect of Low LEVel TrAgus STimulation on the Electrophysiological Substrate of Patients With Ischemic CardioMyopathy Substrate of Subjects With Ischemic CardioMyopathy (ELEVATE-ICM)

Primary Purpose

Ischemic Cardiomyopathy

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Low level tragus stimulation
Sponsored by
University of Oklahoma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ischemic Cardiomyopathy focused on measuring ischemic cardiomyopathy; neuromodulation; repolarization alternans

Eligibility Criteria

18 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Ischemic cardiomyopathy (LVEF <35%) and heart failure
  2. Implantable device with an atrial lead (dual chamber ICD or CRT-D)
  3. Sinus rhythm at the time of the study

Exclusion Criteria:

  1. Recent (<6 months) stroke or myocardial infarction
  2. Persistent atrial fibrillation
  3. Recurrent vaso-vagal syncopal episodes
  4. Unilateral or bilateral vagotomy
  5. Pregnancy or breast feeding
  6. Uncontrolled diabetes or hypertension
  7. Sick sinus syndrome and 2nd or 3rd degree AV block (without a pacemaker)
  8. Bifascicular block or prolonged first degree block
  9. Hypotension due to autonomic dysfunction
  10. Inability or unwillingness to understand and/or sign informed consent

Sites / Locations

  • University of Oklahoma Health Sciences Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

low level tragus stimulation (LLTS)

Arm Description

Patients with ischemic cardiomyopathy (left ventricular ejection fraction <35%) and heart failure who already have an implantable device with an atrial lead (dual chamber defibrillator or biventricular defibrillator) will undergo sequentially 1. Sham LLTS (5min), 2. Active LLTS at 5Hz (15min) and 20Hz (15min) and 3. Active LLTS group with atrial pacing at 100bpm at 5Hz (15min) and 20Hz (15min).

Outcomes

Primary Outcome Measures

Repolarization alternans, an ECG measure for susceptibility to VT/VF
Repolarization alternans will be measured by analyzing a regular 12-lead ECG using a custom-made software

Secondary Outcome Measures

Full Information

First Posted
May 25, 2018
Last Updated
May 25, 2022
Sponsor
University of Oklahoma
Collaborators
Massachusetts General Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT03549468
Brief Title
The Effect of Low LEVel TrAgus STimulation on the Electrophysiological Substrate of Patients With Ischemic CardioMyopathy Substrate of Subjects With Ischemic CardioMyopathy
Acronym
ELEVATE-ICM
Official Title
The Effect of Low LEVel TrAgus STimulation on the Electrophysiological Substrate of Patients With Ischemic CardioMyopathy
Study Type
Interventional

2. Study Status

Record Verification Date
May 2022
Overall Recruitment Status
Completed
Study Start Date
May 25, 2018 (Actual)
Primary Completion Date
June 30, 2021 (Actual)
Study Completion Date
March 30, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Oklahoma
Collaborators
Massachusetts General Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Patients with ischemic cardiomyopathy (left ventricular ejection fraction <35%) and heart failure who already have an implantable device with an atrial lead (dual chamber defibrillator or biventricular defibrillator) will undergo sequentially 1. Sham low level tragus stimulation (LLTS) (5min), 2. Active LLTS at 5Hz (15min) and 20Hz (15min) and 3. Active LLTS group with atrial pacing at 100bpm at 5Hz (15min) and 20Hz (15min). The latter is required to examine the effect of LLTS on RA independent of heart rate. Repolarization alternans will be measured by analyzing a regular 12-lead ECG using a custom-made software.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ischemic Cardiomyopathy
Keywords
ischemic cardiomyopathy; neuromodulation; repolarization alternans

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
low level tragus stimulation (LLTS)
Arm Type
Experimental
Arm Description
Patients with ischemic cardiomyopathy (left ventricular ejection fraction <35%) and heart failure who already have an implantable device with an atrial lead (dual chamber defibrillator or biventricular defibrillator) will undergo sequentially 1. Sham LLTS (5min), 2. Active LLTS at 5Hz (15min) and 20Hz (15min) and 3. Active LLTS group with atrial pacing at 100bpm at 5Hz (15min) and 20Hz (15min).
Intervention Type
Device
Intervention Name(s)
Low level tragus stimulation
Intervention Description
All patients will undergo sequentially: sham stimulation; LLTS (5Hz), LLTS (20Hz). The sequence will be repeated during atrial pacing at 100bpm
Primary Outcome Measure Information:
Title
Repolarization alternans, an ECG measure for susceptibility to VT/VF
Description
Repolarization alternans will be measured by analyzing a regular 12-lead ECG using a custom-made software
Time Frame
during acute stimulation procedure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Ischemic cardiomyopathy (LVEF <35%) and heart failure Implantable device with an atrial lead (dual chamber ICD or CRT-D) Sinus rhythm at the time of the study Exclusion Criteria: Recent (<6 months) stroke or myocardial infarction Persistent atrial fibrillation Recurrent vaso-vagal syncopal episodes Unilateral or bilateral vagotomy Pregnancy or breast feeding Uncontrolled diabetes or hypertension Sick sinus syndrome and 2nd or 3rd degree AV block (without a pacemaker) Bifascicular block or prolonged first degree block Hypotension due to autonomic dysfunction Inability or unwillingness to understand and/or sign informed consent
Facility Information:
Facility Name
University of Oklahoma Health Sciences Center
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States

12. IPD Sharing Statement

Learn more about this trial

The Effect of Low LEVel TrAgus STimulation on the Electrophysiological Substrate of Patients With Ischemic CardioMyopathy Substrate of Subjects With Ischemic CardioMyopathy

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