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Non-invasive Mapping of Rhythm Disorders (CARRY)

U

University Hospital of Bordeaux

Status

Completed

Conditions

Cardiac Rhythm Disorders

Treatments

Device: Cardioinsight® mapping system
Other: Conventional method without non-invasive mapping

Study type

Interventional

Funder types

Other

Identifiers

NCT02647749
CHUBX 2015/01

Details and patient eligibility

About

This current care protocol follows the biomedical research protocol entitled "Non-invasive mapping of the heart ECG high amplification" that demonstrated the clinical value of noninvasive Cardioinsight® mapping system.

Guide the management of patients hospitalized for cardiac rhythm radiofrequency ablation of cardiac arrhythmias, implantation or programming of a pacemaker, or assess the risk of serious arrhythmias or sudden death, with the currently used non-invasive mapping routine. The results obtained with non-invasive mapping will be compared with those obtained with the conventional method without non-invasive mapping.

Full description

This current care protocol is for 3 groups of patients :

  1. Role of mapping arrhythmias before radiofrequency ablation :

    Radiofrequency ablation is a treatment of atrial or ventricular arrhythmias resistant to drug treatment. The electrocardiogram does not allow a full diagnosis of arrhythmias and it appears difficult to get a comprehensive and simultaneous view of cardiac activity during invasive maps. The Investigators have demonstrated the feasibility of mapping atrial fibrillation and its usefulness to guide radiofrequency ablation. The non-invasive mapping would allow a better understanding of complex cardiac arrhythmias mechanism (atrial fibrillation, ventricular tachycardia and ventricular fibrillation in particular), would identify the arrhythmogenic sites and thus facilitate radiofrequency ablation.

  2. Optimizing the site of implantation of cardiac pacing leads and programming the pacemaker:

    The optimal position of the cardiac pacing leads may vary from one patient to another and the current choice of implantation sites is essentially guided by imaging and does not use power requirements because of the inadequacies of the ECG standard. The Investigators have already demonstrated the usefulness of non-invasive mapping in the selection of potential responders to cardiac resynchronization therapy. The non-invasive mapping would study the cardiac electrical activation in order to determine the optimal pacing sites and optimum programming according to each patient and thus improve the clinical response to pacing.

  3. Role diagnostic and prognostic for patients referred for evaluation of the risk of occurrence of a serious rhythm disorder or sudden death :

The possibility to identify electrically abnormal areas either during the activation, or during cardiac repolarization with the high-resolution ECG is an indication of myocardial pathology that can be both unapparent on standard ECG and inaccessible to imaging techniques (ultrasound, CT or MRI). It is likely that such electrical anomalies are early diagnostic features of heart disease that will later be apparent. Such anomalies can also have an adverse prognostic weight (risk of arrhythmias or sudden death) that can be corrected if it is highlighted. Non-invasive mapping seems particularly important in patients with unexplained symptoms by conventional tests (palpitations or discomfort - syncope). It will also be applicable to patients with heart disease (myocardial infarction, cardiomyopathy) in search of localized electrical disorders that can be an originating site of arrhythmia.

Enrollment

492 patients

Sex

All

Ages

15+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Oral agreement of the patient or of the holder of parental responsibility after reading the informed consent form.
  • Patients with the following 3 conditions :
  • Ablation of drugs rebels arrhythmias.
  • Or implantation or programming of a pacemaker (pacemaker or defibrillator)
  • Or symptoms and / or cardiopathy with risk of sudden death.

Exclusion criteria

  • Pregnancy and lactation.
  • Patients unable to give oral agreement.
  • Inconsistent patient's morphology with the establishment of the electrode jacket

Trial design

Primary purpose

Prevention

Allocation

Non-Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

492 participants in 6 patient groups

Group 1 : Cardiac rythm radiofrequency ablation
Experimental group
Description:
Prospective recruitment
Treatment:
Device: Cardioinsight® mapping system
Group 1: Implantation or programming of a pacemaker
Experimental group
Description:
Prospective recruitment
Treatment:
Device: Cardioinsight® mapping system
Group 1: Risk of serious arrhythmias or sudden death
Experimental group
Description:
Prospective recruitment
Treatment:
Device: Cardioinsight® mapping system
Group 2: Cardiac rythm radiofrequency ablation
Active Comparator group
Description:
Retrospective recruitment
Treatment:
Other: Conventional method without non-invasive mapping
Group 2 : Implantation or programming of a pacemaker
Active Comparator group
Description:
Retrospective recruitment
Treatment:
Other: Conventional method without non-invasive mapping
Group 2 : Risk of serious arrhythmias or sudden death
Active Comparator group
Description:
Retrospective recruitment
Treatment:
Other: Conventional method without non-invasive mapping

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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