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Cryoablation for Monomorphic Ventricular Tachycardia (CryoCure-VT)

Not Applicable
Active, not recruiting
Conditions
Monomorphic Ventricular Tachycardia
Interventions
Device: Ablation in the ventricles with the Adagio Medical VT Cryoablation System
Registration Number
NCT04893317
Lead Sponsor
Adagio Medical
Brief Summary

A prospective, single-arm, multi-center, pre-market, clinical study designed to provide safety and performance data regarding the use of the Adagio Medical VT Cryoablation System in the treatment of ventricular tachycardia.

Detailed Description

Study subjects will include patients who experience recurrent monomorphic VT and are scheduled for an endocardial VT ablation. Study subjects have or will have an Implantable Cardioverter Defibrillator (ICD) prior to hospital discharge following the cryoablation procedure.

A VT ablation procedure is performed by finding the abnormal ventricular heart tissue that is causing the VT and applying energy with an ablation catheter to the area. The goal is to apply energy to create a scar or destroy the tissue that causes the VT, such that VT is no longer present or inducible.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
64
Inclusion Criteria

IC 1 Male or female the ages of ≥ 18 years

IC 2 Eligible for a catheter ablation due to Ischemic and/or non-ischemic recurrent symptomatic sustained monomorphic Ventricular Tachycardia also defined as having a similar QRS configuration from beat to beat.

IC 3 Has or will be receiving an ICD prior to hospital discharge post procedure.

IC 4 Refractory to at least one AAD (Refractory is defined as an AAD not able to treat the arrhythmia satisfactorily or induces unwanted side effects).

IC 5 Subject has LVEF > 20%, confirmed by echo or comparable technique in the previous 3 months or during baseline evaluation

IC 6 Willingness, ability, and commitment to participate in baseline and follow-up evaluations for the full length of the study

IC 7 Willingness and ability to give an informed consent

Exclusion Criteria

EC 1 Any known objective contraindication to ventricular tachycardia ablation, TEE, or anticoagulation, including but not limited to the identification of any cardiac thrombus or evidence of sepsis

EC 2 Any duration of continuous arrythmia that is not monomorphic ventricular tachycardia. Multiple monomorphic tachycardia is acceptable, but polymorphic VT is not.

EC 3 Any VT ablation within 4 weeks prior to enrollment

EC 4 More than one prior (>4 weeks) Ventricular Tachycardia ablation or prior surgical treatment for ventricular tachycardia

EC 5 Ventricular tachycardia secondary to electrolyte imbalance, active thyroid disease, or any other reversible or non-cardiac cause

EC 6 Structural heart disease as described below:

  1. Class IV heart failure
  2. Aortic aneurysm
  3. Previous cardiac surgery or percutaneous coronary intervention within 60 days prior to the procedure
  4. Interatrial baffle, closure device, patch, or PFO occlusion device
  5. IVC filter
  6. Coronary artery bypass graft (CABG) procedure within six (6) months prior to the ablation procedure
  7. Severe Mitral or Aortic insufficiency or stenosis based on most recent TTE
  8. Cardiac myxoma
  9. Significant congenital anomaly
  10. Recent Myocardial Infarct (MI) or unstable angina, within 60 days prior to the ablation procedure
  11. Mechanical aortic or mitral valve

EC 7 Any previous history of cryoglobulinemia

EC 8 History of blood clotting or bleeding disease

EC 9 Any prior history of documented cerebral vascular accident (CVA), TIA or systemic embolism (excluding a post-operative Deep Vein Thrombosis, DVT), within 6 months prior to the ablation procedure.

EC 10 Breastfeeding, pregnant, or anticipated pregnancy during study follow-up

EC 11 Current enrollment in any other study protocol where testing or results from that study may interfere with the procedure or outcome measurements for this study

EC 12 Any other condition that, in the judgment of the investigator, makes the patient a poor candidate for this procedure, the study or compliance with the protocol (includes vulnerable patient population, mental illness, addictive disease, candidate for heart transplantation, patient with ventricular assist device, or terminal illness with a life expectancy less than 12 months)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Ablation in the ventricle with the Adagio VT cryoablation systemAblation in the ventricles with the Adagio Medical VT Cryoablation Systemall study subjects will receive an ablation procedure using the Adagio Medical VT Cryoablation System
Primary Outcome Measures
NameTimeMethod
Primary Endpoint for Clinical Performance6 month post cryoablation procedure

an analysis of the proportion of patients receiving a single cryoablation procedure with freedom from ventricular tachycardia lasting longer than 30 seconds or appropriate ICD intervention until the end of the 6 month follow up period.

Primary Endpoint for Safetyduring and 30 days post cryoablation procedure

An analysis of the proportion of subjects who are free from definite or probable device/procedure related Major Adverse Events (MAEs) that occur during or within 30 days following the cryoablation procedure

Primary Endpoint for Procedure Performanceat the end of the cryoablation procedure

an analysis of the proportion of subjects with non-inducible clinical monomorphic VT at the conclusion of the initial cryoablation procedure

Secondary Outcome Measures
NameTimeMethod
Performance - VT burden6 and 12 months post cryoablation procedure

Reduction of VT burden at 6 and 12 months

Descriptive Statistical Outcome - Hospitalization12 months post cryoablation procedure

Freedom from cardiovascular (CV) hospitalizations or CV-related ER visits through 12 months

Safety - freedom from procedure or device related SAE12 months post cryoablation procedure

The proportion of study subjects with probable or definite device or procedure related serious adverse events (SAEs) including MAEs as described above, or serious adverse device effects (SADEs) between 30-days up to 12 months post-procedure.

Performance - non-inducible sustained monomorphic VTat the end of the cryoablation procedure

The proportion of study subjects with non-inducible sustained monomorphic VT at the end of the ablation procedure

Performance - freedom from VT at 12-M off AADs12 months post cryoablation procedure

The proportion of study subjects with freedom from Ventricular Tachycardia lasting longer than 30 seconds at 12 months without the use of anti-arrhythmic drugs (AADs)

Performance - freedom from VT at 12-M on previously failed AADs12 months post cryoablation procedure

The proportion of study subjects with freedom from Ventricular Tachycardia lasting longer than 30 seconds at 12 months with previously failed anti-arrhythmic drugs (AADs)

Descriptive Statistical Outcome - procedure timeat the end of the cryoablation procedure

Total ablation time

Descriptive Statistical Outcome - ICD shocks12 months post cryoablation procedure

Number of appropriate and inappropriate ICD therapies (shocks and pacing) in the follow up period

Descriptive Statistical Outcome - ablation strategiesat the end of the cryoablation procedure

Mapping and ablation strategies utilized during the ablation procedure

Descriptive Statistical Outcome - cryoablation lesionsat the end of the cryoablation procedure

Number and location of cryoablation lesions

Descriptive Statistical Outcome - ablation timeat the end of the cryoablation procedure

Total ablation time

Descriptive Statistical Outcome - AADs use12 months post cryoablation procedure

Recording of the use of AADs in the follow up period

Descriptive Statistical Outcome - fluoroscopy timeat the end of the cryoablation procedure

Procedure fluoroscopy time

Descriptive Statistical Outcome - inducible VTsat the end of the cryoablation procedure

Number of inducible clinical VTs before and after cryoablation

Trial Locations

Locations (7)

St Antonius Ziekenhuis

🇳🇱

Nieuwegein, Netherlands

Onze Lieve Vrouwziekenhuis

🇧🇪

Aalst, Belgium

McGill University Health Centre

🇨🇦

Montréal, Canada

Montreal Hear Institute

🇨🇦

Montréal, Canada

CHU-Bordeaux, Pôle cardio-thoracique, Hôpital Haut-Lévêque

🇫🇷

Bordeaux, France

Herzzentrum Leipzig Universitätsklinik für Kardiologie

🇩🇪

Leipzig, Germany

Nemocnice na Homolce

🇨🇿

Prague, Czechia

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