Efficacy and Safety of Etripamil for the Termination of Spontaneous Paroxysmal Supraventricular Tachycardia (PSVT).
- Conditions
- Paroxysmal Supraventricular Tachycardia
- Interventions
- Registration Number
- NCT03464019
- Lead Sponsor
- Milestone Pharmaceuticals Inc.
- Brief Summary
This was a three-part, multi-center, randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of etripamil nasal spray (NS) self-administered by participants who experienced an episode of paroxysmal supraventricular tachycardia (PSVT) in an at-home setting.
NODE-301 Part 1 included participants that received the randomized study drug to treat an episode of PSVT until the 150th positively adjudicated PSVT episode. Part 2 (also referred as the RAPID study) included participants that did not receive the randomized study drug in Part 1 and newly enrolled participants until the 180th positively adjudicated PSVT episode in Part 2. The study continued for approximately 6 months after the 180th positively adjudicated PSVT episode in Part 2 and this extension is referred to as Part 3 (also referred to as RAPID Extension).
- Detailed Description
NODE-301 was a three-part, multi-center, randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of etripamil NS self-administered by participants who experienced an episode of PSVT in an at-home setting. Each episode was documented by an ambulatory Cardiac Monitoring System (CMS) that was placed on the chest by the participants or caregiver when symptoms begin and recorded at least 5 hours of continuous electrocardiogram (ECG).
This was an event-driven study. The study comprised of three parts: Parts 1, 2, and 3.
NODE-301 Part 1 included participants that received the randomized study drug to treat an episode of PSVT until the 150th positively adjudicated PSVT episode (January 15th, 2020). Participants were randomized to etripamil 70 mg or placebo in a 2:1 ratio. Participants had a Test Dose Randomization Visit where they received 70 mg etripamil in sinus rhythm and a Treatment Period during which they could administer the randomized study drug during a perceived episode of PSVT.
Part 2 (also referred as the RAPID study) included participants that did not use the randomized study drug to treat a perceived episode of PSVT before the Part 1 data cutoff and newly enrolled participants. Before randomization in the RAPID study, all participants received a Test Dose of etripamil consisting of an initial dose of etripamil 70 mg followed by a second dose of etripamil 70 mg 10 minutes later to evaluate tolerability and to train participants on the study procedures. After a successful Test Dose, participants in Part 2 were randomized to etripamil or placebo in a 1:1 ratio. When experiencing a PSVT episode, participants were instructed to administer a first dose of randomized study drug (70 mg etripamil or placebo) followed 10 minutes later, if PSVT symptoms persisted, by a second dose of study drug (70 mg etripamil or placebo). After having administered the randomized study drug for a perceived episode of PSVT, participants could enter an open-label period during which they had the possibility to treat a second episode of PSVT with open-label etripamil (70 mg etripamil with optional second dose of 70 mg etripamil).
Part 2 continued until the 180th positively adjudicated PSVT episode (the data on which the primary efficacy analysis of RAPID was conducted) (July 20th 2022). The study continued for approximately 6 months after the 180th positively adjudicated PSVT episode in Part 2 and this extension is referred to as Part 3 (also referred to as RAPID Extension). The design of Parts 2 and 3 were the same and therefore their results are combined in this publication.
NODE-301 study comprised 6 arms:
* 2 arms consisting of participants enrolled in Part 1 that treated a perceived episode of PSVT with randomized study drug (etripamil NS 70 mg or placebo) in a 2:1 ratio.
* 1 arm consisting of participants that only received the Test Dose in Part 1.
* 2 arms consisting of participants enrolled in Parts 2 and 3 that treated a perceived episode of PSVT with randomized study drug (etripamil NS 70 mg with optional second dose of 70 mg etripamil or placebo) in a 1:1 ratio and could be enrolled in the open-label period to treat an additional PSVT episode with etripamil
* 1 arm consisting of participants that only received the Test Dose in Parts 2 and 3.
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 1097
Participants who met all of the following criteria were eligible to participate in the study:
-
Male or female participants at least 18 years of age;
-
Electrographically documented history of PSVT (e.g., electrocardiogram [ECG] obtained during an episode of PSVT, Holter monitoring, loop recorder, etc). If participant had a prior ablation for PSVT, participant had to have documented ECG evidence of PSVT post-ablation;
-
History of sustained episodes of PSVT (i.e., typically lasting approximately 20 minutes or longer);
-
Females of childbearing potential who were sexually active with a male partner who were not surgically sterile (i.e., vasectomy) had to agree to use a highly effective form of contraception from the time of signed informed consent until 30 days after the last administration of study drug. Females of childbearing potential had to have a negative serum pregnancy test result at the Screening Visit and at the Final Study Visit, a negative urine pregnancy test at the Test Dose Randomization Visit and had to use a highly effective form of contraception between the visits.
The following categories defined females who were NOT considered to be of childbearing potential:
-
Premenopausal females with 1 of the following:
- Documented hysterectomy,
- Documented bilateral salpingectomy or tubal ligation; or
- Documented bilateral oophorectomy, or
-
Postmenopausal females, defined as having amenorrhea for at least 12 months without an alternative medical cause;
-
-
Male participants, except those who were surgically sterile, had to use an approved highly effective form of contraception during the 3 days after any study drug administration; and
-
Signed written informed consent.
Participants who met any of the following criteria were excluded from participation in the study:
- Systolic blood pressure <90 mmHg after a 5-minute rest in sitting position at the Screening Visit or before the Test Dose. In participants treated with a chronic prophylactic drug for PSVT (e.g., beta-blockers, verapamil, and diltiazem), the drug could be stopped for at least the equivalent of 5 half-lives, participants could be rescreened once, and chronic use of the drug could not be restarted after randomization;
- History of severe symptoms of hypotension, especially syncope, during episodes of PSVT;
- History of atrial arrhythmia that did not involve the AV node as part of the tachycardia circuit (e.g., atrial fibrillation, atrial flutter, intra-atrial tachycardia);
- History of allergic reaction to verapamil;
- Current therapy with digoxin or any Class I or III antiarrhythmic drug, except if these drugs were stopped at least the equivalent of 5 half-lives before the Test Dose Randomization Visit;
- Current chronic therapy with oral amiodarone, or had taken oral amiodarone within 30 days prior to the Test Dose Randomization Visit;
- Evidence of ventricular pre-excitation (e.g., delta waves, short PR interval <100 msec, Wolff-Parkinson-White syndrome) on the ECG performed at the Screening Visit or before the Test Dose administration;
- Evidence of a second- or third-degree AV block on the ECG performed at the Screening Visit or before the Test Dose administration;
- History or evidence of severe ventricular arrhythmia (e.g., torsades de pointes, ventricular fibrillation, or ventricular tachycardia);
- Current congestive heart failure defined by the New York Heart Association Class II to IV;
- History of Acute Coronary Syndrome or stroke within 6 months of screening;
- Evidence of hepatic dysfunction defined as alanine aminotransferase or aspartate aminotransferase >3 × the upper limit of normal (ULN) or total bilirubin >2 × ULN at the Screening Visit, unless due to Gilbert syndrome;
- Evidence of End-Stage Renal Disease as determined by an estimated glomerular filtration rate assessed at the Screening Visit of <15 mL/min/1.73m2, or requiring hemodialysis;
- Females who were pregnant or lactating;
- Evidence or history of any significant physical or psychiatric condition including drug abuse, which, in the opinion of the Investigator, could jeopardize the safety of participants, or affect their participation in the study. Additionally, the Investigator had the ability to exclude a participant if for any reason the Investigator judged the participant was not a good candidate for the study or would not be able to follow study procedures;
- Participation in any investigational drug or device study or the use of any investigational drug or device within 30 days of the Screening Visit; or
- Previously enrolled in a clinical trial for etripamil and received study drug during a perceived episode of PSVT.
Before randomization in the study, all participants received a Test Dose of an etripamil NS dosing regimen (etripamil 70 NS mg in Part 1 and in Parts 2 and 3 an initial dose of etripamil NS 70 mg followed by a second dose of etripamil NS 70 mg not earlier than 10 minutes and not later than 15 minutes after the first dose) to evaluate tolerability and to train participants on the study procedures. Participants who passed the Test Dose were randomized in the NODE-301 (2:1) or RAPID and RAPID Extension (2:1) study. A failure of the Test Dose was considered if participants met any of the following criteria occurring after administration of the either the first or second dose of etripamil NS 70 mg:
-
Any symptoms consistent with clinically severe hypotension such as pre-syncope, medically significant lightheadedness, syncope, nausea, or vomiting;
-
For participants with a pre-Test Dose Systolic Blood Pressure above 100 mmHg:
- Decrease in SBP ≥40 mmHg after Test Dose; or
- Post-Test Dose SBP <80 mmHg;
-
For participants with a pre-Test Dose SBP between 90 mmHg and 100 mmHg (inclusive):
a) Post-Test Dose SBP <75 mmHg;
-
Third-degree AV block, Mobitz II second-degree AV block, or Wenckebach with bradycardia ≤40 bpm;
-
New, significant sinus bradycardia Heart Rate ≤40 bpm or sinus pauses (≤3 seconds), if considered by the Investigator to put the participant's safety at risk if either were to occur while not under medical supervision;
-
Any new ventricular arrhythmia considered significant by the Investigator; or
-
Atrial fibrillation, atrial flutter or atrial tachycardia (event lasting longer than 30 seconds);
-
Refusal of second dose of etripamil Test Dose regimen.
Participants who failed the Test Dose proceeded in the study as follows:
- If the Investigator identified a possible reversible cause of the initial Test Dose failure (e.g., concomitant medication such as beta-blocker), a re-challenge with a new Test Dose of etripamil dose regimen was possible after elimination of the reversible cause (e.g., withdrawal of concomitant therapy with the appropriate washout period). Participants could be randomized if they passed the second Test Dose and the cause of the Test Dose failure was eliminated for the duration of the study; or
- If the Investigator could not identify a reversible cause of the initial Test Dose failure, or if the potential cause could not be modified (e.g., necessary antihypertensive drug to control blood pressure), participants could not be randomized and completed a Final Study Visit. Participants who failed the Test Dose are part of the Test Dose Only Population.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Part 1: Placebo Single Dose Placebo Self-administration of a single dose of placebo for a perceived episode of PSVT. Part 1: Test dose only (etripamil 70 mg) Etripamil Test Dose Single test dose of etripamil 70 mg in sinus rhythm Part 2 & Part 3: Etripamil 70 mg with Optional Second Dose Etripamil Self-administration of 70 mg etripamil for a perceived episode of PSVT followed 10 minutes later by an optional second dose of 70 mg etripamil, if symptoms persisted. Participants could be enrolled in the open-label period to treat an additional PSVT episode with etripamil. Part 2 & Part 3: Placebo with Optional Second Dose Placebo Self-administration of placebo for a perceived episode of PSVT followed 10 minutes later by an optional second dose of placebo, if symptoms persisted. Participants could be enrolled in the open-label period to treat an additional PSVT episode with etripamil. Part 2 & Part 3: Test dose only (etripamil 70 mg + 70 mg) Etripamil Test Dose Repeat Test Dose of etripamil 70 mg (2X 70mg) 10 minutes apart in sinus rhythm Part 1: Etripamil 70 mg Single Dose Etripamil Self-administration of a single dose etripamil 70 mg for a perceived episode of PSVT.
- Primary Outcome Measures
Name Time Method The Time to Conversion of an Episode of PSVT to Sinus Rhythm (SR) After Study Drug Administration. NODE-301 Part 1: Within 5 hours of start of study drug dosing. NODE-301 Parts 2 and 3: Within 30 minutes of start of study drug dosing. The primary efficacy endpoint is defined as an adjudicated termination of a positively adjudicated episode of PSVT (AV nodal reentrant tachycardia or AV reentrant tachycardia determination if possible) and conversion to sinus rhythm (SR) for at least 30 seconds within 5 hours (NODE-301 Part 1), or 30 minutes (NODE-301 Parts 2 and 3) of start of study drug dosing.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (161)
Cardiology Associates of Fairfield County
🇺🇸Norwalk, Connecticut, United States
St. Michael's Hospital
🇨🇦Toronto, Ontario, Canada
The Ohio State University (OSU) Wexner Medical Center
🇺🇸Columbus, Ohio, United States
Baylor College of Medicine
🇺🇸Houston, Texas, United States
United Health Research, LLC
🇺🇸Miami, Florida, United States
Hatton Institute for Research & Education, Trihealth, Inc. - Cardiology
🇺🇸Cincinnati, Ohio, United States
Slingeland Ziekenhuis
🇳🇱Doetinchem, Netherlands
Ziekenhuis Gelderse Vallei
🇳🇱Ede, Netherlands
Franciscus Gasthuis & Vlietland - Locatie Vlietland
🇳🇱Schiedam, Netherlands
Diakonessenhuis - Locatie Utrecht
🇳🇱Utrecht, Netherlands
Samodzielny Publiczny Zaklad Opieki Zdrowotnej Centralny Szpital Kliniczny, Uniwersytetu Medycznego w Lodzi
🇵🇱Łódź, Lodz, Poland
NZOZ Pro Cordis Sopockie Centrum Badan Kardiologicznych
🇵🇱Sopot, Poland
Osrodek Badan Klinicznych CLINSANTE S.C.
🇵🇱Toruń, Poland
Vancouver Coastal Health Research
🇨🇦Vancouver, British Columbia, Canada
Medical Arts Health Research Group - North Vancouver
🇨🇦North Vancouver, British Columbia, Canada
Debreceni Egyetem Klinikai
🇭🇺Debrecen, Hungary
Victoria Cardiac Arrhythmia Trials, Inc.
🇨🇦Victoria, British Columbia, Canada
Del-pesti Centrumkorhaz
🇭🇺Budapest, Hungary
CRU Hungary Kft.
🇭🇺Encs, Hungary
Libin Cardiovascular Institute of Alberta - University of Calgary
🇨🇦Calgary, Alberta, Canada
Cambridge Cardiac Care Centre
🇨🇦Cambridge, Ontario, Canada
Dr Lakatos Ferenc Belgyogyaszati-Kardiologiai Maganrendelo
🇭🇺Bekescsaba, Bekescaba, Hungary
The Montreal Heart Institute
🇨🇦Montreal, Quebec, Canada
Kardiologische Praxis
🇩🇪Dresden, Germany
Maerkische Gesundheitsholding GmbH - Klinikum Luedenscheid
🇩🇪Lüdenscheid, Ludenscheid, Germany
FAZ Dresden-Neustadt GbR
🇩🇪Dresden, Germany
Centre Hospitalier de Pau
🇫🇷Pau, France
Intermountain Medical Center
🇺🇸Murray, Utah, United States
CIUSSS de l'Estrie - CHUS
🇨🇦Sherbrooke, Quebec, Canada
Magyar Honvedseg Egeszsegugyi Kozpont
🇭🇺Budapest, Hungary
HCL Hopital Louis Pradel
🇫🇷Bron, France
Hopital Saint-Louis de La Rochelle
🇫🇷La Rochelle, France
Vivantes Klinikum Neukoelln
🇩🇪Berlin, Germany
Peter Osypka Herzzentrum Munchen
🇩🇪München, Munchen, Germany
CardioVasc HR
🇨🇦Saint-Jean-sur-Richelieu, Quebec, Canada
Clinique Du Sud- Luxembourg
🇧🇪Arlon, Belgium
CHU Grenoble-Alpes - Hopital Michallon
🇫🇷La Tronche, Grenoble, France
McGill University Health Center - Research Institute
🇨🇦Montréal, Quebec, Canada
Nehezlegzes Ambulancia
🇭🇺Debrecen, Debrecon, Hungary
Belvarosi Egeszseghaz
🇭🇺Zalaegerszeg, Hungary
Tergooiziekenhuizen Blaricum
🇳🇱Blaricum, Netherlands
Reinier de Graaf Gasthuis
🇳🇱Delft, Netherlands
CHU de Lille - Institut Cœur Poumon
🇫🇷Lille, France
Kliniczny Szpital Wojewódzki nr 2, Rzeszów
🇵🇱Rzeszów, Rzeszow, Poland
Hospital Universitari de Bellvitge
🇪🇸Barcelona, Spain
Instytut Centrum Zdrowia Matki Polki
🇵🇱Łódź, Lodz, Poland
Ziekenhuis Rijnstate - Locatie Arnhem
🇳🇱Arnhem, Netherlands
MEDICOME Sp. z o.o.
🇵🇱Oswiecim, Poland
SP ZOZ Szpital Specjalistyczny w Pulawach
🇵🇱Puławy, Poland
Hospital Clinico Universitario Virgen de la Arrixaca
🇪🇸El Palmar, Murcia, Spain
Maastricht University Medical Center
🇳🇱Maastricht, Netherlands
MICS Centrum Medyczne Torun
🇵🇱Bydgoszcz, Poland
Kardiosystem
🇵🇱Warsaw, Poland
Complejo Hospitalario Universitario de Granada - Hospital Universitario Virgen de las Nieves
🇪🇸Granada, Spain
Hospital Alvaro Cunqueiro
🇪🇸Vigo, Pontevedra, Spain
Gabinety Daszmed
🇵🇱Kraków, Krakov, Poland
Deventer Ziekenhuis
🇳🇱Deventer, Netherlands
Centrum Medyczne Kermed
🇵🇱Bydgoszcz, Poland
Specjalistyczna Praktyka Lekarska
🇵🇱Katowice, Poland
Alrijne Ziekenhuis
🇳🇱Leiderdorp, Netherlands
Hospital Universitari Sant Joan de Reus
🇪🇸Reus, Spain
Prywatny Specjalistyczny Gabinet Internistyczny
🇵🇱Libiąż, Poland
X Oddzial Kardiologii Inwazyjnej, Elektrofizjologii i Elektrostymulacji
🇵🇱Tychy, Poland
Hospital General Universitario de Alicante
🇪🇸Alicante, Spain
Jeroen Bosch Ziekenhuis
🇳🇱Utrecht, Netherlands
Hospital Clinico Universitario de Valencia
🇪🇸Valencia, Spain
Institut Universitaire de Cardiologie et de Pneumologie De Quebec
🇨🇦Québec, Quebec, Canada
CSSS du Sud de Lanaudiere - Hopital Pierre Le Gardeur
🇨🇦Terrebonne, Quebec, Canada
Kardiologische Gemeinschaftspraxis Papenburg
🇩🇪Papenburg, Germany
Zentrum fuer Praevention und Rehabilitation
🇩🇪Siegen, Germany
Hospital General Universitario Gregorio Maranon
🇪🇸Madrid, Spain
Hospital Universitario Vall d'Hebron
🇪🇸Barcelona, Spain
Hospital Universitario La Paz
🇪🇸Madrid, Spain
Hospital Universitario Puerta de Hierro
🇪🇸Majadahonda, Spain
Complejo Hospitalario de Navarra
🇪🇸Pamplona, Spain
Hospital Universitario la Paz Rua Choupana
🇪🇸Santiago De Compostela, Spain
Hospital Universitario Virgen Macarena
🇪🇸Sevilla, Spain
Hospital Universitario Virgen del Rocio
🇪🇸Sevilla, Spain
Hospital Universitario Clínico Lozano Blesa
🇪🇸Zaragoza, Spain
Arizona Arrhythmia Research Center
🇺🇸Phoenix, Arizona, United States
Arkansas Cardiology
🇺🇸Little Rock, Arkansas, United States
Medvin Clinical Research
🇺🇸Cerritos, California, United States
University of Arkansas for Medical Sciences
🇺🇸Little Rock, Arkansas, United States
Titan Medical Research - Oceanside
🇺🇸Encinitas, California, United States
North Coast Cardiolog
🇺🇸Encinitas, California, United States
Amicis Research Center - Northridge
🇺🇸Northridge, California, United States
Los Alamitos Cardiovascular
🇺🇸Los Alamitos, California, United States
FWD Clinical Research
🇺🇸Boca Raton, Florida, United States
South Denver Cardiology Associates, P.C
🇺🇸Littleton, Colorado, United States
RESPIRE Research
🇺🇸Palm Springs, California, United States
Piedmont Heart Institute-Fayetteville
🇺🇸Fayetteville, Georgia, United States
St. Luke's Idaho Cardiology Associates
🇺🇸Boise, Idaho, United States
Baptist Health Ambulatory Services d/b/a
🇺🇸Jacksonville, Florida, United States
Idaho Catalyst Clinical Research
🇺🇸Idaho Falls, Idaho, United States
IACT Health
🇺🇸Columbus, Georgia, United States
AMITA Health Medical Group Heart & Vascular Elk Grpve Village
🇺🇸Elk Grove Village, Illinois, United States
Piedmont Heart Institute- Fayetteville
🇺🇸Fayetteville, Georgia, United States
Georgia Arrythmia Consultants&Research Institute
🇺🇸Macon, Georgia, United States
Parkview Physicians Group - Cardiology
🇺🇸Fort Wayne, Indiana, United States
Mercy One Iowa Heart Center
🇺🇸West Des Moines, Iowa, United States
Clinical Trials of America, LLC - Monroe, LA
🇺🇸West Monroe, Louisiana, United States
Sparrow Clinical Research Institute
🇺🇸Lansing, Michigan, United States
MedStar Health Research Institute - Chesapeake Cardiovascular Associates
🇺🇸Baltimore, Maryland, United States
Mercy Research
🇺🇸Saint Louis, Missouri, United States
Atlantic Health System - Morristown Medical Center
🇺🇸Morristown, New Jersey, United States
Revival Research Institute, LLC - Southgate, MI
🇺🇸Southgate, Michigan, United States
Cardiovascular Associates of the Delaware Valley - Elmer
🇺🇸Elmer, New Jersey, United States
Columbia University
🇺🇸New York, New York, United States
Cardiovascular Associates of the Delaware Valley
🇺🇸Haddon Heights, New Jersey, United States
Cary Research Group, LLC
🇺🇸Cary, North Carolina, United States
Sanger Heart and Vascular Institute
🇺🇸Charlotte, North Carolina, United States
New York Presbyterian Hospital/Weill Cornell Medical Center
🇺🇸New York, New York, United States
The Presbyterian Hospital DBA Novant Health Heart and Vascular Institute
🇺🇸Charlotte, North Carolina, United States
Rama Research LLC
🇺🇸Marion, Ohio, United States
ProMedica Toledo Hospital
🇺🇸Toledo, Ohio, United States
Heart House Research Foundation, LLC
🇺🇸Springfield, Ohio, United States
Prisma Health Midlands
🇺🇸Columbia, South Carolina, United States
North Texas Research Associates
🇺🇸Allen, Texas, United States
Monument Health Clinical Research, a department of Monument Health Rapid City Hospital, Inc
🇺🇸Rapid City, South Dakota, United States
Revival Research Institute, LLC
🇺🇸Denton, Texas, United States
Cardiovascular Clinic of North Texas
🇺🇸Denton, Texas, United States
Apex Trials Group
🇺🇸Fort Worth, Texas, United States
Angiocardiac Care of Texas
🇺🇸Houston, Texas, United States
Scott & White Memorial Hospital: Baylor Scott & White Research Institute
🇺🇸Temple, Texas, United States
Bay Area Heart
🇺🇸Webster, Texas, United States
Imelda Hospital
🇧🇪Bonheiden, Belgium
Antwerp University Hospital (UZA)
🇧🇪Edegem, Belgium
Regional Hospital Centre Citadelle
🇧🇪Liège, Belgium
CHU Ambroise Pare
🇧🇪Mons, Belgium
University Hospital (UZ) Leuven
🇧🇪Leuven, Belgium
Dalhousie University - QEII Health Sciences Centre
🇨🇦Halifax, Nova Scotia, Canada
Dawson Road Medical Centre
🇨🇦Guelph, Ontario, Canada
University of Manitoba, St Boniface General Hospital
🇨🇦Winnipeg, Manitoba, Canada
Partners in Advanced Cardiac Evaluation (PACE) Cardiology Clinic
🇨🇦Newmarket, Ontario, Canada
Hamilton Health Sciences
🇨🇦Hamilton, Ontario, Canada
CHUM Recherche Cardiologie
🇨🇦Montreal, Quebec, Canada
London Health Sciences Centre
🇨🇦London, Ontario, Canada
CHRU Besancon - Hopital Jean Minjoz
🇫🇷Besançon, Besancon, France
CHRU de Brest - Hopital de la Cavale Blanche
🇫🇷Brest, France
Meander Medisch Centrum - Locatie Amersfoort
🇳🇱Amersfoort, Netherlands
IJsselland ziekenhuis
🇳🇱Capelle Aan Den IJssel, Netherlands
Rode Kruis Ziekenhuis
🇳🇱Beverwijk, Netherlands
Amphia Ziekenhuis - Locatie Breda Molengracht
🇳🇱Breda, Netherlands
Treant Zorggroep
🇳🇱Hoogeveen, Netherlands
Ropcke-Zweers Ziekenhuis
🇳🇱Hardenberg, Netherlands
American Heart of Poland S.A., IV Oddzial Kardiologii Inwazyjnej, Elektrostymulacji i Angiologii
🇵🇱Kędzierzyn-Koźle, Kedzierzyn Kozle, Poland
Hospital Universitario Reina Sofia
🇪🇸Córdoba, Cordoba, Spain
Hospital Germans Trias i Pujol
🇪🇸Badalona, Barcelona, Spain
Martínez Hervás Cardiólogos
🇪🇸Granada, Andalucia, Spain
Hospital General Universitario de Valencia (HGUV)
🇪🇸Valencia, Comunidad Valenciana, Spain
Hospital Universitario Virgen de la Victoria
🇪🇸Málaga, Malaga, Spain
Hospital de la Santa Creu i Sant Pau
🇪🇸Barcelona, Spain
Hospital Universitario Central de Asturias
🇪🇸Oviedo, Spain
Universite Libre de Bruxelles (ULB) - Hopital Erasme
🇧🇪Bruxelles, Belgium
CHU UCL Namur - Site Godinne
🇧🇪Yvoir, Belgium
Grand Hopital de Charleroi (GHdC) - Site Saint-Joseph
🇧🇪Gilly, Belgium
Pharmacy Campus Virga Jesse (losplaats 7)
🇧🇪Hasselt, Belgium
UVC Brugmann University Hospital - Centre Hospitalier Universitaire (CHU)
🇧🇪Bruxelles, Belgium
Medical University of South Carolina (MUSC)
🇺🇸Charleston, South Carolina, United States
Royal Alexandra Hospital
🇨🇦Edmonton, Alberta, Canada
Montefiore Medical Center
🇺🇸Bronx, New York, United States