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Predicting Arrhythmogenic Risk in Congenital Heart Patients: the PRECISION Study

Not Applicable
Terminated
Conditions
Congenital Heart Disease
Arrhythmia in Children
Interventions
Diagnostic Test: Provocative electrophysiology study
Registration Number
NCT04768634
Lead Sponsor
Boston Children's Hospital
Brief Summary

In this research study we want to learn more about abnormal heart rhythm after cardiac surgery in children. These abnormal heart rhythms, also called arrhythmias, may occur due to several reasons after cardiac surgery. They can be due to abnormal electrical pathway or an irritable area of the heart that stimulates abnormal impulses. Regardless of the cause, arrhythmias after cardiac surgery can be a problem, extending the hospital stay, requiring additional medications and even leading to cardiac arrest.

Current practice is to monitor for arrhythmias after cardiac surgery, and to treat them if they occur. With this research, we want to investigate whether we can identify patients who will develop arrhythmia, and treat them before they occur.

Detailed Description

This is a prospective, randomized controlled trial of provocative electrophysiology testing and prophylactic treatment of inducible SVT versus expectant management

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
46
Inclusion Criteria
  • Patients aged < 18 years of age on admission to the cardiac intensive care unit following cardiac surgery with a predicted probability of supraventricular tachycardia >10%
Exclusion Criteria
  • Patients following orthotopic heart transplant, ventricular assist device implantation, primary extracorporeal membrane oxygenation cannulation, pacemaker or implantable cardioverter-defibrillator implantation or sympathectomy
  • Patients on antiarrhythmic medication at the time of surgery
  • Patients with atrioventricular conduction disease (1st degree atrioventricular block with PR interval greater than 200 ms, 2nd degree atrioventricular block or complete heart block)
  • Patients with severe ventricular dysfunction in whom therapy with beta-blocker or sotalol is deemed contra-indicated by the primary team
  • Patients with absent or non-functioning atrial pacing wires

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
TestingProvocative electrophysiology studyPatients will undergo provocative electrophysiology testing, and antiarrhythmic medication considered if arrhythmias can be induced.
Primary Outcome Measures
NameTimeMethod
Number of patients with supraventricular tachycardiaThrough hospital discharge after cardiac surgery, or up to 90 days

Number of days post-operatively at time of supraventricular tachycardia

Secondary Outcome Measures
NameTimeMethod
Number of days post-operatively in the intensive care unitThough hospital discharge
Number of patients with adverse events related to antiarrhythmic treatmentThrough hospital discharge after cardiac surgery, or up to 90 days
Number of patients with supraventricular tachycardia after hospital discharge12 months
Number of patients with sustained supraventricular tachycardiaThrough hospital discharge after cardiac surgery, or up to 90 days

Number of days post-operatively at time of sustained supraventricular tachycardia

Number of patients with other tachyarrhythmiasThrough hospital discharge after cardiac surgery, or up to 90 days
Number of days post-operatively at time of extubationThrough hospital discharge after cardiac surgery, or up to 90 days
Number of patients with major adverse cardiac events (including need for CPR, ECMO or death)Through hospital discharge after cardiac surgery, or up to 90 days
Number of patients with adverse events related to provocative electrophysiology testingThrough hospital discharge after cardiac surgery, or up to 90 days
Number of days in the hospitalThrough hospital discharge after cardiac surgery, or up to 90 days

Trial Locations

Locations (1)

Boston Children's Hospital

🇺🇸

Boston, Massachusetts, United States

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