AdaptResponse Clinical Trial
- Conditions
- Heart Failure With Left Bundle Branch Block
- Interventions
- Device: aCRT ONDevice: aCRT OFF
- Registration Number
- NCT02205359
- Lead Sponsor
- Medtronic Cardiac Rhythm and Heart Failure
- Brief Summary
The purpose of this clinical study is to test the hypothesis that market released Cardiac Resynchronization Therapy (CRT) devices which contain the AdaptivCRT® (aCRT) algorithm have a superior outcome compared to standard CRT devices in CRT indicated patients with normal atrio-ventricular (AV) conduction and left bundle branch block (LBBB).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 3797
- Subject is willing to sign and date the study Patient Informed Consent Form.
- Subject is indicated for a CRT device according to local guidelines.
- Sinus Rhythm at time of enrollment
- Complete Left Bundle Branch Block (LBBB) as documented on an ECG (within 30 days prior to enrollment). Strauss Criteria used for LBBB.
- Intrinsic, normal AV conduction as documented on an ECG by a PR interval less than or equal to 200ms (within 30 days prior to enrollment).
- Left ventricular ejection fraction less than or equal to 35% (documented within 180 days prior to enrollment).
- NYHA class II, III or IV (documented within 30 days prior to enrollment) despite optimal medical therapy. Optimal medical therapy is defined as maximal tolerated dose of Beta-blockers and a therapeutic dose of ACE-I, ARB or Aldosterone Antagonist.
- Subject is less than 18 years of age (or has not reached minimum age per local law).
- Subject is not expected to remain available for at least 2 years of follow-up visits.
- Subject has permanent atrial arrhythmias for which pharmacological therapy and/or cardioversion have been unsuccessful or have not been attempted
- Subject is, or previously has been, receiving cardiac resynchronization therapy.
- Subject is currently enrolled or planning to participate in a potentially confounding drug or device trial during the course of this study. Co-enrollment in concurrent trials is only allowed when documented pre-approval is obtained from the Medtronic study manager.
- Subject has unstable angina, or experienced an acute myocardial infarction (MI) or received coronary artery revascularization (CABG) or coronary angioplasty (PTCA) within 30 days prior to enrollment.
- Subject has a mechanical tricuspid heart valve or is scheduled to undergo valve repair or valve replacement during the course of the study.
- Subject is post heart transplant (subjects on the heart transplant list for the first time are not excluded).
- Subject has a limited life expectancy due to non-cardiac causes that would not allow completion of the study.
- Subject is pregnant (if required by local law, women of child-bearing potential must undergo a pregnancy test within seven days prior to device implant).
- Subject meets any exclusion criteria required by local law.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description aCRT ON aCRT ON The aCRT algorithm has been developed to provide RV-synchronized LV pacing when intrinsic AV conduction is normal or BiV pacing otherwise aCRT OFF aCRT OFF Standard CRT
- Primary Outcome Measures
Name Time Method Combined Endpoint of All-cause Mortality and Intervention for Heart Failure Decompensation from subject randomization until the first occurrence of death or intervention for heart failure decompensation, median follow-up 4.9 years (max. follow-up 8.1 years) The first occurrence of death or intervention for heart failure decompensation (defined as an event requiring invasive intervention or inpatient hospitalization).
- Secondary Outcome Measures
Name Time Method All-cause Mortality from subject randomization until the occurrence of death, median follow-up 4.9 years (max. follow-up 8.1 years) All-cause mortality in the aCRT ON group vs the aCRT OFF group
Atrial Fibrillation from subject randomization until the first occurrence of atrial fibrillation lasting >6 hours in one day, median follow-up 4.9 years (max. follow-up 8.1 years) Occurrence of atrial fibrillation lasting \>6 hours in one day
Change in Quality of Life Measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ) from baseline to 24M follow up The overall summary score of the Kansas City Cardiomyopathy Questionnaire will be analyzed. The KCCQ measures Quality of Life on a 0-100 scale with higher scores indicating better QoL
Change in Quality of Life Measured by the EQ-5D from baseline to 24M follow up The EQ-5D descriptive system comprises the following five dimensions, each describing a different aspect of health: MOBILITY, SELF-CARE, USUAL ACTIVITIES, PAIN /DISCOMFORT and ANXIETY / DEPRESSION. Each dimension has three levels: no problems, some problems, extreme problems (labelled 1-3). We calculated the EQ-5D summary index by applying a specific formula providing a valuation to the health states (Shaw et al. Medical Care 2005). For the summary index, value 0 represents health that is valued as equal to death and value 1 represents best possible health.
All-cause Re-admissions Within 30 Days After a Heart Failure Admission Per 100 Patient Years from subject randomization until study exit, median follow-up 4.9 years (max. follow-up 8.1 years) All-cause hospital re-admissions within 30 days after discharge from a heart failure admission are reported as number of cases per 100 patient years
Clinical Composite Score CCS at 6 month post randomization The Clinical Composite Score (CCS) classifies patients according their clinical status at 6 months post randomization into categories Improved, Unchanged, and Worsened. A patient is classified Worsened in case of death, hospitalization for worsening heart failure, worsened NYHA class (using last observation carried forward), or worsened status on the Global Assessment Score. Also patients that exit the study or cross over because of worsening heart failure are classified Worsened. A patient is classified Improved when not Worsened and there is an improvement in NYHA class or Global Assessment Score. Patients that are not Worsened or Improved are Unchanged.
Percent of Patients With Interventions for Heart Failure Decompensation from subject randomization until the first occurrence of intervention for heart failure decompensation, median follow-up 4.9 years (max. follow-up 8.1 years) First occurence of intervention for heart failure decompensation is defined as an event requiring invasive intervention or inpatient hospitalization.
Trial Locations
- Locations (220)
University of Pennsylvania
🇺🇸Philadelphia, Pennsylvania, United States
The Ohio State University
🇺🇸Columbus, Ohio, United States
Emory University Hospital Midtown
🇺🇸Atlanta, Georgia, United States
Piedmont Heart Institute
🇺🇸Atlanta, Georgia, United States
Medical Center of the Rockies
🇺🇸Loveland, Colorado, United States
Universitätskliniken des Saarlandes
🇩🇪Homburg/Saar, Germany
Azienda Ospedaliero-Universitaria di Parma
🇮🇹Parma, Italy
University Hospitals Case Medical Center
🇺🇸Cleveland, Ohio, United States
Duke University Medical Center (DUMC)
🇺🇸Durham, North Carolina, United States
Hirosaki University Hospital
🇯🇵Hirosaki, Aomori Prefecture, Japan
Icahn School of Medicine at Mount Sinai
🇺🇸New York, New York, United States
EN Meshalkin National medical research center of the Ministry of Health of the Russian Federation
🇷🇺Novosibirsk, Russian Federation
Almazov National Medical Research Centre
🇷🇺St Petersburg, Russian Federation
The University of Vermont Medical Center Inc
🇺🇸Burlington, Vermont, United States
CardioVascular Associates of Mesa
🇺🇸Mesa, Arizona, United States
Bridgeport Hospital
🇺🇸Bridgeport, Connecticut, United States
Saint Vincent Heart Clinic Arkansas
🇺🇸Little Rock, Arkansas, United States
CAMC Health Education & Research Institute Inc
🇺🇸Charleston, West Virginia, United States
Górnośląskie Centrum Medyczne im prof Leszka Gieca Śląskiego Uniwersytetu Medycznego w Katowicach
🇵🇱Katowice, Poland
Unidade Local de Saude do Baixo Alentejo, EPE - Hospital José Joaquim Fernandes
🇵🇹Beja, Portugal
King Faisal Specialist Hospital & Research Center
🇸🇦Riyadh, Saudi Arabia
NUSCH, a.s.
🇸🇰Bratislava 37, Slovakia
National Taiwan University Hospital Hsin Chu Branch
🇨🇳Hsinchu, Taiwan
Washington Hospital Center
🇺🇸Washington, District of Columbia, United States
AZ Sint-Jan Brugge-Oostende av
🇧🇪Brugge, Belgium
Chiba University Hospital
🇯🇵Chiba-Shi, Japan
Academisch Medisch Centrum
🇳🇱Amsterdam, Netherlands
Medisch Centrum Leeuwarden
🇳🇱Leeuwarden, Netherlands
Regional Hospital Szpital Wojewodski
🇵🇱Kielce, Poland
Centro Hospitalar de Coimbra
🇵🇹Coimbra, Portugal
HFR Fribourg - Hôpital cantonal
🇨🇭Fribourg, Switzerland
National Taiwan University Hospital
🇨🇳Taipei, Taiwan
Medanta - The Medicity
🇮🇳Gurgaon, India
Canisius-Wilhelmina ziekenhuis
🇳🇱Nijmegen, Netherlands
Universitair Medisch Centrum Utrecht
🇳🇱Utrecht, Netherlands
Isala Klinieken - Locatie Weezenlanden
🇳🇱Zwolle, Netherlands
Cardiovascular Center
🇵🇷San Juan, Puerto Rico
Universitätsspital Basel
🇨🇭Basel, Switzerland
Kantonsspital St.Gallen
🇨🇭Saint Gallen, Switzerland
Wojewódzki Szpital Specjalistyczny im. Stefana Kardynała Wyszyńskiego
🇵🇱Lublin, Poland
Hospital de Espírito Santo E.P.E.
🇵🇹Évora, Portugal
The Arrhythmia Group
🇵🇷Coto Laurel, Puerto Rico
King Fahad Armed Forces Hospital
🇸🇦Jeddah, Saudi Arabia
The College of Medicine & King Khalid University Hospital, King Saud University
🇸🇦Riyadh, Saudi Arabia
Stredoslovensky ustav srdcovych a cievnych chorob a.s
🇸🇰Banska Bystrica, Slovakia
United Heart and Vascular Clinic
🇺🇸Saint Paul, Minnesota, United States
Northwerstern University
🇺🇸Chicago, Illinois, United States
Massachusetts General Hospital (Boston MA)
🇺🇸Boston, Massachusetts, United States
Saint Francis Medical Group Indiana Heart Physician
🇺🇸Indianapolis, Indiana, United States
MedStar Health Research Institute
🇺🇸Baltimore, Maryland, United States
Prairie Education and Research Cooperative
🇺🇸Springfield, Illinois, United States
Michigan Heart
🇺🇸Ypsilanti, Michigan, United States
Sparrow Clinical Research Institute
🇺🇸Lansing, Michigan, United States
Lourdes Cardiology Services
🇺🇸Voorhees, New Jersey, United States
William Beaumont Hospital
🇺🇸Troy, Michigan, United States
Central New York Cardiology
🇺🇸Utica, New York, United States
Weill Medical College of Cornell University
🇺🇸New York, New York, United States
Presbyterian Heart Group
🇺🇸Albuquerque, New Mexico, United States
North Memorial Heart and Vascular Institute
🇺🇸Robbinsdale, Minnesota, United States
Glacier View Research Institute Cardiology
🇺🇸Kalispell, Montana, United States
Cleveland Clinic
🇺🇸Cleveland, Ohio, United States
University of Minnesota Medical Center Fairview
🇺🇸Minneapolis, Minnesota, United States
Bethesda North Hospital
🇺🇸Cincinnati, Ohio, United States
Stony Brook University Medical Center
🇺🇸Stony Brook, New York, United States
Asheville Cardiology Associate PA
🇺🇸Asheville, North Carolina, United States
OhioHealth Research Institute
🇺🇸Columbus, Ohio, United States
The Lindner Research Center
🇺🇸Cincinnati, Ohio, United States
Wake Forest Baptist Health High Point Medical Center
🇺🇸High Point, North Carolina, United States
Raleigh Cardiology Associates
🇺🇸Raleigh, North Carolina, United States
Mercer Bucks Cardiology
🇺🇸Newtown, Pennsylvania, United States
CHI St. Luke's Heath Baylor College of Medicine Medical Center
🇺🇸Houston, Texas, United States
Fiona Stanley Hospital
🇦🇺Murdoch, Western Australia, Australia
Ziekenhuis Oost Limburg - Campus St.-Jan
🇧🇪Genk, Belgium
Swedish Medical Center Cherry Hill
🇺🇸Seattle, Washington, United States
McGill Universtiy Health Centre (MUHC)
🇨🇦Montreal, Canada
London Health Sciences Centre - University Campus
🇨🇦London, Canada
Providence Spokane Cardiology
🇺🇸Spokane, Washington, United States
Royal Columbian Hospital
🇨🇦Vancouver, Canada
Keski-Suomen Keskussairaala
🇫🇮Jyväskylä, Finland
Satakunnan keskussairaala
🇫🇮Pori, Finland
Kokura Memorial Hospital
🇯🇵Kitakyushu, Japan
Centre Hospitalier Universitaire de Clermont-Ferrand - Gabriel-Montpied
🇫🇷Clermont-Ferrand, France
Herz- und Diabeteszentrum NRW - Ruhr-Universität Bochum
🇩🇪Bochum, Germany
Nouvelles Cliniques Nantaises
🇫🇷Nantes, France
Herz Riesa, Gemeinschaftspraxis
🇩🇪Riesa, Germany
Klinikum der Universität München - Campus Großhadern
🇩🇪München, Germany
Kyorin University Hospital
🇯🇵Mitaka-Shi, Japan
Magyar Honvédség Honvédkorház
🇭🇺Budapest, Hungary
Nagoya University Hospital
🇯🇵Nagoya, Japan
Universitätsklinikum Ulm
🇩🇪Ulm, Germany
Hospital Clínico Virgen de la Victoria
🇪🇸Málaga, Spain
Complexo Hospitalario Universitario de Vigo - Hospital Xeral Cíes
🇪🇸Vigo, Spain
Saitama Medical Center Jichi Medical University
🇯🇵Shimonoseki-Shi, Japan
University of Fukui Hospital
🇯🇵Tsukuba, Japan
Kyung Hee University Hospital
🇰🇷Seoul, Korea, Republic of
Keimyung University Dongsan Medical Center
🇰🇷Daegu, Korea, Republic of
Amphia Ziekenhuis - Locatie Molengracht Breda
🇳🇱Breda, Netherlands
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
Hospital Angeles Leon
🇲🇽Leon, Guanajuato, Mexico
Maasstad Ziekenhuis
🇳🇱Rotterdam, Netherlands
Wojewódzki Szpital Zespolony im. Ludwika Perzyny w Kaliszu
🇵🇱Kalisz, Poland
Hospital Clinico Universitario de Salamanca
🇪🇸Salamanca, Spain
Golden Jubilee National Hospital - NHS Trust
🇬🇧Glasgow, United Kingdom
Akademiska Sjukhuset
🇸🇪Uppsala, Sweden
Erasmus Medisch Centrum
🇳🇱Rotterdam, Netherlands
Nuevo Hospital de Burgos
🇪🇸Burgos, Spain
Hospital Virgen de la Arrixaca
🇪🇸El Palmar, Spain
Spital Wojewodzki nr 2
🇵🇱Rzeszów, Poland
Slaskie Centrum Chorob Serca
🇵🇱Zabrze, Poland
King Abdul Aziz University Hospital
🇸🇦Jeddah, Saudi Arabia
Hospital Universitario Infanta Cristina
🇪🇸Badajoz, Spain
Helse Bergen HF - Haukeland Universitetssjukehus
🇳🇴Bergen, Norway
Hospital Universitario Virgen de las Nieves
🇪🇸Granada, Spain
CHR Metz-Thionville Hôpital de Mercy
🇫🇷Metz, France
CHRU La Rochelle
🇫🇷La Rochelle, France
CHRU de Lille
🇫🇷Lille, France
Hôpital de la Timone - Centre Hospitalier Universitaire de Marseille
🇫🇷Marseille, France
Liverpool Heart and Chest Hospital NHS Foundation Trust
🇬🇧Liverpool, United Kingdom
University Hospitals of North Midlands NHS Trust - Royal Stoke University Hospital
🇬🇧Liverpool, United Kingdom
Karolinska Universitetssjukhuset
🇸🇪Solna, Sweden
Vancouver General Hospital
🇨🇦Vancouver, Canada
University of South Florida Health (USF)
🇺🇸Tampa, Florida, United States
Phoenix Cardiovascular Research Group, LLC
🇺🇸Phoenix, Arizona, United States
Oklahoma Heart Hospital Research Foundation
🇺🇸Oklahoma City, Oklahoma, United States
Centennial Heart Cardiovascular Consultants LLC
🇺🇸Nashville, Tennessee, United States
Vanderbilt University Medical Center
🇺🇸Nashville, Tennessee, United States
Medical College of Wisconsin
🇺🇸Milwaukee, Wisconsin, United States
University of Utah
🇺🇸Salt Lake City, Utah, United States
Aurora Cardiovascular Services
🇺🇸Milwaukee, Wisconsin, United States
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
MVZ am Küchwald GmbH ambulantes Herz Zentrum Chemnitz
🇩🇪Chemnitz, Germany
Klinikum Coburg GmbH
🇩🇪Coburg, Germany
Washington University School of Medicine
🇺🇸Saint Louis, Missouri, United States
Hospital Universitario Nuestra Señora de Candelaria
🇪🇸Santa Cruz de Tenerife, Spain
Hospital Universitario Virgen del Rocío
🇪🇸Sevilla, Spain
Cardiovascular Research Center of South Florida
🇺🇸Miami, Florida, United States
Sacred Heart Medical Center
🇺🇸Eugene, Oregon, United States
Mount Carmel East
🇺🇸Columbus, Ohio, United States
Lancaster General Hospital
🇺🇸Lancaster, Pennsylvania, United States
University of Pittsburgh Medical Center UPMC Presbyterian
🇺🇸Pittsburgh, Pennsylvania, United States
Great Valley Cardiology
🇺🇸Scranton, Pennsylvania, United States
Tyler Cardiovascular Consultants
🇺🇸Tyler, Texas, United States
Hospital Universitario Miguel Servet
🇪🇸Zaragoza, Spain
Lehigh Valley Hospital
🇺🇸Allentown, Pennsylvania, United States
Cardiology Institute of Northwest Florida
🇺🇸Panama City, Florida, United States
Praxisklinik Herz und Gefässe - Akademische Lehrpraxisklinik der TU Dresden
🇩🇪Dresden, Germany
Universitätsklinikum Düsseldorf
🇩🇪Düsseldorf, Germany
Coggins & Levy Medical Associates
🇺🇸San Jose, California, United States
Scripps Green Hospital Scripps Clinic Torrey Pines
🇺🇸La Jolla, California, United States
Penrose Hospital
🇺🇸Colorado Springs, Colorado, United States
Stanford Hospital & Clinics
🇺🇸Stanford, California, United States
Cedars-Sinai Medical Center
🇺🇸Los Angeles, California, United States
Saint Joseph's Medical Center
🇺🇸Stockton, California, United States
Heart & Vascular Institute of Florida
🇺🇸Clearwater, Florida, United States
Florida Heart Rhythm Specialists PLLC
🇺🇸Fort Lauderdale, Florida, United States
First Coast Cardiovascular Institute PA
🇺🇸Jacksonville, Florida, United States
New York Methodist Hospital
🇺🇸Brooklyn, New York, United States
NYU Langone Medical Center
🇺🇸New York, New York, United States
Hudson Valley Heart Center
🇺🇸Poughkeepsie, New York, United States
Thomas Jefferson University Hospital
🇺🇸Philadelphia, Pennsylvania, United States
Capital Area Research
🇺🇸Camp Hill, Pennsylvania, United States
Sutherland Cardiology Clinic
🇺🇸Memphis, Tennessee, United States
The University of Texas (UT) Southwestern Medical Center
🇺🇸Dallas, Texas, United States
EP Heart LLC
🇺🇸The Woodlands, Texas, United States
Baylor Research Institute
🇺🇸Plano, Texas, United States
Sentara Norfolk General Hospital
🇺🇸Norfolk, Virginia, United States
University of Virginia Medical Center
🇺🇸Charlottesville, Virginia, United States
Austin Hospital
🇦🇺Heidelberg, Victoria, Australia
Saint Vincent's Hospital (Sydney)
🇦🇺Sydney, Australia
John Hunter Hospital
🇦🇺New Lambton, New South Wales, Australia
Landeskrankenhaus Innsbruck - Universitätskliniken
🇦🇹Innsbruck, Austria
Allgemeines Krankenhaus der Stadt Linz
🇦🇹Linz, Austria
Southlake Regional Health Centre
🇨🇦Newmarket, Canada
Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ)
🇨🇦Quebec, Canada
University of Ottawa Heart Institute
🇨🇦Ottawa, Canada
Odense Universitetshospital
🇩🇰Odense C, Denmark
Centre Hospitalier Universitaire de Amiens - Hôpital SU
🇫🇷Amiens, France
Centre Hospitalier Sud Francilien
🇫🇷Corbeil-Essonnes, France
CHRU Tours - Hôpital Trousseau
🇫🇷Chambray lès tours, France
Centre Hospitalier Universitaire de Grenoble-Hopital Albert Michallon
🇫🇷La Tronche, France
groupe Hospitalier de L'Institut Catholique de Lille - Hôpital Saint-Philibert
🇫🇷Lomme, France
Hopital prive Clairval - Ramsay Sante
🇫🇷Marseille, France
Institut Hospitalier Jacques Cartier
🇫🇷Massy, France
CHRU de Montpellier - Hôpital Arnaud de Villeneuve
🇫🇷Montpellier Cedex 5, France
CMC-Clinique Ambroise Pare
🇫🇷Neuilly-sur-Seine, France
Hôpital Pontchaillou - CHU de Rennes
🇫🇷Rennes Cedex 9, France
Immanuel Diakonie Group - Evangelisch-Freikirchlichen Krankenhaus und Herzzentrum Brandenburg
🇩🇪Bernau bei Berlin, Germany
CHU Toulouse - Hôpital Rangueil
🇫🇷Toulouse Cedex 9, France
Universitätsklinikum Heidelberg
🇩🇪Heidelberg, Germany
Märkische Gesundheitsholding GmbH & Co. KG - Klinikum Lüdenscheid
🇩🇪Lüdenscheid, Germany
Berufsgenossenschaftliche Universitätsklinik Bergmannsheil GmbH
🇩🇪Lüdenscheid, Germany
Universitätsklinikum Jena - Friedrich Schiller Universität
🇩🇪Jena, Germany
Universitätsklinikum Schleswig-Holstein - Campus Lübeck
🇩🇪Lübeck, Germany
Otto von Guericke Universität - Universitätsklinikum Magdeburg A.ö.R.
🇩🇪Magdeburg, Germany
Kliniken Maria Hilf GmbH Mönchengladbach - Krankenhaus St. Franziskus
🇩🇪Mönchengladbach, Germany
Semmelweis Egyetem AOK
🇭🇺Budapest, Hungary
Policlinico Sant' Orsola - Malpighi
🇮🇹Bologna, Italy
Azienda Ospedaliera Carlo Poma
🇮🇹Mantova, Italy
Fortis Escorts Heart Institute
🇮🇳New Delhi, India
Azienda Ospedaliera Spedali Civili di Brescia
🇮🇹Brescia, Italy
Ospedale Civile Madonna Della Navicella
🇮🇹Chioggia, Italy
Azienda Ospedaliera Universitaria Integrata Verona
🇮🇹Verona, Italy
Sakakibara Heart Institute of Okayama
🇯🇵Okayama-Shi, Japan
National Cerebral and Cardiovascular Center
🇯🇵Suita-Shi, Japan
Yeungnam University Medical Center
🇰🇷Daegu, Korea, Republic of
Fujita Health University Hospital
🇯🇵Toyoake, Japan
Seoul National University Bundang Hospital
🇰🇷Gyeonggi-Do, Korea, Republic of
Royal Brompton & Harefield NHS Foundation Trust - Royal Brompton Hospital
🇬🇧London, United Kingdom
Manchester University NHS Foundation Trust - Wythenshawe Hospital
🇬🇧Manchester, United Kingdom
AdventHealth Cardiovascular Research Institute
🇺🇸Orlando, Florida, United States
Mid America Heart Institute (MAHI)
🇺🇸Kansas City, Missouri, United States
University of Michigan
🇺🇸Ann Arbor, Michigan, United States
Medical University of South Carolina (MUSC)
🇺🇸Charleston, South Carolina, United States
The Cardiac & Vascular Institute
🇺🇸Gainesville, Florida, United States
Ochsner Medical Center
🇺🇸New Orleans, Louisiana, United States
Texas Cardiac Arrhythmia Research
🇺🇸Austin, Texas, United States
Virginia Cardiovascular Specialists PC
🇺🇸Richmond, Virginia, United States
Virginia Commonwealth University Health System
🇺🇸Richmond, Virginia, United States
North Ohio Heart-Elyria
🇺🇸Elyria, Ohio, United States
AV Vishnevsky Institute of Surgery of the Ministry of Health of the Russian Federation
🇷🇺Moscow, Russian Federation