Ignite Creation Date:
2024-07-17 @ 11:41 AM
Last Modification Date:
2024-10-26 @ 3:32 PM
Study NCT ID:
NCT06464315
Status:
NOT_YET_RECRUITING
Last Update Posted:
2024-06-20
First Post:
2024-05-23
Brief Title:
Functional Substrate-Only Guided VT Ablation
Sponsor:
VA Office of Research and Development
Organization:
VA Office of Research and Development
Study Overview
Official Title:
Computational Cardiac Mapping Techniques to Guide Ablation of Arrhythmogenic Substrate Underlying Ventricular Tachycardia
Status:
NOT_YET_RECRUITING
Status Verified Date:
2024-10
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
NoMoVT
Brief Summary:
Ventricular tachycardia VT is a leading cause of death and suffering in the Veteran population Currently ablation procedures are performed to destroy the diseased tissue that causes this problem This study will test to see if an experimental strategy of only targeting regions of slow conduction without the induction of VT can improve the efficacy and safety of VT ablation Once this study is completed the investigators will know whether this ablation strategy could help increase the efficacy safety and efficiency of ablation therapy of fatal heart rhythms
Detailed Description:
Ventricular tachycardia VT remains a leading cause of death and morbidity in the veteran population but current ablation procedures to treat VT are limited by hemodynamic instability of induced VT during standard invasive activation mapping up to 80 of induced VT lengthy ablation procedures 8 hours and difficulty in accurately localizing the critical origination sites of VT The long-term goal is to simplify VT ablation using invasive functional substrate mapping techniques to improve the safety efficacy and efficiency of VT catheter ablation The overall objectives in this application are to i perform a randomized clinical trial to test whether performing simplified VT ablation guided only by invasive functional substrate mapping without VT induction improves the safety and efficiency of VT ablation while maintaining similar efficacy compared to standard ablation and ii mechanistically correlate abnormal functional substrate with VT origination sites localized using gold standard invasive activation mapping The central hypothesis is that ablation of slowly conducting tissue characterized by high frequency signals is sufficient to eliminate VT and improves clinical outcomes of VT ablation The rationale is that recently developed sophisticated techniques to characterize functionally abnormal tissue can localize critical VT-sustaining substrate without needing to subjecting patients to mapping of hemodynamically unstable VT which is routinely done during standard of care ablation The central hypothesis will be tested by pursuing one primary specific aim Perform a randomized clinical trial to determine whether VT ablation guided only by invasive functional substrate mapping without VT induction decreases procedure time fluoroscopy time and procedural complications while maintaining similar efficacy compared to standard VT ablation controls This study also includes 2 sub-aims to uncover VT mechanisms characterizing the distance of slowly conducting tissue to VT exit sites and provide a method to unmask critical arrhythmogenic substrate in non-ischemic cardiomyopathy patients in whom scar is not easily identified The research proposed is innovative because it tests a novel strategy using new algorithms that can identify the critical tissue sustaining VT without requiring the induction of VT The proposed research is significant because a functional substrate-guided only approach to VT ablation while still localizing the critical tissue causing VT is expected to increase the safety efficacy and efficiency of treating a fatal heart rhythm disorder
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
True
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
True
Is an FDA AA801 Violation?:
None