Programmed Ventricular Stimulation to Risk Stratify for Early Cardioverter-Defibrillator (ICD) Implantation to Prevent Tachyarrhythmias Following Acute Myocardial Infarction (PROTECT-ICD)

NARecruitingINTERVENTIONAL
Enrollment

1,058

Participants

Timeline

Start Date

February 27, 2014

Primary Completion Date

December 6, 2027

Study Completion Date

December 6, 2029

Conditions
Sudden Cardiac Death
Interventions
PROCEDURE

Electrophysiology study (EPS)

EPS will be performed in all patients in the intervention arm with programmed ventricular stimulation with a drive train of 8 beats at 400 ms with up to 4 extrastimuli and stimulation from the right ventricular apex with current delivered at twice pacing threshold. The end point for stimulation will be sustained monomorphic ventricular tachycardia (VT) lasting \> 10 seconds. If sustained monomorphic VT with cycle length (CL) ≥200ms is induced by ≤4 extra stimuli the EPS result will be considered positive for inducible VT.30 Ventricular fibrillation or flutter with CL\<200ms will be considered a negative result. The Programmed Ventricular Stimulation (PVS) induction will be repeated a second time if the initial induction was negative for VT.

OTHER

Standard Care

The control group receive ongoing standard care according to the practise of their institution. This includes discharge from hospital as per their treating physician and follow up as usual in the community. Participants in this group would be eligible to receive an ICD according to the standard practise of their cardiologist (guideline recommendations are after 40 days following myocardial infarction or 90 days following revascularisation only in patients with left ventricular ejection fraction less than or equal to 30% or less than or equal to 35% in the presence of heart failure).

PROCEDURE

Cardiac Magnetic Resonance (CMR)

CMR will be performed on either a 1.5-T or 3-T scanner. Gadolinium contrast (Gd-BOPTA, MultihanceTM) will be administered for quantification myocardial perfusion imaging with subsequent late gadolinium enhanced imaging after a total dose of 0.1mmol/kg. Exclusion criteria specific for CMR will include pregnancy, renal insufficiency defined as glomerular filtration rate (GFR) \<30 mL/min, contraindication to MRI (including non-MRI compatible pacemaker/ICD or metal implants, non-MR safe prosthetic heart valves), claustrophobia which cannot be controlled via standard methods (benzodiazepines and/or sedative antihistamine administration) and prior allergic reaction to gadolinium-based contrast agent.

Trial Locations (52)

1023

WITHDRAWN

Auckland City Hospital, Grafton

2025

WITHDRAWN

Middlemore Hospital, Otahuhu

2031

RECRUITING

Prince of Wales Hospital, Randwick

2065

RECRUITING

Royal North Shore Hospital, Saint Leonards

2145

RECRUITING

Westmead Hospital, Westmead

2305

RECRUITING

John Hunter Hospital, New Lambton Heights

2500

RECRUITING

Wollongong Hospital, Wollongong

2605

RECRUITING

Canberra Hospital, Garran

2747

RECRUITING

Nepean Hospital, Kingswood

2820

RECRUITING

Wellington Hospital, Wellington

3010

RECRUITING

University Hospital Bern, Bern

3076

WITHDRAWN

Northern Hospital, Epping

3084

TERMINATED

Austin Hospital, Melbourne

3168

COMPLETED

MonashHeart, Clayton

3204

RECRUITING

Waikato Hospital, Hamilton W.

4029

RECRUITING

Royal Brisbane and Women's Hospital, Herston

4031

RECRUITING

University Hospital Basel, Basel

4032

RECRUITING

The Prince Charles Hospital, Chermside

4102

RECRUITING

Princess Alexandra Hospital, Woolloongabba

4215

RECRUITING

Gold Coast University Hospital, Southport

4575

RECRUITING

Sunshine Coast University Hospital, Birtinya

4814

RECRUITING

The Townsville Hospital, Douglas

4870

RECRUITING

Carins Hospital, Cairns

5112

RECRUITING

Lyell McEwin Hospital, Elizabeth Vale

50400

RECRUITING

Institut Jantung Negara Sdn Bhd, Kuala Lumpur

119074

RECRUITING

National University Heart Centre, Singapore (NUHCS), Singapore

02215

NOT_YET_RECRUITING

Beth Israel Deaconess Medical Center, Boston

Unknown

WITHDRAWN

Western Health, Sunshine and Footscray Hospitals, Melbourne

NOT_YET_RECRUITING

Institute for Clinical and Experimental Medicine, Prague

RECRUITING

Cardiovascular Center Bad Neustadt, Bad Neustadt an der Saale

RECRUITING

Klinikum Brandenburg, Brandenburg

ACTIVE_NOT_RECRUITING

Universitaetsmedizin Gittingen (University of Göttingen Medical Center), Göttingen

ACTIVE_NOT_RECRUITING

Leipzig Heart Center, Leipzig

NOT_YET_RECRUITING

Universitätsklinikum Leipzig, Leipzig

ACTIVE_NOT_RECRUITING

General Hospital of Athens Giorgios Gennimatas, Athens

ACTIVE_NOT_RECRUITING

General Hospital of Athens Ippokrateio, Athens

NOT_YET_RECRUITING

University Hospital of Heraklion Crete, Heraklion

RECRUITING

Semmelweis University Heart and Vascular Center, Budapest

RECRUITING

University of Debrecen, Debrecen

RECRUITING

University of Pécs, Pécs

RECRUITING

Sharee Zadek Medical Centre, Jerusalem

RECRUITING

Paul Stradins University Clinic, Riga

RECRUITING

Pusat Jantung Sarawak (PJS)(Sarawak Heart Centre), Kuala Lumpur

RECRUITING

Christchurch Hospital, Christchurch

RECRUITING

Medical University of Łódź - Biegański Provincial Specialist Hospital, Lodz

RECRUITING

Medical University of Łódź - WAM Hospital, Lodz

RECRUITING

Medical University of Łódź, Lodz

NOT_YET_RECRUITING

National Institute of Cardiology Warsaw, Warsaw

NOT_YET_RECRUITING

Almazov National Medical Research Centre, Saint Petersburg

WITHDRAWN

Samara State Medical University, Samara

NOT_YET_RECRUITING

The National Institute of Cardiovascular Diseases, Bratislava

WITHDRAWN

Lausanne University Hospital, Lausanne

All Listed Sponsors
lead

Western Sydney Local Health District

OTHER