Clinical Trial Comparing Devices Used for Cardioversion of Atrial Fibrillation

Sponsor
Inova Health Care Services (Other)
Overall Status
Enrolling by invitation
CT.gov ID
NCT05992623
Collaborator
(none)
560
1
4
16.1
34.7

Study Details

Study Description

Brief Summary

The goal of this single center, investigator initiated, open label prospective randomized controlled trial is to compare the efficacy of a single 200J RBW shock and a single 360J BTE shock. The secondary objective of the study is to compare the frequency of adverse events after one or two 200J RBW or 360J BTE shocks

Condition or Disease Intervention/Treatment Phase
  • Device: Zoll external defibrillator
  • Device: Lifepak external defibrillator
N/A

Detailed Description

Data will be derived from approximately 560 patients arriving to Inova sites of care in Atrial Fibrillation (AF) scheduled to undergo either Atrial Fibrillation ablation with expected Direct Current Cardioversion (DCCV) or elective stand-alone AF DCCV. Patients will be included if they are in AF prior to their procedure and are willing to sign the information sheet and comply with the research procedures. Participants will be excluded if they are in a rhythm other than AF on arrival, have not been appropriately anticoagulated with warfarin or direct oral anticoagulant, or have known left atrial appendage thrombus prior to their procedure.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
560 participants
Allocation:
Randomized
Intervention Model:
Crossover Assignment
Intervention Model Description:
Participants will be randomized to a Zoll or Lifepak defibrillator to perform the DCCV. All shocks will be full output (200J for Zoll shocks and 360J for Lifepak shocks). Follow up will be assessment and documentation of rhythm 1 minute after the last shock is delivered. Participants who do not have first shock success will have a second full output shock ≥1 minute after the first shock. Participants who do not have success after a second full output shock will be crossed over to the other defibrillator waveform and receive up to 2 full output shocks with a minimum of 1 minute between each shock to ascertain the outcome of the immediately prior shock.Participants will be randomized to a Zoll or Lifepak defibrillator to perform the DCCV. All shocks will be full output (200J for Zoll shocks and 360J for Lifepak shocks). Follow up will be assessment and documentation of rhythm 1 minute after the last shock is delivered. Participants who do not have first shock success will have a second full output shock ≥1 minute after the first shock. Participants who do not have success after a second full output shock will be crossed over to the other defibrillator waveform and receive up to 2 full output shocks with a minimum of 1 minute between each shock to ascertain the outcome of the immediately prior shock.
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Pragmatic Randomized Clinical Trial Comparing Rectilinear Biphasic Waveform and Biphasic Truncated Exponential Waveform Shocks for Cardioversion of Atrial Fibrillation (Zoll vs Lifepak)
Actual Study Start Date :
Jul 21, 2023
Anticipated Primary Completion Date :
May 23, 2024
Anticipated Study Completion Date :
Nov 23, 2024

Arms and Interventions

Arm Intervention/Treatment
Active Comparator: Output synchronized to 200J using Zoll Rectilinear Biphasic Waveform (RBW) defibrillator

Participants receiving Direct Current Cardioversion (DCCV) using full output Rectilinear Biphasic Waveform (RBW) shocks from a Zoll defibrillator (200 Joules) up to 2 shocks.

Device: Zoll external defibrillator
Patients with AF will be randomized to receive a full output synchronized 200J shock using a RBW waveform from a Zoll defibrillator

Active Comparator: Output synchronized to 360J Lifepak Biphasic Truncated Exponential Waveform (BTE) defibrillator

Participants receiving Direct Current Cardioversion (DCCV) using full output Biphasic Truncated Exponential Waveform (BTE) shocks from a Physiocontrol/Medtronic Lifepak defibrillator (360 Joules) up to 2 shocks.

Device: Lifepak external defibrillator
Patients with AF will be randomized to receive a full output synchronized 360J shock using a BTE waveform from a Lifepak defibrillator

Active Comparator: Zoll defibrillator waveform used after unsuccessful second full output shock.

Participants who received first shock via Zoll that do not have success after a second full output shock will be crossed over to the Lifepak defibrillator waveform and receive up to 2 full output shocks with a minimum of 1 minute between each shock to ascertain the outcome of the immediately prior shock.

Device: Lifepak external defibrillator
Patients with AF will be randomized to receive a full output synchronized 360J shock using a BTE waveform from a Lifepak defibrillator

Active Comparator: Lifepak defibrillator waveform used after unsuccessful second full output shock.

Participants who received first shock via Lifepak that do not have success after a second full output shock will be crossed over to the Zoll defibrillator waveform and receive up to 2 full output shocks with a minimum of 1 minute between each shock to ascertain the outcome of the immediately prior shock.

Device: Zoll external defibrillator
Patients with AF will be randomized to receive a full output synchronized 200J shock using a RBW waveform from a Zoll defibrillator

Outcome Measures

Primary Outcome Measures

  1. The number of participants in normal sinus rhythm (NSR) by ECG after the first DCCV shock [Up to 1 minute after shock delivered]

    The frequency of NSR one minute, identified by ECG, after a single full output DCCV shock is delivered by either a Zoll RBW waveform defibrillator or Lifepak BTE waveform defibrillator

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  1. Age ≥ 18 years

  2. In AF on presentation with plan for DCCV in either the Electrophysiology lab or DCCV procedure area

Exclusion Criteria:
  1. Participants who are receiving any other investigational agents.

  2. Parents/guardians or participants who, in the opinion of the Investigator, may be non-compliant with study schedules or procedures.

  3. Patients with arrhythmias other than AF

  4. Patients with hemodynamically unstable AF

  5. Patients with untreated hyperthyroidism

  6. Patients with known or suspected pregnancy

  7. Patients without sufficient anticoagulation or a transesophageal echocardiogram or computed tomography scan documenting the absence of intracardiac thrombi

Contacts and Locations

Locations

Site City State Country Postal Code
1 Inova Health System Falls Church Virginia United States 22042

Sponsors and Collaborators

  • Inova Health Care Services

Investigators

  • Principal Investigator: Brett Atwater, MD, Inova Health Care Services

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Inova Health Care Services
ClinicalTrials.gov Identifier:
NCT05992623
Other Study ID Numbers:
  • U23-04-5042
First Posted:
Aug 15, 2023
Last Update Posted:
Aug 15, 2023
Last Verified:
Aug 1, 2023
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
Yes
Product Manufactured in and Exported from the U.S.:
No
Additional relevant MeSH terms:

Study Results

No Results Posted as of Aug 15, 2023