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Futility
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The LEVER study is a prospective, unblinded, non-randomized, first in human feasibility study that will assess and characterize early safety and effectiveness of low energy therapies in converting monomorphic ventricular tachycardias (MVTs).
The LEVER study is a prospective, unblinded, non-randomized, first in human feasibility study that will assess and characterize early safety and effectiveness of low energy therapies in converting monomorphic ventricular tachycardias (MVTs). Subjects must be already indicated for standard of care VT procedure during which VT is likely to be induced (such as VT testing, VT ablation, VT mapping, or VT risk stratification testing.)
The study patches will be applied to the subject's torso, and the patches will be connected to the LEVER Acute Study System. Pacing capture threshold capture may be assessed. If monomorphic VT is induced and reaches at least 170bpm (350ms/cycle), one or more of the low energy therapies will be applied under oversight of the investigator, in an attempt to treat and convert the VT.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Acute Testing | Experimental | Single-arm study - all subjects who meet the I&E criteria, sign the consent form and have inducible VT within the protocol-specified criteria may be tested for VT conversion with the LEVER Acute Study System. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| LEVER Acute Study System | Device | The LEVER Acute Study System is an acute pacing and shock delivery system intended for investigational use only. The LEVER Acute Study System is intended for acute conversion testing of monomorphic ventricular tachycardia by one of three different VT conversion methods. |
| Measure | Description | Time Frame |
|---|---|---|
| System and Procedure Related Adverse Events | All system and procedure-related adverse events through 7 days (-1/+3 days) post-procedure will be collected and tracked. | 7 days post-procedure |
| Conversion Efficacy of Low Energy VT Therapies | Effectiveness of LEVER Acute Study System low energy therapies to convert MVTs will be collected and tracked as an aggregate success rate (%) on a per-attempt basis for each therapy tested. | Acute - eg within 5 seconds of test therapy delivery |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Kurt Roberts-Thompson, MD | Royal Adelaide Hospital | Principal Investigator |
| Andreas Bollmann, MD | Hertz Centrum, Leipzig | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Royal Adelaide Hospital | Adelaide | Australia |
Acute feasibility study of possible new product feature, confidential information
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| ID | Title | Description |
|---|---|---|
| FG000 | Acute Testing | Single-arm study - all subjects who meet the I&E criteria, sign the consent form and have inducible VT within the protocol-specified criteria may be tested for VT conversion with the LEVER Acute Study System. LEVER Acute Study System: The LEVER Acute Study System is an acute pacing and shock delivery system intended for investigational use only. The LEVER Acute Study System is intended for acute conversion testing of monomorphic ventricular tachycardia by one of three different VT conversion methods. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Acute Testing | Single-arm study - all subjects who meet the I&E criteria, sign the consent form and have inducible VT within the protocol-specified criteria may be tested for VT conversion with the LEVER Acute Study System. LEVER Acute Study System: The LEVER Acute Study System is an acute pacing and shock delivery system intended for investigational use only. The LEVER Acute Study System is intended for acute conversion testing of monomorphic ventricular tachycardia by one of three different VT conversion methods. |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | System and Procedure Related Adverse Events | All system and procedure-related adverse events through 7 days (-1/+3 days) post-procedure will be collected and tracked. | Posted | Number | participants | 7 days post-procedure |
|
from the time of the acute testing until 7 days post-procedure
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Acute Testing | Single-arm study - all subjects who meet the I&E criteria, sign the consent form and have inducible VT within the protocol-specified criteria may be tested for VT conversion with the LEVER Acute Study System. LEVER Acute Study System: The LEVER Acute Study System is an acute pacing and shock delivery system intended for investigational use only. The LEVER Acute Study System is intended for acute conversion testing of monomorphic ventricular tachycardia by one of three different VT conversion methods. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| post-procedure VT recurred | Cardiac disorders | Systematic Assessment | patient had a recurrence of VT post-procedure (likely due to unsuccessful VT ablation that was not a specific aspect of the study) |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| muscle soreness | Musculoskeletal and connective tissue disorders | Systematic Assessment | pt temporarily reported muscle soreness after the procedure |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Greg Voss | Boston Scientific CRM | 651-581-3068 | gregory.voss@bsco.com |
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| ID | Term |
|---|---|
| D017180 | Tachycardia, Ventricular |
| ID | Term |
|---|---|
| D013610 | Tachycardia |
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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|
| years |
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| Sex: Female, Male | Count of Participants | Participants |
|
| Units | Counts |
|---|
| Participants |
|
|
| Primary | Conversion Efficacy of Low Energy VT Therapies | Effectiveness of LEVER Acute Study System low energy therapies to convert MVTs will be collected and tracked as an aggregate success rate (%) on a per-attempt basis for each therapy tested. | 6 of 9 subjects had at least one inducible VT, a total of 14 attempts to convert VT with multiple pulses were delivered and none converted the VT in any subject. | Posted | Number | percentage of VF conversion success | Acute - eg within 5 seconds of test therapy delivery | Attempts at VF Conversion | Attempts at VF Conversion |
|
|
|
| 3 |
| 9 |
| 2 |
| 9 |
|
| VT accelerated to VF | Cardiac disorders | Systematic Assessment | during the procedure an induced VT accelerated to VF, but was successfully converted. This is not unexpected for a such a procedure involving VT induction. |
|
| LV impairment | Cardiac disorders | Systematic Assessment | 7 days post-procedure the pt had chest pain, and was found to have LV impairment. The condition resolved and the subject was released 2 days later. |
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| VT acceleration to VF | Cardiac disorders | Systematic Assessment | during the procedure a VT spontaneously occurred that accelerated to VF and was converted by an external shock |
|
This an early-stage feasibility study with significant intellectual property value to the sponsor. The sponsor controls access to the data and no publications can be submitted without the sponsors approval. Since the study was stopped early due to futility it may not be publishable, but preliminary data was submitted via abstract for presentation at Heart Rhythm 2017.
| D000075224 |
| Cardiac Conduction System Disease |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |