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Up to 15 subjects will be enrolled to evaluate initial safety and performance of the AtaCor Temporary Pacing System. Safety will be evaluated through analysis of all Adverse Events. Performance will be evaluated through (1) the incidence of successful StealthTrac Lead placement using the MACH I Delivery Tool, (2) electrical performance measurements, such as pacing capture thresholds, sensed R-wave amplitudes, pacing impedance and skeletal muscle stimulation at rest. Appropriate sensing and pacing capture will be ascertained from ECG Holter Monitor recordings during periods of in-hospital ambulation.
Enrolled Subjects will have both a market-released transvenous pacing lead and investigational StealthTrac Temporary Pacing Lead placed and evaluated. During the placement procedure, diagnostic echocardiograms will be performed to detect any new pericardial effusions. Once inserted, the StealthTrac Lead will be used to deliver high rate pacing (160 to 220 BPM) in clinically appropriate Subjects, to demonstrate suitability for use in transcatheter procedures that require brief periods of temporary pacing. Lead positions will be documented using fluoroscopic images before the Subject leaves the procedure room. On the following two days after the procedure, electrical performance will be evaluated in multiple postures and appropriate pacing and sensing will be confirmed during activity using ECG Holter monitor recordings. Subjects will also be asked patient-centric questions about their experience with the StealthTrac Lead throughout the study period. Evaluations will continue for a minimum of two (2) and a maximum of seven (7) days after the index procedure. Prior to StealthTrac Lead removal, an X-Ray will be taken to document the final lead position and diagnostic echocardiography will be performed to (1) detect any latent pericardial effusions and (2) assess differences in cardiac function with intrinsic conduction and while pacing. A final follow-up will be performed 25-30 days after removal to identify any latent adverse events before the Subject exits the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Subcostal temporary extracardiac pacing lead | Experimental | All subjects will receive a subcostal temporary extracardiac pacing lead for a minimum of 48 hours in-hospital and undergo all protocol testing. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Subcostal Temporary Extracardiac Pacing Lead | Device | The StealthTrac Lead is designed to facilitate extracardiac temporary ventricular pacing and sensing. The distal end of the StealthTrac Lead is designed to reside within the connective tissue of the anterior mediastinum outside the pericardium. The StealthTrac Lead is delivered using the MACH I Delivery Tool, which is designed to facilitate insertion of the StealthTrac Lead through a small skin incision parallel to the sternum, without the need for fluoroscopic guidance. |
| Measure | Description | Time Frame |
|---|---|---|
| Safety Outcome: Number of Subjects Experiencing an Adverse Device Effect | Safety will be evaluated through analysis of all Adverse Device Effects | 30 days |
| Performance Outcome: Mean Pacing Capture Threshold (V) | Minimum current required to pacing the heart (in multiple postures) | Up to 2 days post insertion |
| Performance Outcome: Mean Pacing Impedance (Ohms) | Impedance measured while pacing the heart (in multiple postures) | Up to 2 days post insertion |
| Performance Outcome: Mean R-Wave Amplitude (mV) | R-Wave amplitudes measured while sensing the heart (in multiple postures) | Up to 2 days post insertion |
| Performance Outcome: % of R-R Intervals With Appropriate Pacing and Sensing During Activity | ECG Holter Recordings obtained during periods of rest and in-hospital activity. The % of R-R intervals with appropriate pacing is calculated as the number of paced intervals that demonstrate pacing capture / the total number of pacing intervals. The % of R-R intervals with appropriate sensing is calculated as the number of intervals where pacing is appropriately delivered or inhibited (depending on the programmed settings of the pacemaker) / the total number of R-R intervals. The outcomes are presented a % of intervals and not an average of the percentages observed across patients. | Up to 2 days post insertion |
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| Measure | Description | Time Frame |
|---|---|---|
| Paced QRS Duration (ms) | QRS duration measured from 12-Lead ECG | 1 day after insertion |
| Echocardiographic Assessment of Left Ventricular Stroke Volume During Pacing (mL) | Measures of cardiac function obtained from echocardiography |
Inclusion Criteria:
Indicated for closed-chest cardiac invasive procedure with the potential for intra-procedural or post-procedural bradycardia and willing to be hospitalized for a minimum of 2 days post procedure.
Examples of such procedures include: transfemoral transcatheter aortic valve replacement (TAVR), balloon valvuloplasty, permanent pacemaker implantation and pacing lead extractions/revisions.
Physically and mentally capable of providing informed consent.
At least 18 years of age or of legal age to provide consent as required by local and national requirements.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Martin Burke, D.O. | AtaCor Medical | Principal Investigator |
| Adrian Ebner, M.D. | Sanatorio Italiano | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sanatorio Italiano | Asunción | Paraguay |
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| Label | URL |
|---|---|
| Sponsor website | View source |
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Eleven (11) of the 12 enrolled subjects underwent a StealthTrac Lead insertion procedure. One (1) subject experienced an adverse clinical event, unrelated to the StealthTrac Lead, that precluded insertion of the StealthTrac Lead and was subsequently withdrawn from the study.
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| ID | Title | Description |
|---|---|---|
| FG000 | Subcostal Temporary Extracardiac Pacing Lead | All subjects will receive a subcostal temporary extracardiac pacing lead for a minimum of 48 hours in-hospital and undergo all protocol testing. Subcostal Temporary Extracardiac Pacing Lead: The StealthTrac Lead is designed to facilitate extracardiac temporary ventricular pacing and sensing. The distal end of the StealthTrac Lead is designed to reside within the connective tissue of the anterior mediastinum outside the pericardium. The StealthTrac Lead is delivered using the MACH I Delivery Tool, which is designed to facilitate insertion of the StealthTrac Lead through a small skin incision parallel to the sternum, without the need for fluoroscopic guidance. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | Subcostal Temporary Extracardiac Pacing Lead | All subjects will receive a subcostal temporary extracardiac pacing lead for a minimum of 48 hours in-hospital and undergo all protocol testing. Subcostal Temporary Extracardiac Pacing Lead: The StealthTrac Lead is designed to facilitate extracardiac temporary ventricular pacing and sensing. The distal end of the StealthTrac Lead is designed to reside within the connective tissue of the anterior mediastinum outside the pericardium. The StealthTrac Lead is delivered using the MACH I Delivery Tool, which is designed to facilitate insertion of the StealthTrac Lead through a small skin incision parallel to the sternum, without the need for fluoroscopic guidance. |
| 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 | Safety Outcome: Number of Subjects Experiencing an Adverse Device Effect | Safety will be evaluated through analysis of all Adverse Device Effects | Posted | Count of Participants | Participants | 30 days |
|
30 Days
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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 | Subcostal Temporary Extracardiac Pacing Lead | All subjects will receive a subcostal temporary extracardiac pacing lead for a minimum of 48 hours in-hospital and undergo all protocol testing. Subcostal Temporary Extracardiac Pacing Lead: The StealthTrac Lead is designed to facilitate extracardiac temporary ventricular pacing and sensing. The distal end of the StealthTrac Lead is designed to reside within the connective tissue of the anterior mediastinum outside the pericardium. The StealthTrac Lead is delivered using the MACH I Delivery Tool, which is designed to facilitate insertion of the StealthTrac Lead through a small skin incision parallel to the sternum, without the need for fluoroscopic guidance. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Pain (Post-Operative) | Surgical and medical procedures | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Alan Marcovecchio, Vice President, Clinical Affairs | AtaCor Medical, Inc. | 949 391 2252 | alan@atacor.com |
| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jul 23, 2019 | Jan 14, 2021 | Prot_001.pdf |
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| ID | Term |
|---|---|
| D001145 | Arrhythmias, Cardiac |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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|
| 2 days after insertion |
| years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race/Ethnicity, Customized | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Primary | Performance Outcome: Mean Pacing Capture Threshold (V) | Minimum current required to pacing the heart (in multiple postures) | One suspected lead dislodgement prevented measurements in all 11 subjects on Day 1 and Day 2. | Posted | Mean | Standard Deviation | Volts | Up to 2 days post insertion |
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|
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| Primary | Performance Outcome: Mean Pacing Impedance (Ohms) | Impedance measured while pacing the heart (in multiple postures) | All eleven (11) Subjects contribute data on Day 0. On Day 1 and Day 2, nine (9) Subjects contribute data and two (2) Subjects do not due to a suspected lead dislodgement and one measurement out of range. | Posted | Mean | Standard Deviation | Ohms | Up to 2 days post insertion |
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| Primary | Performance Outcome: Mean R-Wave Amplitude (mV) | R-Wave amplitudes measured while sensing the heart (in multiple postures) | Only 4 of 11 subjects had an intrinsic rhythm for measurement of R waves. | Posted | Mean | Standard Deviation | millivolts | Up to 2 days post insertion |
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| Primary | Performance Outcome: % of R-R Intervals With Appropriate Pacing and Sensing During Activity | ECG Holter Recordings obtained during periods of rest and in-hospital activity. The % of R-R intervals with appropriate pacing is calculated as the number of paced intervals that demonstrate pacing capture / the total number of pacing intervals. The % of R-R intervals with appropriate sensing is calculated as the number of intervals where pacing is appropriately delivered or inhibited (depending on the programmed settings of the pacemaker) / the total number of R-R intervals. The outcomes are presented a % of intervals and not an average of the percentages observed across patients. | All subjects with a StealthTrac Lead | Posted | Number | % of intervals | Up to 2 days post insertion |
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| Other Pre-specified | Paced QRS Duration (ms) | QRS duration measured from 12-Lead ECG | Not Posted | 1 day after insertion | Participants |
| Other Pre-specified | Echocardiographic Assessment of Left Ventricular Stroke Volume During Pacing (mL) | Measures of cardiac function obtained from echocardiography | Not Posted | 2 days after insertion | Participants |
| 0 |
| 11 |
| 0 |
| 11 |
| 2 |
| 11 |
| Inability to Pace | Cardiac disorders | Non-systematic Assessment |
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Investigator must obtain prior written consent of Sponsor before publishing.
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| Title | Measurements |
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