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NCT05034432PHASE4Recruiting

The PIVATAL Study -Study of Ventricular Arrhythmia (VTA) Ablation in Left Ventricular Assist Device (LVAD) Patients

University of Rochester

Start Date

5/27/2022

Completion Date

6/30/2027

Summary

To investigate the effect of VTA ablation at the time of LVAD implant to see if it can reduce the incidence of VTA after surgery

Detailed Description

This study is a prospective, multicenter, open-label, randomized-controlled clinical trial enrolling 100 patients who are LVAD candidates with a history of VTA who will be randomized in a 1:1 ratio to intra-operative VTA ablation vs. conventional medical management. Comprehensive data on arrhythmia history, medication history will be collected in all randomized subjects. Antiarrhythmic medical therapy will be handled in a uniform pattern between the two arms. Randomized subjects will then be followed per routine schedules for post LVAD implant. Arrhythmia data, ICD therapy, additional procedures including repeat surgery, ramp echocardiographic tests, right heart catheterization and catheter-based VTA ablation will be collected. In addition, adverse events such as unplanned hospitalizations, emergency department visits, clinic visits, and all other aspects of health care utilization will be gathered. The planned average follow-up period will be 18 months.

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: * Age \> 18 years * Presence of advanced cardiomyopathy (of all INTERMACS classification) and eligible for LVAD implant per the decision of the Heart Failure clinical team * Implanted cardioverter defibrillator (ICD) any time in past with remote monitoring or planned to undergo ICD (or ICM as an alternative, if an ICD cannot be implanted for a clinical reason) implant within the index hospitalization for LVAD implant * History of treated or monitored sustained (i.e., \>30 seconds in duration ) VT or VF episode within the past 5 years. Exclusion Criteria: * Past successful VTA ablation without recurrent VTA prior to LVAD implant (Patients who continue to experience VTA post ablation and pre LVAD implant qualify to be enrolled) * Participation in other clinical trials (observational registries are allowed with approval) * Unable or unwilling to provide informed consent

Interventions

PROCEDURE

Intra-Op Prophylactic VT ablation

OTHER

Conventional Management

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Conditions

ArrythmiaCardiomyopathies

Locations

Banner University Medical Center

Phoenix, Arizona 85006

United States

UCLA Cardiac Arrthmia Center

Los Angeles, California 90095

United States

University of California San Francisco

San Francisco, California 94143

United States

Medstar Washington Hospital Center

Washington D.C., District of Columbia 20010

United States

Piedmont Heart Institute

Atlanta, Georgia 30309

United States

Emory University

Atlanta, Georgia 30322

United States

Ascension St. Vincent Indianapolis

Indianapolis, Indiana 46260

United States

Univedrsity of Louisville

Louisville, Kentucky 40202

United States

Johns Hopkins University

Baltimore, Maryland 21287

United States

Tufts Medical Center

Boston, Massachusetts 02111

United States

Henry Ford Health

Detroit, Michigan 48202

United States

Columbia University Medical Center

New York, New York 10026

United States

University of Rochester

Rochester, New York 14642

United States

Cleveland Clinic

Cleveland, Ohio 44195

United States

University of Pennsylvania

Philadelphia, Pennsylvania 19104

United States

UPMC

Pittsburgh, Pennsylvania 15213

United States

Medical University of South Carolina

Charleston, South Carolina 29425

United States

Vanderbilt University Medical Center

Nashville, Tennessee 37232

United States

Houston Methodist Hospital

Houston, Texas 77030

United States