Cardiomyopathies, ICD, Implantable Defibrillator User
Conditions
Keywords
ICD, arrhythmia, algorithm, haemodynamic sensor, bipolar electrogram
Brief summary
Implantable cardioverter defibrillators (ICD) are used to treat life-threatening heart rhythm disturbances (arrhythmias). They have been proven to reduce the risk of sudden cardiac death; however, there are limitations with current ICDs. Firstly, they may deliver inappropriate therapies (therapies delivered in the absence of life-threatening arrhythmias). Secondly, slower life-threatening arrhythmias may be left untreated because current programming recommendations, designed to minimise inappropriate therapies, rely predominantly on heart rates. Therefore, there is considerable potential to make ICDs safer with more sophisticated ICD algorithms. In this research study the investigators will collect data from participants with newly implanted or existing ICDs whilst they are in induced or spontaneously occurring abnormal rhythms. The data will come from sensors placed on the skin that can measure blood flow or electrical properties of the body. In addition, in 20 participants, the investigators will also collect further data from a small loop recorder implanted under the skin. The investigators will use this data to help develop and validate new methods of reliably identifying life-threatening arrhythmias so that future ICDs deliver therapies when only needed. The research is funded by the British Heart Foundation, and will take place at Hammersmith Hospital over 3 years. The investigators aim to recruit 100 patients in total.
Detailed description
This novel arrhythmia detection algorithm will incorporate a haemodynamic sensor and extra bipolar electrogram with an aim to outperform current commercially used arrhythmia detection algorithms that rely primarily on heart rate.
Interventions
OTHERObservational Study during Clinical and Simulated arrhythmias in patients with ICDs
Observational Study during Clinical and Simulated arrhythmias in patients with ICDs
Sponsors
Imperial College London
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
Study A and B 1. Patients referred for conventional defibrillator implantation or generator change. 2. Adults (age \> 18 years) 3. Willing to take part and able to give consent. Study C 1. Patients with defibrillators who are undergoing a VT ablation. 2. Adults (age \> 18 years) 3. Willing to take part and able to give consent. Study D 1. Patients with defibrillators already implanted who are able to exercise and raise their heart rate substantially 2. Adults (age \> 18 years) 3. Willing to take part and able to give consent. Study E 1. Patients with a defibrillator already implanted admitted with atrial arrhythmias, ventricular tachycardia or RV lead fracture. 2. Adults (age \> 18 years) 3. Willing to take part and able to give consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Outperforming current arrhythmia detection algorithms | 3 years | Improvement in sensitivity and specificity in accurately detecting ventricular arrhythmias in comparison to current algorithms. sensor and a separate electrical signal can out-perform current implantable cardioverter defibrillator algorithms. We will run different simulated and genuine arrhythmias through our novel detection algorithm and compare it against detection algorithms from all the major manufacturers with devices programmed as per HRS primary prevention guidelines. |
Countries
United Kingdom
Outcome results
None listed