Phase I/II Study of EP-guided Noninvasive Cardiac Radioablation for Treatment of Ventricular Tachycardia (ENCORE-VT)
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The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. |
ClinicalTrials.gov Identifier: NCT02919618 |
Recruitment Status :
Active, not recruiting
First Posted : September 29, 2016
Results First Posted : September 10, 2019
Last Update Posted : December 2, 2021
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Study Type | Interventional |
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Study Design | Allocation: N/A; Intervention Model: Single Group Assignment; Masking: None (Open Label); Primary Purpose: Treatment |
Conditions |
Ventricular Tachycardia Cardiomyopathy Premature Ventricular Contractions |
Intervention |
Radiation: stereotactic body radiotherapy (SBRT) |
Enrollment | 19 |
Recruitment Details | Twenty-one patients were consented between July 11, 2016 and December 20, 2017. These patients were evaluated as either inpatient or outpatient. Once patients met initial enrollment criteria, screening procedures were conducted to determine if the patient was eligible for SBRT. |
Pre-assignment Details |
Nineteen patients were consented, screened, and deemed eligible for SBRT. Two additional patients signed consent and went through screening procedures; however, were later deemed ineligible to obtain SBRT. |
Arm/Group Title | Patients Overall Who Received SBRT |
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Noninvasive Stereotactic Body Radiotherapy (SBRT) will be delivered in a single fraction to a region of the heart determined by EP-guidance, using noninvasive electrical mapping combined with anatomic imaging. Stereotactic Body Radiotherapy (SBRT): (Cardiac ablative radiotherapy) |
Period Title: Overall Study | |
Started | 19 |
Primary Safety Endpoint (</=90 Days) [1] | 19 |
Primary Efficacy Endpoint (6 Months) [2] | 18 |
Completed | 18 |
Not Completed | 1 |
Reason Not Completed | |
Death | 1 |
[1]
Phase 1 - Defined by a </=20% rate of SAEs using CTCAE v4.0 criteria.
[2]
Phase 2 - Number of subjects with a reduction in ICD therapies 6mo before and 6mo post-SBRT.
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Arm/Group Title | Patients Overall Who Received SBRT | |
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Noninvasive SBRT will be delivered in a single fraction to a region of the heart determined by EP-guidance, using noninvasive electrical mapping combined with anatomic imaging. Stereotactic Body Radiotherapy (SBRT): (Cardiac ablative radiotherapy) |
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Overall Number of Baseline Participants | 19 | |
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[Not Specified]
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Age, Continuous
Median (Full Range) Unit of measure: Years |
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Number Analyzed | 19 participants | |
66
(49 to 81)
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Sex: Female, Male
Measure Type: Count of Participants Unit of measure: Participants |
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Number Analyzed | 19 participants | |
Female |
2 10.5%
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Male |
17 89.5%
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Race (NIH/OMB)
Measure Type: Count of Participants Unit of measure: Participants |
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Number Analyzed | 19 participants | |
American Indian or Alaska Native |
0 0.0%
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Asian |
1 5.3%
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Native Hawaiian or Other Pacific Islander |
0 0.0%
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Black or African American |
1 5.3%
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White |
17 89.5%
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More than one race |
0 0.0%
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Unknown or Not Reported |
0 0.0%
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BMI
Median (Full Range) Unit of measure: Kg/m^2 |
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Number Analyzed | 19 participants | |
33.0
(24.3 to 48.6)
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Age-Adjusted Charlson Comorbidity Index
[1] Median (Full Range) Unit of measure: Score |
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Number Analyzed | 19 participants | |
4
(2 to 13)
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[1]
Measure Description: The Charlson Comorbidity Index predicts 10-year survival in patients with multiple comorbidities. The Charlson Comorbidity Index scale ranges from 0 (no comorbidities) to 37 (all comorbidities in equation). The score is then adjusted based on the age of the patient, adding 0 to 4 points to the Charlson Comorbidity Index score, thus providing the Age-Adjusted Charlson Comorbidity Index.
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Type of Cardiomyopathy
Measure Type: Count of Participants Unit of measure: Participants |
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Number Analyzed | 19 participants | |
Ischemic Cardiomyopathy |
11 57.9%
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Nonischemic Cardiomyopathy |
8 42.1%
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Type of Nonischemic Cardiomyopathy
[1] Measure Type: Count of Participants Unit of measure: Participants |
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Number Analyzed | 8 participants | |
Idiopathic |
5 62.5%
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Myocarditis (Chronic) |
2 25.0%
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Valvular |
1 12.5%
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[1]
Measure Analysis Population Description: Based on the number of patients enrolled with nonischemic cardiomyopathy (8/19).
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New York Heart Association (NYHA) Class
[1] Measure Type: Count of Participants Unit of measure: Participants |
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Number Analyzed | 19 participants | |
NYHA I |
1 5.3%
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NYHA II |
4 21.1%
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NYHA III |
10 52.6%
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NYHA IV |
4 21.1%
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[1]
Measure Description: NYHA Class I: No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea; NYHA Class II: Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea; NYHA Class III: Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, dyspnea; NYHA Class IV: Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases.
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Left Ventricular Ejection Fraction
Median (Full Range) Unit of measure: Percentage of Ejection Fraction |
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Number Analyzed | 19 participants | |
25
(15 to 58)
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Number of Previous Catheter Ablations
Median (Full Range) Unit of measure: Invasive Procedures |
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Number Analyzed | 19 participants | |
1
(0 to 4)
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Total Number of Prior Catheter Ablation Approaches
Measure Type: Number Unit of measure: Invasive Ablation Approaches |
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Endocardial | Number Analyzed | 19 participants |
25 | ||
Epicardial | Number Analyzed | 19 participants |
4 | ||
Study Eligibility Criteria
Measure Type: Count of Participants Unit of measure: Participants |
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Number Analyzed | 19 participants | |
Incessant Ventricular Tachycardia (VT) |
2 10.5%
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VT Storm (>3 episodes of VT in 24 hours) |
10 52.6%
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ICD Therapies (>3 shocks or ATP in 6 months) |
5 26.3%
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PVC-Related Cardiomyopathy |
2 10.5%
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Device
Measure Type: Count of Participants Unit of measure: Participants |
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Number Analyzed | 19 participants | |
Single- or Dual-Chamber ICD |
8 42.1%
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Biventricular ICD |
10 52.6%
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No Device |
1 5.3%
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Current Antiarrhythmic Drugs
Measure Type: Number Unit of measure: Count of Participants |
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>1 Antiarrhythmic Drug at Baseline | Number Analyzed | 19 participants |
11 | ||
High-Dose Amiodarone (>/=300mg per day) | Number Analyzed | 19 participants |
10 | ||
Low-Dose Amiodarone (<300mg per day) | Number Analyzed | 19 participants |
2 | ||
Class III (excluding amiodarone) | Number Analyzed | 19 participants |
7 | ||
Class I | Number Analyzed | 19 participants |
11 | ||
Other Medications
Measure Type: Number Unit of measure: Count of Participants |
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Beta Blocker | Number Analyzed | 19 participants |
18 | ||
Angiotensin Converting Enzyme Inhibitor | Number Analyzed | 19 participants |
10 | ||
Angiotensin Receptor Blocker | Number Analyzed | 19 participants |
7 | ||
Oral Anticoagulation | Number Analyzed | 19 participants |
14 | ||
Variable
Measure Type: Number Unit of measure: Count of Participants |
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Chronic Obstructive Pulmonary Disease/Emphysema | Number Analyzed | 19 participants |
4 | ||
Diabetes Mellitus, Type II | Number Analyzed | 19 participants |
7 | ||
Hypertension | Number Analyzed | 19 participants |
10 | ||
Chronic Kidney Disease (Stage >/=3) | Number Analyzed | 19 participants |
9 |
Name/Title: | Dr. Phillip Cuculich |
Organization: | Washington University |
Phone: | 314-454-7698 |
EMail: | pcuculic@wustl.edu |
Responsible Party: | Phillip Cuculich, Washington University School of Medicine |
ClinicalTrials.gov Identifier: | NCT02919618 |
Other Study ID Numbers: |
201606081 |
First Submitted: | September 28, 2016 |
First Posted: | September 29, 2016 |
Results First Submitted: | July 1, 2019 |
Results First Posted: | September 10, 2019 |
Last Update Posted: | December 2, 2021 |