Continuous Cardiac Arrhythmia Monitoring in Hemodialysis Patients (CARE-ESRD)
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Purpose
Hemodialysis patients have a rate of fatal arrhythmias that is 40 times greater than the general population, but the causes and types of fatal arrhythmias they experience is unclear. The purpose of this prospective observational cohort study is to capture and characterize occult arrhythmias which occur in hemodialysis patients over a 6 month period. After informed consent and baseline assessment, 30 adult hemodialysis patients without a prior history of cardiac arrhythmias will undergo implantation of a continuous cardiac monitoring device (REVEAL, Medtronic). Three followup visits will be scheduled to download device data and quantify the number of potentially malignant arrhythmias which occur in study subjects during the 6 month period. Additionally, captured events will be monitored remotely via regular patient initiated transmission of device data every 2 weeks. Any serious occult arrhythmias detected will be immediately acted upon with a predefined management algorithm. Descriptive data and simple proportions will be used to describe the incidence and types of arrhythmias among the study cohort. Risks of this study include 1) potential loss of patient confidentiality 2) risks related to insertion of device including pocket hematoma, device infection, pain and discomfort secondary to procedure. These will be minimized by strict security measures to protect each patient's protected health information (PHI), preprocedural screening and insertion of monitoring devices by highly trained operators, and frequent careful direct patient followup.
| Condition | Intervention |
|---|---|
|
Arrhythmias, Cardiac |
Device: continuous cardiac monitoring device (REVEAL, Medtronic) |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | Characterization of Cardiac Arrhythmias in End Stage Kidney Disease Patients on Hemodialysis Using an Implantable Continuous Cardiac Rhythm Monitoring Device: A Pilot Study |
- Number of Participants With a Significant Arrhythmia Detected [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- Number of Participants Experiencing a Peridialytic or Intradialytic Arrhythmias [ Time Frame: 6 months ] [ Designated as safety issue: No ]
| Enrollment: | 8 |
| Study Start Date: | June 2009 |
| Study Completion Date: | February 2011 |
| Primary Completion Date: | February 2011 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
Hemodialysis patients
This is a single arm observational study. The single arm consists of adult hemodialysis patients without a prior history of cardiac arrhythmias who will be implanted with a continuous cardiac monitoring device (REVEAL, Medtronic) for an FDA approved indication.
|
Device: continuous cardiac monitoring device (REVEAL, Medtronic)
hemodialysis patients without a prior history of cardiac arrhythmias will undergo implantation of a continuous cardiac monitoring device, and will undergo 6 months of follow-up
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Duke hemodialysis patients with end stage renal disease
Inclusion Criteria:
- Greater than 18 years of age
- ESRD receiving hemodialysis for at least 3 months
Exclusion Criteria:
- Inability to give informed consent
- Pre-existing implantable cardiac device (pacemaker or ICD) or imminent device implantation
- Imminent renal transplantation
- Life expectancy < 1yr
- PT-INR or aPTT > 1.7 upper limit of normal (ULN) or history of bleeding diathesis
- Unstable medical condition as deemed by primary nephrologist or study staff
- Known sustained ventricular tachycardia due to non-reversible cause.
- Active infection
- Known atrial fibrillation
- Women who are pregnant
Contacts and Locations| United States, North Carolina | |
| Duke University Medical Center | |
| Durham, North Carolina, United States, 27710 | |
| Principal Investigator: | Sana Al-Khatib, MD | Duke University Health System |
More Information
Publications:
| Responsible Party: | Duke University |
| ClinicalTrials.gov Identifier: | NCT00932659 History of Changes |
| Other Study ID Numbers: | Pro00012031 |
| Study First Received: | July 2, 2009 |
| Results First Received: | December 13, 2012 |
| Last Updated: | April 11, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Duke University:
|
End-Stage Renal Disease Hemodialysis Cardiac Arrhythmias |
Additional relevant MeSH terms:
|
Arrhythmias, Cardiac Kidney Failure, Chronic Heart Diseases Cardiovascular Diseases Pathologic Processes |
Renal Insufficiency, Chronic Renal Insufficiency Kidney Diseases Urologic Diseases |
ClinicalTrials.gov processed this record on June 13, 2013