Use of Loop Recorders for Diagnosis of Palpitations in A&E (LIAISE)
Recruitment status was Recruiting
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Purpose
Heart rhythm abnormalities underlie one of the common presenting complaints to the A&E and out-patient departments, specifically awareness of heart beats or palpitations. Unless an ECG (electrocardiogram) tracing of the heart rhythm can be recorded while the patient is having symptoms, it is very difficult to determine the cause of the palpitations. The conventional approach is to refer these patients from the emergency departments to the Cardiology outpatients where they undergo repeated short term rhythm monitoring hoping to record the rhythm underlying the patient's complaint. Unfortunately, this often yields no results thus delaying definitive treatment and incurring extra costs of repeated investigations and A&E presentations. This study aims to compare the ability of the conventional approach to establish a definite diagnosis compared to that of an early invasive monitoring approach with a small implantable device that records the heart rhythm at all time for up to 18 months.
| Condition | Intervention |
|---|---|
|
Palpitations |
Device: Implantable Loop Recorder |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Diagnostic |
| Official Title: | Use of Implantable Loop Recorders as a Primary Investigation of Infrequent Undiagnosed ArrhythmIa Symptoms in the Emergency Department |
- The primary endpoint of the study is the proportion of patients achieving a definite diagnosis in each of the two groups at the end of one year [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- The time taken from randomisation in the A&E to making the diagnosis (if any) in each group [ Time Frame: 1 Year ] [ Designated as safety issue: No ]
- The cost of achieving a diagnosis in each group [ Time Frame: 1 Year ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 56 |
| Study Start Date: | April 2010 |
| Estimated Primary Completion Date: | October 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Group 1: ILR Group
Group allocated to receiving an ILR in the A&E department.
|
Device: Implantable Loop Recorder
Other Name: Reveal XT
|
|
No Intervention: Group 2: Conventional
Group randomised to conventional lines of investigation
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age 18 years or older
- Good history of episodic symptomatic sustained palpitations (sudden onset and offset, fast heart beats, may be associated with shortness of breath or dizziness)
- Terminates before presentation to hospital
- Episodes occur at a frequency of less than once every two weeks
- Never previously caught on ECG or ambulatory monitoring
- Normal resting ECG
Exclusion Criteria:
- Contraindication to ILR implantation i.e. ongoing oral anticoagulation with INR >1.6, ongoing infection, sepsis or fever, etc.
- Palpitations suggestive of extrasystoles (single missed or dropped beats)
Known or suspected severe valvular or myocardial heart disease
- An audible heart murmur
- Any abnormality on the surface ECG
- Thyrotoxicosis
- Patients who refuse an ILR when offered will not be included in either limb of the study
Contacts and Locations| Contact: Richard Schilling, MD, FRCP | +442076018639 | r.schilling@qmul.ac.uk |
| United Kingdom | |
| Barts and the London NHS Trust | Recruiting |
| London, United Kingdom, EC1A 7BE | |
| Principal Investigator: | Richard Schilling, MD, FRCP | Barts and the London NHS Trust, Queen Mary University of London |
More Information
No publications provided
| Responsible Party: | Professor Richard Schilling, Barts and the London NHS Trust/ Queen Mary University of London |
| ClinicalTrials.gov Identifier: | NCT01170559 History of Changes |
| Other Study ID Numbers: | 006628 BLT |
| Study First Received: | July 26, 2010 |
| Last Updated: | March 21, 2011 |
| Health Authority: | United Kingdom: Barts and the London NHS Trust United Kingdom: Camden and Islington Research Ethics Committee |
ClinicalTrials.gov processed this record on May 23, 2013