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Study of Defibrillation Testing In Patients Undergoing Initial ICD Implantation (TNT-ICD)

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. Identifier: NCT01905007
Recruitment Status : Unknown
Verified July 2013 by Andrea M. Russo, MD, The Cooper Health System.
Recruitment status was:  Recruiting
First Posted : July 22, 2013
Last Update Posted : July 22, 2013
University of Washington
Information provided by (Responsible Party):
Andrea M. Russo, MD, The Cooper Health System

Brief Summary:
The primary objective of this study is to compare the composite outcome of total mortality and operative complications in patients who do not undergo defibrillation testing to those who do undergo defibrillation testing at the time of initial ICD implantation.

Condition or disease Intervention/treatment Phase
Ventricular Arrhythmias Device: Defibrillation testing Phase 4

Detailed Description:

Implantable cardioverter-defibrillators (ICDs) are the most effective treatment for the primary and secondary prevention of sudden cardiac death (SCD). At the time of ICD implantation, ventricular fibrillation (VF) is typically induced to demonstrate effective arrhythmia termination by the implanted device. Although defibrillation threshold (DFT) testing with induction of VF at time of ICD insertion is currently considered the "standard of care," and instructions for usage of devices approved by the Food and Drug Administration (FDA) include labeling with DFT testing, the value of defibrillation testing with modern-day devices has been questioned. Defibrillation testing can be associated with serious complications and may add to the cost of the procedure.

It is hypothesized that patients who do not undergo defibrillation testing will have outcomes similar to those who do undergo defibrillation testing at the time of initial implantation. This pilot study is being performed to determine the feasibility of performing a larger, multi-center clinical trial with longer follow-up to investigate whether or not defibrillation testing will have any impact on overall mortality, implant complications, or long-term first shock efficacy during clinical follow-up.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 100 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: "Test-No Test" Implantable Cardioverter Defibrillator Pilot Study (TNT-ICD)
Study Start Date : December 2010
Estimated Primary Completion Date : December 2014
Estimated Study Completion Date : December 2014

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Active Comparator: Defibrillation testing
Defibrillation testing at initial ICD implantation
Device: Defibrillation testing
Defibrillation testing at initial ICD implantation
Other Name: Medtronic implantable cardioverter defibrillator

No Intervention: No defibrillation testing
No defibrillation testing at initial ICD implantation

Primary Outcome Measures :
  1. Composite all-cause mortality and operative complications [ Time Frame: Procedure-related complications will be defined as those occurring within 90 days post-implantation and mortality will be measured at 2 year follow-up ]
    The composite endpoint of implant complications and mortality rates will be compared in the DFT vs. no DFT groups.

Secondary Outcome Measures :
  1. 1st shock efficacy for clinical occurrence of ventricular tachycardia (VT)/VF [ Time Frame: 2 years ]
    The efficacy of 1st shock therapy for VT/VF will be compared between the DFT and no DFT groups.

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Age ≥ 18 years
  • Initial ICD implantation (single, dual, or CRT) for a standard Class I or Class II indication according to the ACC/AHA/HRS practice guidelines
  • Anticipated life expectancy >6 months

Exclusion Criteria:

  • Contraindications to defibrillation testing as determined by the managing physician*
  • ICD replacement implants
  • Right-sided pectoral implants
  • Abdominal implants
  • Chronic oral amiodarone therapy (for >6 weeks and continued need for amiodarone)
  • Inability to give informed consent

    • Contraindications to defibrillation testing include the following: hemodynamic instability, LA thrombus, atrial fibrillation without adequate anticoagulation, LV thrombus, recent CVA or TIA, severe unrevascularized coronary artery disease or unstable angina, severe aortic stenosis, inotropic dependence, patient refusal, other patient-specific medical conditions that are deemed as contraindications, as determined by the implanting physician.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01905007

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Contact: Andrea M. Russo, MD 856-968-7096
Contact: Julie Field 856-669-8847

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United States, New Jersey
Cooper University Hospital Recruiting
Camden, New Jersey, United States, 08103
Contact: Andrea M. Russo, M.D.    856-968-7096      
Contact: Julie Field    856-669-8847   
Principal Investigator: Andrea M. Russo, MD         
Sub-Investigator: John Andriulli, MD         
Sub-Investigator: Matthew Ortman, MD         
Sub-Investigator: Claudine Pasquarello, PA-C         
United States, Washington
University of Washington Not yet recruiting
Seattle, Washington, United States, 98195
Contact: Jeanne Poole, MD         
Principal Investigator: Jeanne Poole, MD         
Sponsors and Collaborators
The Cooper Health System
University of Washington
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Principal Investigator: Andrea M. Russo, MD The Cooper Health System

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Responsible Party: Andrea M. Russo, MD, Professor of Medicine, Director of Electrophysiology & Arrhythmia Services, The Cooper Health System Identifier: NCT01905007    
Other Study ID Numbers: CUH-09-087
First Posted: July 22, 2013    Key Record Dates
Last Update Posted: July 22, 2013
Last Verified: July 2013
Keywords provided by Andrea M. Russo, MD, The Cooper Health System:
Implantable cardioverter defibrillator
Defibrillation threshold testing
Additional relevant MeSH terms:
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Arrhythmias, Cardiac
Heart Diseases
Cardiovascular Diseases
Pathologic Processes