Hypertrophic CardiomyopathyPhase 2NCT00035386
Alcohol Septal Ablation in Obstructive Hypertrophic Cardiomyopathy: A Pilot Study
A Phase 2 study testing trans-right ventricular alcohol septal ablation (TRVASA) in people with Hypertrophic Cardiomyopathy, run by National Heart, Lung, and Blood Institute (NHLBI) at 1 site in United States.
Trial summary
This study will test the feasibility of a modified procedure for treating obstructive hypertrophic cardiomyopathy (OHC). Patients with OHC have a thickening of the heart muscle that obstructs blood flow out of the heart, causing breathlessness, chest pain, palpitations, tiredness, lightheadedness, and fainting. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Hypertrophic Cardiomyopathy
- What is being tested?
- trans-right ventricular alcohol septal ablation (TRVASA)
- Type of treatment
- Surgery or procedure
- How many people
- 12 participants
- Where
- 1 siteUnited States
- Study dates
- Apr 2002to Apr 2003
- Phase
- Phase 2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Patients of either gender, aged 18-85 years.
- Symptomatic patients receiving clinically indicated evaluation for cardiomyopathy and found to have obstructive HCM.
- LV outflow tract gradient greater than 30 mm Hg at rest by echocardiography or cardiac catheterization.
Who cannot join
- Positive pregnancy test.
Trial locations and contacts
1 site in 1 country.
United States1 site
National Heart, Lung and Blood Institute (NHLBI)
Bethesda, Maryland, 20892
About this study
Official title: Trans-Right Ventricular Approach to Alcohol Septal Ablation in Obstructive Hypertrophic Cardiomyopathy: A Pilot Feasibility Study
This study will test the feasibility of a modified procedure for treating obstructive hypertrophic cardiomyopathy (OHC). Patients with OHC have a thickening of the heart muscle that obstructs blood flow out of the heart, causing breathlessness, chest pain, palpitations, tiredness, lightheadedness, and fainting.
The current treatment for OHC is a procedure called alcohol septal ablation (also percutaneous transluminal septal ablation, or PTSA), which involves injecting a small amount of alcohol into a tiny artery that supplies the part of muscle causing blood flow obstruction. The success of PTSA is limited, however, by problems of heart anatomy and the ability to find the appropriate artery to inject. Modifying the procedure by injecting the alcohol through the wall of the lower right chamber of the heart may improve its safety and effectiveness. The new technique requires positioning a catheter (a flexible tube) into the appropriate area of the heart. This study will test the ability to accurately guide the catheter to that area.
Patients with OHC 18 years of age and older who are scheduled to have a cardiac catheterization may be eligible for this study. At the end of the catheterization procedure, participants will undergo intra-cardiac echocardiographic imaging. For this test, one of the catheters placed in the femoral artery (at the top of the leg) for cardiac catheterization will be substituted for a larger one. Through this catheter, a special catheter will be introduced and advanced to the heart to provide images. This pilot feasibility study does not involve injection of alcohol.
Read the detailed description
Patients with obstructive hypertrophic cardiomyopathy (HCM) and drug-refractory symptoms have traditionally been referred for cardiac surgery to widen the left ventricular (LV) outflow tract. More recently, percutaneous transluminal septal ablation (PTSA) has also been shown to thin the subvalvular septum and thereby to reduce LV outflow pressure gradients and to improve symptoms in obstructive HCM. However, this procedure is not infrequently limited by septal coronary artery anatomy and inability to identify and cannulate the appropriate artery that supplies the septal region of interest. Some attempts are also associated with coronary artery dissection, particularly, if there is associated coronary artery disease. A trans-right ventricular (RV) alcohol septal ablation (TRVASA) would significantly simplify the procedure, and increase its safety. The purpose of this study is to initially test our ability to visualize and guide a delivery catheter to a targeted part of the anterior interventricular septum involved in the generation of the LV outflow obstruction using intracardiac echocardiography (ICE). No therapy is intended: alcohol will not be injected into the septum in this initial study.
- Conditions
- Hypertrophic Cardiomyopathy
- Being tested
- trans-right ventricular alcohol septal ablation (TRVASA)
- Keywords
- Outflow Obstruction, ICE, HCM, Hypertrophic Cardiomyopathy, OHC, Obstructive HCM, Cardiomyopathy
- Medical subject headings
- Cardiomyopathy, Hypertrophic, Cardiomyopathies
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
trans-right ventricular alcohol septal ablation (TRVASA)Procedure or surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 May 2002 (estimated)
- Study startApr 2002
- Study completionApr 2003
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Hypertrophic CardiomyopathyStudies of the same condition, open and under way.
- More trials run by National Heart, Lung, and Blood Institute (NHLBI)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Enrolment
- 12 participants
Sponsor and investigators
- Sponsor type
- US National Institutes of Health
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00035386
- Sponsor's protocol ID
- 020125
- Other IDs
- 02-H-0125
- Status last verified
- Apr 2003
- First submitted
- 2 May 2002
- Last updated
- 4 Mar 2008
- Results posted
- No
Publications
McIntosh CL, Maron BJ. Current operative treatment of obstructive hypertrophic cardiomyopathy. Circulation. 1988 Sep;78(3):487-95. doi: 10.1161/01.cir.78.3.487. No abstract available.
PubMed 3409494Krajcer Z, Leachman RD, Cooley DA, Coronado R. Septal myotomy-myomectomy versus mitral valve replacement in hypertrophic cardiomyopathy. Ten-year follow-up in 185 patients. Circulation. 1989 Sep;80(3 Pt 1):I57-64.
PubMed 2766539Delahaye F, Jegaden O, de Gevigney G, Genoud JL, Perinetti M, Montagna P, Delaye J, Mikaeloff P. Postoperative and long-term prognosis of myotomy-myomectomy for obstructive hypertrophic cardiomyopathy: influence of associated mitral valve replacement. Eur Heart J. 1993 Sep;14(9):1229-37. doi: 10.1093/eurheartj/14.9.1229.
PubMed 8223738
Study at a glance
From the registry record, last updated by the sponsor on 4 Mar 2008. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Trans-Right Ventricular Approach to Alcohol Septal Ablation in Obstructive Hypertrophic Cardiomyopathy: A Pilot Feasibility Study
- ClinicalTrials.gov ID
- NCT00035386
- Acronym / sponsor ID
- 020125
- Conditions
- Hypertrophic Cardiomyopathy
- Keywords
- Outflow Obstruction, ICE, HCM, Hypertrophic Cardiomyopathy, OHC, Obstructive HCM, Cardiomyopathy
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 12 participants
- Lead sponsor
- National Heart, Lung, and Blood Institute (NHLBI)US National Institutes of Health
- Study start
- Apr 2002
- Study completion
- Apr 2003
- First posted
- 3 May 2002 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will test the feasibility of a modified procedure for treating obstructive hypertrophic cardiomyopathy (OHC). Patients with OHC have a thickening of the heart muscle that obstructs blood flow out of the heart, causing breathlessness, chest pain, palpitations, tiredness, lightheadedness, and fainting.
The current treatment for OHC is a procedure called alcohol septal ablation (also percutaneous transluminal septal ablation, or PTSA), which involves injecting a small amount of alcohol into a tiny artery that supplies the part of muscle causing blood flow obstruction. The success of PTSA is limited, however, by problems of heart anatomy and the ability to find the appropriate artery to inject. Modifying the procedure by injecting the alcohol through the wall of the lower right chamber of the heart may improve its safety and effectiveness. The new technique requires positioning a catheter (a flexible tube) into the appropriate area of the heart. This study will test the ability to accurately guide the catheter to that area.
Patients with OHC 18 years of age and older who are scheduled to have a cardiac catheterization may be eligible for this study. At the end of the catheterization procedure, participants will undergo intra-cardiac echocardiographic imaging. For this test, one of the catheters placed in the femoral artery (at the top of the leg) for cardiac catheterization will be substituted for a larger one. Through this catheter, a special catheter will be introduced and advanced to the heart to provide images. This pilot feasibility study does not involve injection of alcohol.
Detailed description
Patients with obstructive hypertrophic cardiomyopathy (HCM) and drug-refractory symptoms have traditionally been referred for cardiac surgery to widen the left ventricular (LV) outflow tract. More recently, percutaneous transluminal septal ablation (PTSA) has also been shown to thin the subvalvular septum and thereby to reduce LV outflow pressure gradients and to improve symptoms in obstructive HCM. However, this procedure is not infrequently limited by septal coronary artery anatomy and inability to identify and cannulate the appropriate artery that supplies the septal region of interest. Some attempts are also associated with coronary artery dissection, particularly, if there is associated coronary artery disease. A trans-right ventricular (RV) alcohol septal ablation (TRVASA) would significantly simplify the procedure, and increase its safety. The purpose of this study is to initially test our ability to visualize and guide a delivery catheter to a targeted part of the anterior interventricular septum involved in the generation of the LV outflow obstruction using intracardiac echocardiography (ICE). No therapy is intended: alcohol will not be injected into the septum in this initial study.
Study design
- Primary purpose
- Treatment
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (3 listed)
- Patients of either gender, aged 18-85 years.
- Symptomatic patients receiving clinically indicated evaluation for cardiomyopathy and found to have obstructive HCM.
- LV outflow tract gradient greater than 30 mm Hg at rest by echocardiography or cardiac catheterization.
Key exclusion criteria (1 listed)
- Positive pregnancy test.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| trans-right ventricular alcohol septal ablation (TRVASA) | Procedure or surgery | – |
Primary outcome
Not reported in the source record.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Mar 2008.
- Background: PubMed 3409494McIntosh CL, Maron BJ. Current operative treatment of obstructive hypertrophic cardiomyopathy. Circulation. 1988 Sep;78(3):487-95. doi: 10.1161/01.cir.78.3.487. No abstract available.
- Background: PubMed 2766539Krajcer Z, Leachman RD, Cooley DA, Coronado R. Septal myotomy-myomectomy versus mitral valve replacement in hypertrophic cardiomyopathy. Ten-year follow-up in 185 patients. Circulation. 1989 Sep;80(3 Pt 1):I57-64.
- Background: PubMed 8223738Delahaye F, Jegaden O, de Gevigney G, Genoud JL, Perinetti M, Montagna P, Delaye J, Mikaeloff P. Postoperative and long-term prognosis of myotomy-myomectomy for obstructive hypertrophic cardiomyopathy: influence of associated mitral valve replacement. Eur Heart J. 1993 Sep;14(9):1229-37. doi: 10.1093/eurheartj/14.9.1229.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing trans-right ventricular alcohol septal ablation (TRVASA) in people with Hypertrophic Cardiomyopathy, run by National Heart, Lung, and Blood Institute (NHLBI) at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 4 Mar 2008. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00035386, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Mar 2008.