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CardiaCare Device for Atrial Fibrillation

(NEUROPULSE Trial)

Recruiting in Palo Alto (17 mi)
VR
MT
Overseen byMohit Turagam, MD
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Icahn School of Medicine at Mount Sinai
Disqualifiers: Rheumatic heart disease, Severe heart failure, others
No Placebo Group

Trial Summary

What is the purpose of this trial?

Determine the role of vagal/median nerve stimulation using the CardiaCare RR2 home care wearable neuromodulation system on suppressing atrial arrhythmias and related symptoms in patients who have undergone AF ablation. The study population will be comprised of adults (age ≥18 yrs.) who have undergone AF ablation for paroxysmal or persistent AF. The study will assess the ability of neuromodulation, using the CardiaCare RR2 home care wearable, to suppress the following: 1. early (0-2 months) post-ablation arrhythmias that occur in the immediate post-ablation time period 2. AF/AT/AFL recurrences between months 2-6 post-ablation.This is a prospective, controlled, double-blind, randomized trial. The first 15 patients will not be randomized and will receive the active median/vagal stimulation only (open label). The Study will be conducted in up to 1 clinical site in the United States. This study will have 1:1 randomization (active median/vagal stimulation vs sham). The study has been given NSR designation from FDA--NO IDE.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the study team or your doctor.

What data supports the effectiveness of the CardiaCare Device for Atrial Fibrillation treatment?

The research highlights various non-drug treatments for atrial fibrillation, such as pacing and defibrillation, which have shown potential in managing the condition. Although not directly related to the CardiaCare Device, these studies suggest that non-invasive approaches can be effective in treating atrial fibrillation.12345

How is the CardiaCare Device treatment for atrial fibrillation different from other treatments?

The CardiaCare Device uses non-invasive median nerve stimulation, which is unique because it reduces cardiac sympathetic drive and prevents atrial electrical remodeling, unlike traditional treatments that often involve medication or invasive procedures.678910

Research Team

VR

Vivek Reddy, MD

Principal Investigator

Icahn School of Medicine at Mount Sinai

MT

Mohit Turagam, MD

Principal Investigator

Icahn School of Medicine at MS

Eligibility Criteria

Adults (age ≥18 yrs.) who have undergone catheter ablation for paroxysmal or persistent atrial fibrillation. Participants must be in the post-ablation period, either early (0-2 months) or between months 2-6. Specific inclusion and exclusion criteria details are not provided.

Inclusion Criteria

I am scheduled for or have had AF ablation and can join a study within 2 days of the procedure.
Ability and willingness to sign an informed consent form
Ability and willingness to use CardiaCare RR2 device, continuous ECG monitoring, and has an available SmartPhone
See 1 more

Exclusion Criteria

Unsuitable for participating in the study according to attending physician
I have had surgery to cut the nerves to my stomach.
I have nerve damage in my arm that was tested.
See 10 more

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks
1 visit (in-person or virtual)

Treatment

Participants receive neuromodulation using the CardiaCare RR2 home care wearable for 6 months

6 months
Continuous home monitoring with periodic in-person or virtual check-ins

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks
2 visits (in-person or virtual)

Open-label extension (optional)

First 15 patients receive open-label active median/vagal stimulation

4 weeks

Treatment Details

Interventions

  • Non-Invasive Median Nerve Stimulation (Procedure)
Trial OverviewThe trial is testing a wearable neuromodulation system called CardiaCare RR2 to see if it can prevent arrhythmias after AF ablation. It's a controlled study where patients are randomly assigned to get either real stimulation or a sham device.
Participant Groups
2Treatment groups
Active Control
Placebo Group
Group I: Participants with CardiaCare RR2Active Control1 Intervention
Participants undergoing Neuromodulation Sessions (mNVS) and Active Median/Vagal Stimulation. Patients will receive training on the RR2 for home-care use, by study personnel either in person or via a video conference meeting. An instructional video will also be available for users.
Group II: Participants with Sham DevicePlacebo Group1 Intervention
Sham device will be dispensed, which will create a sensation but not provide therapy

Find a Clinic Near You

Research Locations NearbySelect from list below to view details:
Icahn School of Medicine at Mount SinaiNew York, NY
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Who Is Running the Clinical Trial?

Icahn School of Medicine at Mount Sinai

Lead Sponsor

Trials
933
Patients Recruited
579,000+

Ziv HealthCare Ltd.

Industry Sponsor

Trials
3
Patients Recruited
130+

Findings from Research

The development of an implantable atrial defibrillator shows promise as a new treatment option for patients with recurrent atrial fibrillation, supported by advances in device technology and the feasibility of low-energy internal cardioversion.
Preliminary data indicate that low-energy shocks for atrial defibrillation are safe and do not lead to dangerous ventricular arrhythmias, but further clinical evaluation is needed to determine the best patient candidates and treatment protocols.
The future role of defibrillators in the management of atrial fibrillation.Ayers, GM., Griffin, JC.[2019]
Nonpharmacologic treatments for atrial fibrillation (AF), such as electrical cardioversion and radiofrequency catheter ablation, are essential for restoring sinus rhythm, especially when medications fail, and anticoagulation is crucial for virtually all patients.
In chronic AF cases, internal atrial defibrillation has shown feasibility and efficacy, suggesting that advanced nonpharmacologic interventions may be necessary when conventional treatments are ineffective.
Nonpharmacologic strategies for treating atrial fibrillation.Lüderitz, B., Pfeiffer, D., Tebbenjohanns, J., et al.[2019]
Current antiarrhythmic drug therapies for atrial fibrillation have limited effectiveness and can pose risks, prompting the exploration of various alternative treatments, including implantable defibrillators and catheter ablation.
While these new interventional therapies show promise, they each have significant limitations, such as invasiveness, variable efficacy, and risks of complications, indicating a need for further research and technological advancements.
Nonpharmacologic therapies for atrial fibrillation.Keane, D., Zou, L., Ruskin, J.[2019]
Atrial fibrillation in patients with heart failure is linked to higher mortality and more hospitalizations, but restoring normal heart rhythm has not shown clear benefits in large trials.
Catheter ablation for atrial fibrillation has demonstrated efficacy rates between 50% and 92% in maintaining sinus rhythm, leading to improvements in heart function, quality of life, and overall functional class.
Catheter ablation of atrial fibrillation in heart failure.Kirubakaran, S., O'Neill, MD.[2013]

References

Dynamic and dual-site atrial pacing in the prevention of atrial fibrillation: The STimolazione Atrial DInamica Multisito (STADIM) Study. [2008]
The future role of defibrillators in the management of atrial fibrillation. [2019]
Nonpharmacologic strategies for treating atrial fibrillation. [2019]
Nonpharmacologic therapies for atrial fibrillation. [2019]
Catheter ablation of atrial fibrillation in heart failure. [2013]
Subcutaneous nerve stimulation for rate control in ambulatory dogs with persistent atrial fibrillation. [2020]
Chronic median nerve modulation reduces ventricular arrhythmia and improves ventricular function in a postmyocardial infarction rabbit model. [2018]
[A wireless implantable stimulating and ECG monitoring system for animal models of chronic atrial fibrillation]. [2018]
Median nerve stimulation prevents atrial electrical remodelling and inflammation in a canine model with rapid atrial pacing. [2019]
Cardioneuroablation Using Epicardial Pulsed Field Ablation for the Treatment of Atrial Fibrillation. [2023]