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Trial registered on ANZCTR
Registration number
ACTRN12617001382369
Ethics application status
Approved
Date submitted
26/09/2017
Date registered
28/09/2017
Date last updated
28/09/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Exercise, Physical Activity and Nurse-Led Education for Patients with an Implantable Cardioverter Defibrillator
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Scientific title
A STructured Exercise, Physical Activity, and Education Intervention in Patients with an ICD: The STEP-ICD Pilot Study
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Secondary ID [1]
292982
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
heart failure
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sudden cardiac death
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Condition category
Condition code
Cardiovascular
304202
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients allocated to the intervention group will undergo a 12-week, goal orientated,
combined home and supervised exercise intervention. Weekly exercise will increase progressively in duration from 45 minutes per week in week 1 to 210 minutes per week by week 12. All patients in the intervention arm will attend a supervised exercise clinic once per fortnight for 15-30 minutes with the remainder of exercise being predominantly home-based and monitored by a wearable accelerometer and heart rate tracking device. Exercise will be prescribed according to individualised intensities (using a rating of perceived exertion scale) by an accredited exercise physiologist. Exercise will be predominantly aerobic exercise throughout, with the addition of bodyweight resistance training in week 8. Furthermore, the intervention will include an education component, led by a cardiovascular nurse, regarding disease and device management. Specifically, patients will meet with a study nurse three times through the intervention (week 1, 4, and 8) to discuss and receive education on, their heart condition, how their cardiac devices works, their cardiovascular risk factors and any anxieties or concerns that they may have,
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Intervention code [1]
299223
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Rehabilitation
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Comparator / control treatment
Participants in the control group will continue to receive optimal medical care for their heart condition according to international guidelines. This varies between patients according to their underlying pathology but may include the continuation of medications including diuretics, beta-blockers, and anti-hypertensive medication.
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Control group
Active
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Outcomes
Primary outcome [1]
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Peak Oxygen Consumption assessed by cardiopulmonary exercise testing
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Assessment method [1]
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Timepoint [1]
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12 weeks, 24 weeks
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Secondary outcome [1]
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Weekly moderate-vigorous physical activity (MVPA) assessed by accelerometry. This metric will also be used to aseess study feasibility by quantifying the amount of physical activity each patients is achieving, comapred to that being recommended.
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Assessment method [1]
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Timepoint [1]
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12 weeks, 24 weeks
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Secondary outcome [2]
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Minnesota Living with Heart Failure Score assessed by questionnaire
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Assessment method [2]
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Timepoint [2]
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12 weeks, 24 weeks
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Secondary outcome [3]
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Hospital Anxiety and Depression Score assessed by questionnaire
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Assessment method [3]
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Timepoint [3]
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12 weeks, 24 weeks
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Eligibility
Key inclusion criteria
- Primary prevention implanted cardioverter defibrillator (ICD), without cardiac resynchronization therapy (CRT-D), implanted within past 35 days
- Aged >18 - 80 years
- LV Ejection Fraction <45%.
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Minimum age
18
Years
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Maximum age
80
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Severely impaired cognitive function, restricting informed consent.
- Severely limited walking capacity.
- New York Heart Association Class I or IV
- Sustained ventricular arrhythmias during baseline cardiopulmonary exercise testing.
- Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC/D)
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
9/10/2017
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Centre for Heart Rhythm Disorders, University of Adelaide
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Address [1]
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Level 8, South Australian Health & Medical Research Institute
North Terrace
Adelaide
SA 5000
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Centre for Heart Rhythm Disorders, University of Adelaide
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Address
Level 8, South Australian Health & Medical Research Institute
North Terrace
Adelaide
SA 5000
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
296621
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of Adelaide Human Research Ethics Committee
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Ethics committee address [1]
298700
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Ethics committee country [1]
298700
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Date submitted for ethics approval [1]
298700
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Approval date [1]
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19/09/2017
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Ethics approval number [1]
298700
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Summary
Brief summary
This study will provide novel, translational data by evaluating the feasibility and efficacy of a structured, goal directed, exercise and physical activity intervention, coupled with nurse-led education, initiated within one month of implant, for patients receiving a primary prevention ICD. Across Australia, there are ~4000 new recipients of an implanted cardioverter defibrillator (ICD) annually. Recipients are commonly those with left ventricular (LV) dysfunction and/or inducible ventricular arrhythmia. Annual all-cause mortality in patients with prophylactic ICD implantation is approximately 5.0 to 8.5% . Additionally, ICD recipients report lower quality of life coupled with both anxiety and depressive symptoms, which may be exaggerated by higher prevalence of inactivity. The rationale for this study is therefore to combine nurse-led education with a physical activity intervention in new recipients of a primary prevention ICD. Both interventions are clinically effective in patients with heart failure or an ICD, yet have not been comprehensively assessed in a combined strategy.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Adrian Elliott
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Address
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Level 8, South Australian Health & Medical Research Institute
North Terrace
Adelaide
SA 5000
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Country
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Australia
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Phone
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+61 8 8222 2723
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Adrian Elliott
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Address
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Level 8, South Australian Health & Medical Research Institute
North Terrace
Adelaide
SA 5000
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Country
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Australia
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Phone
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+61 8 8222 2723
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Adrian Elliott
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Address
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Level 8, South Australian Health & Medical Research Institute
North Terrace
Adelaide
SA 5000
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Country
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Australia
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Phone
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+61 8 8222 2723
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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