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Trial registered on ANZCTR
Registration number
ACTRN12620000140954
Ethics application status
Approved
Date submitted
21/01/2020
Date registered
12/02/2020
Date last updated
10/06/2022
Date data sharing statement initially provided
12/02/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Utilization of a portable hand-held electrocardiogram (ECG) monitor for mapping normal heart signals to investigate the optimal placement of insertable cardiac monitors for patient having heart rhythm disorders investigated.
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Scientific title
Optimal sensing electrode configuration for enhanced P-wave visibility: implications for new generation insertable cardiac monitor (ICM) for patients being investigated for heart rhythm disorders - ‘Cherchez le P’ study.
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Secondary ID [1]
300220
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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:
Cardiac Rhythm Disorders
315780
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Condition category
Condition code
Cardiovascular
314064
314064
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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
Surface electrocardiogram (ECG) recordings will be obtained using a holter monitor from participants in sinus rhythm. Holter monitor ECG is a normal routine practice for patients with heart rhythm disorders.
Participants will have ECG electrodes attached to the chest to allow recording of heart signals. This will be performed by trained cardiology technicians of the research team. ECG strips will be obtained from a specific set of vectors at the standard precordial V2/V3 electrode position of a 12-lead ECG. The vector will be varied by
(1st) inter-electrode lengths {45mm vs 75mm},
(2nd) vector orientation {vertical vs oblique 45 degrees from vertical vs oblique 75 degrees from vertical},
(3rd) intercontercostal spacing {normal V2/V3 position vs one intercostal space superior}. Recordings will last 30 seconds each. Recordings for all vectors should be obtained from each participants and the entire observation will last up to 10 minutes on only a single occasion.
Each ECG strip will be analyzed offline and compared for p-wave amplitude by caliper measurement.
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Intervention code [1]
316706
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Diagnosis / Prognosis
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Comparator / control treatment
All participants will undergo all the different electrode arrangements and act as their own control. The p-wave amplitude obtained by the shorter electrode spacing (45mm) will be the control for any p-wave measured for the longer electrode spacing (75mm) at each different vector angle and chest position.
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Control group
Active
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Outcomes
Primary outcome [1]
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Change in p-wave amplitude as assessed by ECG with different electrode vector spacing .
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Assessment method [1]
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Timepoint [1]
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This is a single point data collection study with no intervention and follow-up requirement. All measurements will be pooled at completion of recruitment for analysis.
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Secondary outcome [1]
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Change in p-wave amplitude as assessed by ECG with different angle of electrode vector.
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Assessment method [1]
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Timepoint [1]
379007
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This is a single point data collection study with no intervention and follow-up requirement. All measurements will be pooled at completion of recruitment for analysis.
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Secondary outcome [2]
379008
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Change in p-wave amplitude for different physical body composition, assessed by BMI and body fat percentage calculated by Omron Fat Loss Monitor (HBF-306)
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Assessment method [2]
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Timepoint [2]
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This is a single point data collection study with no intervention and follow-up requirement. All measurements will be pooled at completion of recruitment for analysis.
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Eligibility
Key inclusion criteria
• Participant must be in sinus rhythm (cardiology inpatients will have telemetry ward monitoring to allow rhythm identification for inclusion).
• Cardiac situs solitus.
• Greater than or equal to 18 years of age.
• Able to provide consent.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
• Unable to provide written informed consent to participate in this study.
• Participating in another clinical research trial which prevents acquisition of surface ECG.
• Cardiac situs inversus or other abnormal cardiac gross displacement.
• Participant not in sinus rhythm.
• Known allergic reaction to ECG electrode dots.
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised 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
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
Continuous data will be presented as the mean ± SD and compared with 2-tailed Student t tests. Nominal data will be presented as frequencies and percentages and compared by Chi-squared test. Statistical analyses will be performed using SPSS (IBM SPSS Inc, Chicago, IL). A p-value of less than .05 will be used for statistical significance.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
14/02/2020
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Actual
14/02/2020
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Date of last participant enrolment
Anticipated
23/01/2023
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Actual
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Date of last data collection
Anticipated
23/01/2023
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Actual
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Sample size
Target
150
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Accrual to date
130
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
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The Royal Adelaide Hospital - Adelaide
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Recruitment postcode(s) [1]
29079
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5000 - Adelaide
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Unfunded
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Address [1]
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Unfunded
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Country [1]
304651
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Primary sponsor type
Individual
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Name
Dr Dennis Lau
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Address
Cardiology Department, Royal Adelaide Hospital, Port Rd, 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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None
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Address [1]
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None
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Country [1]
305069
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
305071
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Central Adelaide Local Health Network Human Research Ethics Committee
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Ethics committee address [1]
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Postal address: Royal Adelaide Hospital Clinical Trial Centre Wayfinder 3D460.02 Level 3 Port Road ADELAIDE SA 5000
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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09/01/2020
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Approval date [1]
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23/01/2020
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Ethics approval number [1]
305071
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12672
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Summary
Brief summary
Patients with suspected heart rhythm disorders or syncope are often offered insertable cardiac monitors (ICM) for prolonged cardiac rhythm monitoring. Early models required surgical implantation (larger incision, more complicated implant tools) which limited acceptance by physicians and patients. Improved technology allowed miniaturization of ICM size and a simplified insertion method with an “injectable” tool which has increased acceptance. One manufacturer's recommended insertion position for ICM spans the V2–V3 electrocardiogram (ECG) electrode location in an oblique 45 degree angle, although data supporting this recommendation for adequate cardiac sensing is limited to R-wave signal analysis only. We will analyze non-invasive surface ECG recordings from healthy participants to measure the P-wave signal seen at the manufacturer's recommended insertion point and in other locations to find the optimal location for p-wave visualisation.
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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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A/Prof Dennis H. Lau
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Address
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Cardiology Department, Royal Adelaide Hospital, Port Rd, Adelaide SA 5000
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Country
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Australia
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Phone
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+61 8 8313 9000
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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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Dennis H. Lau
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Address
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Cardiology Department, Royal Adelaide Hospital, Port Rd, Adelaide SA 5000
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Country
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Australia
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Phone
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+61 8 8313 9000
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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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Dennis H. Lau
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Address
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Cardiology Department, Royal Adelaide Hospital, Port Rd, Adelaide SA 5000
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Country
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Australia
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Phone
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+61 8 8313 9000
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Fax
99172
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Not included in Human Research Ethics Committee application
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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
Source
Title
Year of Publication
DOI
Embase
Factors affecting electrogram sensing in an insertable cardiac monitor: Insights from surface electrocardiogram mapping analysis.
2023
https://dx.doi.org/10.1016/j.hrthm.2023.05.034
N.B. These documents automatically identified may not have been verified by the study sponsor.
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