Prospective, multicenter, roll-in, pilot clinical trial. Study subjects will be studied during the TAVR procedure and their 12 lead ECGs collected and analyzed for New-Onset Conduction Disturbances (NOCD). The study will be conducted in two stages: During the first roll-in stage of the study, 50 intended to undergo TAVR (all comers) will be enrolled. Data will be collected according to the study schedule below of pre-, during and after the TAVR procedure up to 14 days FU. This data for the first 50 patients will be analyzed to evaluate the ability of the Cara Monitor prediction of NOCD post TAVR. The second stage of the stage will be conducted upon completion of the first stage analysis and will be considered to randomize 1:1 the subjects connected to Cara Monitor during the procedure versus site-specific current practice. The effect of Cara Monitor on reduction of NOCD post TAVR compared to patients treated and followed per regular site-specific practice will be estimated.
Data to be collected during the study procedure for both stages: 1. Pre-procedure: 1. Demographics, medical history, cardiac history, medications 2. Cardiac CT raw data to be collected from all the pre-procedure CT scans performed in Medical Centers and from out-of-hospital sources (if available). 3. In hospital 12 lead ECG 2. Procedure: During the procedure, the 12 lead ECG will be recorded processed, and displayed on the Cara monitor that is connected to Norav NR-1207-3 ECG Holter System. The Hemodynamic and Fluoroscopy monitors will be recorded on a commercially available video recorder. 3. Post-procedure (in hospital) 1. After the procedure patients will continue to be connected to a commercially available to a commercially available 14 days ambulatory Holter monitor (AEM) (e.g. Bittium Faros™ ; MoMe™ Kardia) and will remain with the patient after the discharge for 14 days. 2. Hospital standard 12 lead ECG will be recorded after the procedure, downloaded and collected by the study team. 4. Post-procedure - out of hospital: At discharge, patients will stay connected to the ambulatory Holter monitor (AEM) (Bittium Faros™; MoMe™ Kardia ) for 14 days post-procedure. Holter will be collected from patients at the end of the 14-day recording and its data downloaded and collected. Patients will be followed according to the current medical practice. 5. Follow-up according to the current medical practice a. 30 days follow-up hospital visit: i. Cardiac echo (if available) ii. 12 lead ECG b. 6 month - Clinical FU phone call c. 12 months Clinical FU phone call Conduction Disturbances (CD) outcome will be subdivided into: 1. PPM or High-Grade AV Block (HGAVB) 2. All other new onset (or deterioration) of CD that are not listed in #1 3. No new onset CD
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
33
Continuous ECG monitoring of Conduction Disturbances in patients undergoing TAVR procedure
Mackram F. Eleid, M.D.
Rochester, Minnesota, United States
Evaluate Cara performance in reduction of New Onset Conduction Disturbances (NOCD)
Estimate the reduction of NOCD (percentage) at 14 days post TAVR while using Cara Monitor
Time frame: 14 days
Evaluate Cara performance in reduction of Permanent Pacemaker (PPM) or High-Grade AV Block (HGAVB)
Estimate the reduction (a percentage) of PPM or High-Grade AV Block (HGAVB)
Time frame: 14 days
Evaluate Cara usability using a dedicated questioner
Estimate learning curve of using CaraTM system (e.g. the experience required with system for achieving above improvements)
Time frame: 1 Day of Procedure
Evaluate Cara Safety, collecting Adverse Events
During the study patients will be followed for any adverse events relevant to the TAVR procedure as defined in the CRF
Time frame: 14 days
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