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Active, not recruitingNCT03493516PAREPET IIUpdated Mar 6, 2026

Prediction of ARrhythmic Events With Positron Emission Tomography II

An observational study in Sudden Cardiac Arrest, Ischemic Cardiomyopathy and Congestive Heart Failure, sponsored by State University of New York at Buffalo. Active, not recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-03-06.

Sponsored by State University of New York at Buffalo · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
302
Ages
18 Years and older
Sex
All
01

Study summary

Sudden cardiac death continues to be a major contributor to mortality in patients with ischemic cardiomyopathy. While implantable defibrillators can prevent death from ventricular arrhythmias, our current approach to identify patients at highest risk primarily rests on demonstrating a reduction in left ventricular ejection fraction less than 35%. The purpose of this observational cohort study is to prospectively test whether this can be enhanced by quantifying the amount of sympathetic denervation, left ventricular end-diastolic volume or brain natriuretic peptide levels.

Read the detailed description

Using current guidelines based primarily on ejection fraction (EF), only one-quarter of patients receiving an implantable cardiac defibrillator (ICD) for the primary prevention of sudden cardiac arrest (SCA) require appropriate ICD therapy within 5 years. The NIH-sponsored PAREPET study (Prediction of ARrhythmic Events with Positron Emission Tomography, ClinicalTrials.gov, NCT01400334) identified four independent risk factors that predict SCA or ICD equivalent in patients with ischemic cardiomyopathy. Using retrospectively defined cut-points, the absence of these risk factors identified 38% of the cohort with a very low risk of SCA (\<1% per year). This rate is actually lower than the 1.5-2% annual rate of SCA among patients with coronary artery disease and mild left ventricular (LV) dysfunction, who are not considered candidates for a primary prevention ICD. This proposal will prospectively determine whether these risk factors can form the basis of a clinically applicable approach to identify a subgroup of patients who are candidates for an ICD, but are at low enough risk of SCA to have an ICD safely withheld. Our long-term goal is to develop better approaches to identify patients with coronary artery disease who are most likely to benefit from prevention of SCA with placement of an implantable defibrillator.

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Conditions studied

  • Sudden Cardiac Arrest
  • Ischemic Cardiomyopathy
  • Congestive Heart Failure

Keywords

  • Positron Emission Tomography
  • Sympathetic Innervation
  • Sudden Death
  • Ventricular Fibrillation
  • LMI-1195
  • Ischemic Cardiomyopathy
  • Risk Prediction
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In context

Death, Sudden, Cardiac

363 studies on the registry are indexed under Death, Sudden, Cardiac; 84 are open to participants now.

This study's planned enrollment of 302 is below the median of 449 across 202 observational studies indexed under Death, Sudden, Cardiac.

Browse Death, Sudden, Cardiac studies →

Lead sponsor

State University of New York at Buffalo is the lead sponsor of 294 studies on the registry; 63 are open to participants now.

Of its 19 completed or terminated interventional studies of FDA-regulated products, 15 (79%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

The study population comprises adult patients of either sex with ischemic cardiomyopathy who have an ejection fraction ≤ 35% and New York Heart Association Class II or III CHF or an ejection fraction ≤ 30% and Class I CHF who are candidates to place an ICD for the primary prevention of SCA. Subjects already having a primary prevention ICD are eligible if they have not yet received an appropriate ICD shock for ventricular arrhythmias.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Coronary artery disease (by cardiac catheterization or definite myocardial infarction)
  • ICD implantation for the primary prevention of SCA
  • Primary prevention patients with a Biventricular ICD

    • Eligible immediately when this is placed to prevent dysynchrony related to intermittent RV pacing and the native QRS duration is ≤ 130 msec in the absence of pacing.
    • Eligible 6 months after implantation when the native QRS duration prior to implant is >130 msec or there is persistent RV pacing.
  • Optimal medical therapy for heart failure.

Exclusion criteria

Exclusion Criteria:

  • Plans for coronary revascularization (due to the independent impact on SCA)
  • for PET (i.e. claustrophobia, pregnancy, physical limitation)
  • Tricyclic antidepressant use (inhibits norepinephrine and LMI1195 uptake)
  • Comorbidities limiting \<2yr.
  • Age \<18 years or inability to provide
  • Primary prevention ICD/BiV recipients who have received an appropriate ICD shock prior to enrollment
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
302 participants (estimated)
Patient registry
No
Biospecimen retention
Samples without dna

Interventions

  • Diagnostic testPET scan quantifying sympathetic denervation using [18F]-LMI1195

    A cardiac PET scan will be obtained to quantify the percentage of the left ventricle that is denervated and has reduced uptake of the sympathetic nerve tracer \[18F\]-LMI1195

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What researchers measure

Primary outcomes

  1. Sudden Cardiac Arrest Events

    The primary end-point will be SCA or ICD equivalent as used in PAREPET. This will consist of ICD therapies for ventricular fibrillation or ventricular tachycardia \>240 bpm, and adjudicated arrhythmic death using the modified Hinkle-Thaler criteria.

    Time frame: Through study completion, an average of 3 years

Other outcomes

  1. All cause cardiac mortality

    Adjudicated total cardiac mortality (SCA + non-sudden cardiac death).

    Time frame: Through study completion, an average of 3 years

  2. All appropriate ICD therapies

    Adjudicated appropriate ICD therapies (ICD shock and anti-tachycardia pacing) for ventricular arrhythmias. Appropriate ICD therapies will be determined from ICD device interrogation.

    Time frame: Through study completion, an average of 3 years

  3. Hospitalization for heart failure and myocardial infarction.

    Interval hospitalizations for heart failure or myocardial infarction will be assessed via phone follow-up at 3 month intervals. Subjects having either will be invited to return for a repeat PET scan, echocardiogram and serum sampling to assess whether the underlying substrate for arrhythmogenesis has changed.

    Time frame: Through study completion, an average of 3 years

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Study locations

1 site
  • University at Buffalo Clinical and Translational Research Center
    Buffalo, New York 14214, United States
08

References and documents

Publications

  • Fallavollita JA, Dare JD, Carter RL, Baldwa S, Canty JM Jr. Denervated Myocardium Is Preferentially Associated With Sudden Cardiac Arrest in Ischemic Cardiomyopathy: A Pilot Competing Risks Analysis of Cause-Specific Mortality. Circ Cardiovasc Imaging. 2017 Aug;10(8):e006446. doi: 10.1161/CIRCIMAGING.117.006446. PubMed 28794139 ↗
  • Malhotra S, Canty JM Jr. Life-Threatening Ventricular Arrhythmias: Current Role of Imaging in Diagnosis and Risk Assessment. J Nucl Cardiol. 2016 Dec;23(6):1322-1334. doi: 10.1007/s12350-015-0392-0. Epub 2016 Jan 15. PubMed 26780530 ↗
  • Goldberger JJ, Basu A, Boineau R, Buxton AE, Cain ME, Canty JM Jr, Chen PS, Chugh SS, Costantini O, Exner DV, Kadish AH, Lee B, Lloyd-Jones D, Moss AJ, Myerburg RJ, Olgin JE, Passman R, Stevenson WG, Tomaselli GF, Zareba W, Zipes DP, Zoloth L. Risk stratification for sudden cardiac death: a plan for the future. Circulation. 2014 Jan 28;129(4):516-26. doi: 10.1161/CIRCULATIONAHA.113.007149. No abstract available. PubMed 24470473 ↗
  • Fallavollita JA, Heavey BM, Luisi AJ Jr, Michalek SM, Baldwa S, Mashtare TL Jr, Hutson AD, Dekemp RA, Haka MS, Sajjad M, Cimato TR, Curtis AB, Cain ME, Canty JM Jr. Regional myocardial sympathetic denervation predicts the risk of sudden cardiac arrest in ischemic cardiomyopathy. J Am Coll Cardiol. 2014 Jan 21;63(2):141-9. doi: 10.1016/j.jacc.2013.07.096. Epub 2013 Sep 25. PubMed 24076296 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: Undecided

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 6, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT03493516
Responsible party
JOHN CANTY (SUNY Distinguished Professor, State University of New York at Buffalo) — Principal investigator
First posted
Apr 10, 2018
Start date
Apr 8, 2018
Primary completion
Dec 31, 2026 (estimated)
Completion
Dec 31, 2026 (estimated)
Last update
Mar 6, 2026

Study contacts

John M Canty, MD
principal investigator · University at Buffalo

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is active, not recruiting, as verified in Mar 2026. You cannot join it, but the record below documents what was studied.

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