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CompletedNCT04112433Updated Feb 11, 2022

Novel Cardiac Signal Processing System

An observational study in Cardiac Arrhythmia, sponsored by BioSig Technologies, Inc.. Completed at 3 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-02-11.

Sponsored by BioSig Technologies, Inc. · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
104
Ages
18 Years and older
Sex
All
01

Study summary

This study is designed to collect parallel intracardiac signal data during pre-defined periods of clinical interest from the PURE EP system and the existing signal recording and mapping systems.

The collected signals will then undergo BLINDED, CONTROLLED evaluation by unbiased electrophysiologist reviewer(s) to determine whether the PURE EP signals provides additional or clearer diagnostic information.

Read the detailed description

Cardiac electrophysiologists rely on the display of electrograms when performing electrophysiology (EP) studies and catheter ablations in patients with arrhythmias. To achieve effective outcomes without complications, it is vital that the recording system enables the recognition of clearly abnormal (scared myocardium) and normal electrical signals.

Current recording systems have limitations in that it can be difficult to clearly distinguish a true cardiac signal from noise or artifact. This is particularly true when pacing the heart and when ablating abnormal myocardial tissue, components of the conduction system or epicardial structures. Therefore, improvement of the fidelity of signals obtained from EP recording systems is needed to enhance identification of the most effective targets for ablation.

There are several standard electrophysiology recording systems in use today, such as the commonly used GE/Prucka CardioLab recording system ("Prucka") which would benefit from additional features in order to improve the ability to record, discriminate and analyze signals from the heart. BioSig Technologies, Inc. ("BioSig") has developed an electrophysiology signal processing system, the PURE EP™ System, which may allow electrophysiologists to better characterize arrhythmogenic tissue during ablation procedures. Specifically, the PURE EP™ System's higher sampling rate and higher dynamic range allow improved visualization of low amplitude signals, especially those temporally situated near low frequency, high amplitude signals or large high-frequency signals.

This multi-center, prospective, non-randomized, observational study will involve at least five patients undergoing elective cardiac ablation procedure for tachycardias such as atrial fibrillation, atypical atrial flutter, ischemic ventricular tachycardia, or symptomatic premature ventricular contractions (PVCs). The existing recording/mapping system clocks will be synchronized to the PURE EP clock prior to each procedure. At the beginning of the procedures, all systems will be optimized for best signal display based on the physician preference. During the ablation procedures, annotations will be captured on the PURE EP system based on pre-determined clinically relevant events defined in this protocol (example - before and after successful ablation therapy).

After the procedures, parallel signal data samples will be harvested from all the systems using the procedure annotations and the time stamps as a guide. Once the signal data is harvested, cleaned, and organized, the individual signal samples will be reviewed in a blinded, controlled fashion by a group of independent, unbiased electrophysiologist(s).

Selected signal sample sets (from the same date and time stamp) will be separated in the survey and arranged in random order. The reviewer will be asked specific and identical questions relevant to each set of signal samples, but the individual samples will be separated and randomized across a full survey containing many different signal samples from many different procedures. The signal survey will be created under the direction of the Principle Investigator. The selection of the independent EP reviewers will also be done under the direction of the Principle Investigator

02

Conditions studied

  • Cardiac Arrhythmia

Keywords

  • Cardiac Signal
  • Ablation
  • Signal Processing
  • Intracardiac Electrogram
  • Electrophysiology
  • Electrogram
  • Signals
  • Cardiac
  • Cardiac Ablation
  • Atrial fibrillation
  • Atrial Flutter
  • Ventricular Tachycardia
  • Arrhythmias
  • PVC's
03

In context

Arrhythmias, Cardiac

915 studies on the registry are indexed under Arrhythmias, Cardiac; 234 are open to participants now.

This study's enrollment of 104 is below the median of 200 across 426 observational studies indexed under Arrhythmias, Cardiac.

Browse Arrhythmias, Cardiac studies →

Lead sponsor

BioSig Technologies, Inc. is the lead sponsor of 2 studies on the registry; none are open to participants now.

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

Any person indicated and consented for an elective cardiac ablation procedure who is >18 years of age.

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

  • Indication for cardiac ablation treatment
  • Signed informed consent

Exclusion criteria

Exclusion Criteria:

  • contraindication to electrophysiology study or ablation
  • Enrollment in any other ongoing arrhythmia study protocol
  • Active Infection or sepsis
  • Pregnancy or lactation
  • \< 18 years of age
05

Study design

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

Groups and cohorts

  • PURE EP 2 Group

    Enrolled and consented patients who are indicated for and receive an elective cardiac ablation procedure using the PURE EP 2 system for monitoring and collection of intracardiac electrogram signals.

    Device: PURE EP 2

Interventions

  • DevicePURE EP 2

    Enrolled patients receiving cardiac ablation treatment using the current standard of care with additional monitoring and intracardiac electrogram signal collection via the PURE EP 2 system.

06

What researchers measure

Primary outcomes

  1. Safe and effective use of the PURE EP 2 system based on system specifications and recorded within the Case Report Form (CRF).

    The primary aim of this study is to further establish the safe and effective use of the PURE EP System during cardiac ablation in the EP Laboratory in a post-market environment. The PURE EP System will be installed to run in parallel to existing mapping and recording systems already in use in the EP lab. Each system will be optimized for viewing intracardiac signals based on the physician preference. The existing systems will serve as the primary method of viewing intracardiac signals and the PURE EP system will be redundant. The intracardiac signals from the PURE EP system will be compared to existing recording and mapping system signals generated in real-time during each ablation procedure. The PURE EP system signals will be monitored by the physician investigator and a company clinical representative to validate the PURE EP 2 system runs as intended based on the system manual and meets expected standards for displaying signals.

    Time frame: Throughout the cardiac ablation procedure

Secondary outcomes

  1. Assess the quality of the PURE EP 2 intracardiac signals when compared to existing recording and mapping systems as determined by controlled survey of blinded, independent expert electrophysiology reviewers.

    The secondary aim of this study is to assess the quality of the PURE EP intracardiac signals and the associated clinical relevance of the signals when compared to other sources of intracardiac signals. During the ablation procedures, annotations will be captured on the PURE EP system based on clinically relevant events defined in the protocol. After the procedure, parallel signal data samples will be harvested from all the systems using annotations and the time stamps as a guide. Once the signal data is harvested and organized, the signal samples across multiple procedures will be reviewed in a blinded, controlled fashion by 2-3 independent, unbiased expert electrophysiologist(s). The sample survey will be created under the direction of the PI.

    Time frame: After the collection of signal samples from at least (5) subjects and until study completion

07

Study locations

3 sites
  • Mayo Clinic Jacksonville
    Jacksonville, Florida 32224, United States
  • Massachusetts General Hospital
    Boston, Massachusetts 02114, United States
  • St. David's Medical Center
    Austin, Texas 78758, United States
08

References and documents

Publications

  • Padmanabhan D, Sugrue A, Vaidya V, Witt C, Yasin O, Naksuk N, Killu A, Foxall T, Drakulic BS, Venkatachalam KL, Asirvatham SJ. Incremental benefit of a novel signal recording system during mapping and ablation. Europace. 2021 Jan 27;23(1):130-138. doi: 10.1093/europace/euaa194. PubMed 33094311 ↗

Individual participant data

Plan to share: Undecided — Collected intracardiac signal samples will be shared with the independent electrophysiologist reviewers, other physician investigators, and possibly other study collaborators like a biostatistician and clinical research organization.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Nov 2019 to primary completion in Jul 2021, 20 months.

Of 62 industry-sponsored observational studies under Arrhythmias, Cardiac, half reached primary completion within 21 months of starting (the median), counting those still running; a quarter within 11 and three quarters within 53. This study's 20 months is close to that.

Counting every sponsor, half of 243 studies reached it within 37 months; a quarter within 15 and three quarters within 91.

How these figures are worked out, and which studies are left out of them.

Registered
Sep 30, 2019
First posted
Oct 2, 2019
StartActual
Nov 12, 2019
Primary completionActual
Jul 20, 2021
CompletionActual
Jan 29, 2022
Last update
Feb 11, 2022
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 11, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04112433
Lead sponsor
BioSig Technologies, Inc.
Responsible party
Sponsor
First posted
Oct 2, 2019
Start date
Nov 12, 2019
Primary completion
Jul 20, 2021
Completion
Jan 29, 2022
Last update
Feb 11, 2022

Oversight

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

Not currently enrolling

This study is completed, as verified in Feb 2022. You cannot join it, but the record below documents what was studied.

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