Patient Perception of MultiPulse Therapy™ (MPT™)

Study Overview
=================
Brief Summary
-----------------
Assess the subject acceptance of MPT, using therapy parameters that have been shown to be effective in terminating episodes of atrial fibrillation.

Detailed Description
-----------------
A prospective non-randomized feasibility study involving acute testing of MPT in subjects having a history of AF during clinically indicated acute electrophysiology procedures including AF ablation, SVT ablation or diagnostic EP procedures (indicated procedure). The primary outcome of the study is the subject response to questions regarding perception and acceptability following MPT delivery.

Official Title
-----------------
A Clinical Feasibility Study to Evaluate Patient Perception of MPT

Conditions
-----------------
Atrial Fibrillation

Intervention / Treatment
-----------------
* Device: MultiPulse Therapy


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Male or female between 18 and 80 years of age Willing and able to comply with the study protocol, provide a written informed consent History of Atrial Fibrillation in past 12 months Indicated to undergo an acute electrophysiology procedure allowing for conscious participation in the clinical study Current treatment and compliance with standard anticoagulation regimen, including uninterrupted OAC, with acceptable coagulation status, as determined by the Principal Investigator Study stage dependent: Stage 1: 6a. History of DC-Cardioversion in past 12 months: With or Without 7b. AFEQT Score: <=89 Study stage dependent: Stage 2 (based on results from study stage 1): 6a: History of DC-Cardioversion in past 12 months: Potential emphasis on patients with history of DCCV 7b. AFEQT Score: Potential emphasis on patients with AFEQT <= 58 Exclusion Criteria: Life expectancy of 1 year or less AF due to reversible causes (e.g., hyperthyroidism, valve disease) Hx of fibromyalgia or any other evidence of wide-spread pain Any current pain condition that could be confused with pain or discomfort associated with MPT >1 current well-defined pain condition (e.g., migraine, joint OA, painful diabetic neuropathy) Use of any opioid analgesic (including tramadol) within 3 months of screening Spielberger's STAI-AD-Trait > 75 AFEQT: Section 1: I was never aware of having atrial fibrillation is checked Allergy or contraindication to anticoagulation therapy Presence of intracardiac thrombus (confirmed with cardiac imaging) Existing Left Atrial Appendage closure device LVEF<20% NYHA Class IV heart failure at the time of enrollment History of embolic stroke, Transient Ischemic Attack (TIA) or other thromboembolic event within the preceding 3 months. Known hyper-coagulable state that increases risk of thrombus History of myocardial infarction or coronary revascularization within the preceding 3 months. History of sustained ventricular arrhythmia or cardiac arrest Presence of chronically implanted lead in the CS Presence of ventricular assist device, including intra-aortic balloon pump Documented bradycardia (<40 BPM) at the time of the study Morbid obesity: BMI>39 kg/m2 Presence of any prosthetic cardiac valve History of significant tricuspid valvular disease requiring surgery Moderate to severe mitral valve regurgitation (>40% regurgitation fraction) Cognitive or mental health status that would interfere with study participation and proper informed consent Cardiovascular anatomical defects that would complicate placement of the stimulation leads required by the protocol, including congenital heart disease and cardiac vein anomalies per the Investigator's discretion Pregnancy confirmed by test within 7 days of procedure. Inability to pass catheters to heart due to vascular limitations Cardiovascular surgery or intervention within 1 month prior to enrollment or planned for up to 1 month after enrollment (other than the planned treatment procedure) Active endocarditis History of hemodynamic compromise due to valvular heart disease Unstable CAD as determined by the investigator Severe proximal three-vessel or left main coronary artery disease without revascularization as determined by the investigator History of Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Dysplasia, Congenital Heart Anomaly, Cardiac Amyloidosis or Cardiac Sarcoidosis Any other medical condition which may affect the outcome of this study or safety of the subject as determined by the investigator

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Interventional Model Description: A prospective non-randomized feasibility study involving acute evaluation of the perception and acceptance of MPT as a therapy to stop episodes of AF in subjects having a history of AF during clinically indicated acute electrophysiology procedures including AF ablation, SVT ablation or diagnostic EP procedures (indicated procedure).
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>The study will be conducted using the venous cannulations that are standard of care for the indicated procedure. Additional access points may be necessary if access to coronary sinus is difficult from existing femoral venous cannulations. Sterile study leads or EP catheters will be temporarily placed into the RA, CS, and RV (for R-wave sensing using intracardiac electrograms - optional) which will be connected to the investigational device (CESS). Up to two MPTs will be delivered and subject responses following each MPT regarding perception and acceptability of MPT to treat AF will be obtained. MPT voltages will not exceed 100V. | Device: MultiPulse Therapy<br>* Electrical Stimulation<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Therapy acceptance as measured by a subject question administered immediately following MPT delivery | Question: Now I want you to think about your experiences with Atrial Fibrillation. Think about how it makes you feel, your daily life while in atrial fibrillation and your experience with in-clinic treatments for atrial fibrillation. If you could use the stimulation you just felt at home and under your control, would you use this stimulation therapy to stop your atrial fibrillation? Please answer yes or no. | Immediately following MPT delivery | 
| Subject perception of MPT as measured by a pain scale administered immediately following MPT delivery | Question: Please rate any pain you experienced at the time of the stimulus, was it: No pain, mild pain, moderate pain, severe pain, the worst possible pain imaginable.? | Immediately following MPT delivery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Safety determined from summary report of Adverse Events | Adverse Event frequency by Adverse Event type | Through 30 days post-intervention | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Atrial Fibrillation