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Trial registered on ANZCTR
Registration number
ACTRN12620000692932
Ethics application status
Approved
Date submitted
12/06/2020
Date registered
22/06/2020
Date last updated
30/06/2021
Date data sharing statement initially provided
22/06/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Atrial Fibrillation in Patients with an Implantable Cardiac Device during the COVID-19 Pandemic
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Scientific title
Atrial Fibrillation in patients with a permanent pacemaker or implantable cardioverter defibrillator during the COVID-19 Pandemic
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Secondary ID [1]
301508
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None
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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:
Atrial fibrillation
317845
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Permanent pacemaker
317846
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Implantable cardioverter defibrillator
317847
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Condition category
Condition code
Cardiovascular
315898
315898
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Observational
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Patient registry
True
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Target follow-up duration
100
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Target follow-up type
Days
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Description of intervention(s) / exposure
Our primary outcome is the impact of the COVID-19 pandemic on atrial fibrillation (AF) in patients with a permanent pacemaker (PPM) or implantable cardioverter defibrillator (ICD) in situ.
Patients who are connected to the the PaceMate remote monitoring service during the COVID pandemic will be included. Data from these patients is automatically collected routinely as part of the PaceMate remote monitoring database. All AF episodes occurring in PPM and ICD patients during the first 100 days of the COVID-19 pandemic in the USA will be included in the analysis (21st January until 29th April 2020).
For comparison, a 100-day Control periods will be included.
The control period is to account for potential seasonal variations. This will be the identical 100-day period, but one year prior. (21st January to 30th April 2019).
To allow direct comparison, only patients who are represented in both the COVID period and the Control period will be included in the comparison analysis.
The study will require no participant involvement. Patients will have their AF episodes recorded, as per usual, on the PaceMate database.
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Intervention code [1]
317815
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Not applicable
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Comparator / control treatment
The control in this observational study is a time period prior to COVID-19.
Data will be collected from the Control period. All AF episodes occurring during the Control period (January 21st until April 30th 2019) will be included in the analysis. These data will be derived from the PaceMate remote monitoring database.
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Control group
Historical
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Outcomes
Primary outcome [1]
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Primary Outcome- the impact of the COVID-19 pandemic on the occurrence of AF.
This outcome will be measured by comparison of the number of AF episodes, and number of patients affected by AF episodes, between the COVID period, and Control periods.
The number of AF episodes, and the number of patients who experience an AF episode will be derived from the PaceMate remote monitoring database.
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Assessment method [1]
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Timepoint [1]
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The primary outcome measure will be assessed daily during in each participant, during the 100-day COVID period, and daily during the 100-day Control period.
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Secondary outcome [1]
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The impact of COVID-19 prevalence per US state, on the occurrence of AF in the patients receiving remote monitoring via PaceMate, in that state.
All US states in which PaceMate provides a remote monitoring service will be included in the analysis. COVID-19 prevalence rates per state, as of April 29th 2020 (end of 100-day COVID period) will be obtained from the US Centers for Disease Control and Prevention (publically available information).
Per state COVID-19 prevalence will be correlated with per state AF rates during the COVID period.
Per state AF rates will be obtained via the PaceMate remote monitoring database.
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Assessment method [1]
383778
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Timepoint [1]
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The secondary outcome measure will be assessed by correlating per state AF rates (assessed daily during the 100-day COVID period) with per state COVID-19 prevalence (measured at a single timepoint- on the last day of the 100-day COVID period (29th April 2020).
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Eligibility
Key inclusion criteria
All patients with a permanent pacemaker (PPM- inclusive of a standard PPM or cardiac resynchronisation therapy PPM) or an implantable cardioverter defibrillator (ICD- inclusive of a standard ICD, or a cardiac resynchronisation therapy ICD) in situ, who received remote monitoring of their PPM/ICD via the PaceMate remote monitoring service, during the first 100 days post the index confirmed COVID-19 case in USA.
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Minimum age
5
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?
No
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Key exclusion criteria
Patients without active use of an atrial lead in their PPM/ICD, as determined by device programming parameters.
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Retrospective
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Statistical methods / analysis
Descriptive statistical analysis will be undertaken via Stata 16 (StataCorp LLC, TX, USA). Categorical variables will be expressed as a percentage. Continuous variables will be expressed as mean ± standard deviation. The primary endpoint of the study is the occurrence of atrial fibrillation in PPM/ICD patients receiving remote monitoring in the USA, via PaceMate, during the COVID-19 pandemic. The 100-day period following the confirmation of the first COVID-19 case within the USA (Early 2020) will be compared with the Control period (Early 2019). The number of patients who experienced a primary event during the Early 2020 period and the Control period will be compared using McNemar’s test. The number of primary events occurring during Early 2020 and the Control period will be compared via a poisson regression analysis, with adjustment for age and COVID-19 cases in the relevant state. A two-sided p value of less than 0.05 will be considered statistically significant.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
24/06/2020
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Actual
27/06/2020
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Date of last participant enrolment
Anticipated
25/06/2020
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Actual
28/06/2020
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Date of last data collection
Anticipated
25/06/2020
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Actual
28/06/2020
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Sample size
Target
10000
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Accrual to date
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Final
10346
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Recruitment outside Australia
Country [1]
22669
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United States of America
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State/province [1]
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Alabama, Colorado, Illinois, Kansas, Kentucky, Louisiana, Maine, New Jersey, Ohio, Oklahoma, South Carolina, Texas, Virginia
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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The University of Adelaide
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Address [1]
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North Terrace
Adelaide SA 5000
AUSTRALIA
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Country [1]
305949
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Australia
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Primary sponsor type
University
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Name
The University of Adelaide
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Address
North Terrace
Adelaide SA 5000
AUSTRALIA
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Country
Australia
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Secondary sponsor category [1]
306404
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None
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Name [1]
306404
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Address [1]
306404
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Country [1]
306404
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
306192
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Central Adelaide Local Health Network Human Research Ethics Committee
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Ethics committee address [1]
306192
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Royal Adelaide Hospital Port Rd Adelaide SA 5000
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Ethics committee country [1]
306192
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Australia
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Date submitted for ethics approval [1]
306192
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12/06/2020
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Approval date [1]
306192
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26/06/2020
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Ethics approval number [1]
306192
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Summary
Brief summary
PRIMARY PURPOSE OF STUDY & STUDY HYPOTHESIS: The primary purpose of this study is to assess the incidence of an abnormal heart rhythm, atrial fibrillation, in patients with a permanent pacemaker or implantable defibrillator during the early coronavirus pandemic, compared with the months prior. A sedentary lifestyle, alcohol intake, and weight gain have all been shown to correlate with atrial fibrillation. We hypothesise that the COVID-19 pandemic will be associated with a rise in atrial fibrillation in pacemaker and defibrillator patients, who have a predisposition to such heart rhythms. To establish this, we plan to to assess all atrial fibrillation episodes in pacemaker and defibrillator patients during the first 100 days of the COVID-19 pandemic in the United States of America, compared the same 100-day period in Early 2019.
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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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Prof Prashanthan Sanders
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Address
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Royal Adelaide Hospital
Department of Cardiology
Port Road
Adelaide SA 5000
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Country
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Australia
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Phone
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+61 870740000
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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
103035
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Prashanthan Sanders
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Address
103035
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Royal Adelaide Hospital
Department of Cardiology
Port Road
Adelaide SA 5000
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Country
103035
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Australia
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Phone
103035
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+61 870740000
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Fax
103035
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Email
103035
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[email protected]
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Contact person for scientific queries
Name
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Prashanthan Sanders
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Address
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Royal Adelaide Hospital
Department of Cardiology
Port Road
Adelaide SA 5000
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Country
103036
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Australia
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Phone
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+61 870740000
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Fax
103036
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Email
103036
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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
Data belongs to PaceMate remote monitoring company
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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
Atrial fibrillation burden during the coronavirus disease 2019 pandemic.
2021
https://dx.doi.org/10.1093/europace/euab099
N.B. These documents automatically identified may not have been verified by the study sponsor.
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