Recruiting

Observational Study

Sponsor:

The Hospital for Sick Children

Code:

NCT04559425

Conditions

Heart Block Complete

Heart Block Second Degree

Eligibility Criteria

Sex: Female

Age: 16 - 50

Healthy Volunteers: Not accepted

Interventions

Dexamethasone

No Dexamethasone

Study Details

Brief summary:

Few studies are specifically designed to address health concerns that are already relevant during pregnancy. The consequence is a lack of evidence on best clinical practice. This includes mothers and their babies when pregnancy is complicated by an abnormally slow heart rate due to maternal antibody-mediated heart disease in the unborn baby (fetus). Since the late seventies, it has been possible to detect and monitor fetal disease by ultrasound images and to treat selected conditions with pharmaceuticals administered via the mother. To this day, physicians need to make decisions about the management of such pregnancies without evidence from prospective clinical trials on drug efficacy and safety. The SLOW HEART REGISTRY is a multi-centered prospective observational study that will address the knowledge gap to guide future management of high-degree immune-mediated heart block to the best of care. The study seeks to establish an international database of the management and outcome of affected fetuses, to be used to publish information on the results of currently available prenatal care and to evaluate the need for additional research.

Conditions

Heart Block Complete

Heart Block Second Degree

Study ID

NCT04559425

Start date

Jan 1, 2020

Status verified date

May, 2024

Completion date

Dec 31, 2029

Anticipated

Primary completion date

Dec 31, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: Female

Age: 16 - 50

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Written informed maternal consent to participate in the Slow Heart Registry
  • High-degree (2nd; 2:1; 2nd-3rd or 3rd degree) AVB diagnosed ≤ 32+0 weeks with or without hydrops
  • Enrollment within maximally 8 days of high-degree AVB diagnosis
  • Positive or pending anti-Ro/La antibody test results at the time of enrollment

Exclusion Criteria:

  • AVB associated with major CHD (e.g. left atrial isomerism, cc-TGA)
  • AVB with known negative anti-Ro and/or La antibody test result at enrollment
  • 1st degree AVB
  • Sinus bradycardia with normal 1:1 AV conduction
  • Blocked atrial bigeminy (irregular atrial rate with failure of AV conduction of the premature atrial beat)
  • Primary delivery for postnatal treatment
  • Maternal-fetal conditions (other than cardiac NL) associated with high odds of premature delivery or death (e.g. renal failure, significant infectious diseases, major extracardiac anomalies, PROM, etc.)
  • Preexisting maternal mental disorder (e.g. bipolar, mania, severe depression, substance abuse)
  • Poorly controlled insulin-dependent diabetes (HbA1c >7%) at CAVB diagnosis
  • Oligohydramnios (deepest/maximal vertical pocket <2 cm)
  • Severe IUGR (estimated fetal weight <3rd percentile)

Study Design

Enrollment

350 participants

Anticipated

Interventions and Outcome Measures

Arms

Prospective observational cohort 1

Complete AVB (3rd degree) diagnosed ≤ 32+0 weeks with or without hydrops

Prospective observational cohort 2

Incomplete AVB (2nd; 2:1; 2nd-3rd degree) diagnosed ≤ 32+0 weeks with or without hydrops

Interventions

Dexamethasone

All management decisions are made by the primary physician and may include: 1) no treatment with dexamethasone or 2) treatment with dexamethasone from the time of enrollment

No Dexamethasone

All management decisions are made by the primary physician and may include: 1) no treatment with dexamethasone or 2) treatment with dexamethasone from the time of enrollment

Primary outcome measure

  • Freedom from cardiac death ≥1 year of life [ Time Frame: up to 12 months ]

Central Contacts and Locations

Central contacts

Locations

Phoenix Children's Hospital

Recruiting

Phoenix, Arizona, United States, 85016

Contacts

University of California San Francisco

Recruiting

San Francisco, California, United States, 94143

Contacts

Anita J Moon-Grady, MD

415-342-8836anita.grady@ucsf.edu

Children's Hospital Colorado

Recruiting

Denver, Colorado, United States, 80205

Contacts

Children's National Medical Center

Recruiting

Washington, District of Columbia, United States, 20010

Principal Investigator:

Mary Donofrio, MD

Johns Hopkins All Children's Hospital

Recruiting

Saint Petersburg, Florida, United States, 33701

Children's Mercy Kansas City

Recruiting

Kansas City, Kansas, United States, 64108

Contacts

Boston Children's Hospital

Recruiting

Boston, Massachusetts, United States, 02115

The Children's Heart Clinic/Children's Minnesota

Recruiting

Minneapolis, Minnesota, United States, 55404

Contacts

Columbia University (New York)

Recruiting

New York, New York, United States, 10027

Contacts

Stéphanie Levasseur, MD, FRCPC

212-305-8356sl2363@cumc.columbia.edu

Texas Children's Hospital

Recruiting

Houston, Texas, United States, 77030

Contacts

Shaine A Morris,, MD, MPH

832-826-5682shainem@bcm.edu

Seattle Children's Hospital

Recruiting

Seattle, Washington, United States, 98105

Contacts

Medical College of Wisconsin

Recruiting

Milwaukee, Wisconsin, United States, 53226

Contacts

Janette Stasburger, MD

414-805-6605jstrasburger@chw.org

Eleanor Saffian, RNC-OB

(414)805-6605esaffian@mcw.edu

IWK Nova Scotia Health

Recruiting

Halifax, Nova Scotia, Canada, B3K 6R8

Contacts

The Hospital for Sick Children

Recruiting

Toronto, Canada

Contacts

Principal Investigator:

Edgar Jaeggi, MD

More Information

Sponsor

The Hospital for Sick Children

Last update posted

May 22, 2024

Last verified

May, 2024

Keywords

  • fetal
  • heart block
  • anti-Ro antibodies
  • steroids
  • outcome

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-25. This information was provided to ClinicalTrials.gov by The Hospital for Sick Children on 2024-05-22. Recruitment status is synced daily from ClinicalTrials.gov and may not reflect the sponsor's current status. Confirm during your call.