Parasternal EV-ICD System Pivotal Study
Official title: Parasternal Extravascular ICD System Pivotal Clinical Investigation (ALARION EV) Study
Run by AtaCor Medical, Inc. · NCT07324031 · Data updated 2026-11-12
This study tests the Parasternal Extravascular ICD System in adults who need an ICD to see if it can safely provide defibrillation without traditional leads.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 280 (estimated) |
| Sponsor | AtaCor Medical, Inc. Industry-sponsored |
| Drugs / interventions | radiation |
| Locations | 35 sites (Scottsdale, Arizona and 34 other locations) |
| Status | Recruiting |
| Started | July 2, 2026 |
| Main results expected | August 31, 2027 |
| Study ends | December 31, 2028 |
| Registry record updated | October 9, 2026 |
| Trial ID | NCT07324031 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults (18+) with class I or IIa ICD indications who do not require permanent bradycardia pacing and can comply with follow-up.
✕Probably not a fit
Patients who are unable to complete six-month follow-up or have contraindications to device materials may not benefit.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This is a prospective, multi-center, single-arm pivotal study to evaluate the safety and effectiveness of the Parasternal EV-ICD System. Up to 280 eligible adults with ICD indications will be enrolled at up to 40 sites worldwide, with at least half in the United States. The primary safety endpoint is freedom from major adverse device effects through six months, while the primary effectiveness endpoint is successful defibrillation during an induced ventricular arrhythmia test in the final system configuration. Participants will receive an Atala lead and EV-ICD Pulse Generator placed on the left chest, with follow-up visits every six months for at least 2.5 years. Endpoints will be summarized in a final report after all active subjects complete the 6-month visit.
Why it matters
Potential benefit: If successful, the EV-ICD system could offer a less invasive option for patients needing defibrillation without transvenous leads.
How similar studies have gone: Previous similar approaches have shown potential in safety and performance, but this specific extravascular parasternally placed ICD is being tested in a pivotal trial.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria:
1. At least 18 years old
2. Class I or IIa indication for implantation of an ICD according to the ACC/AHA/HRS Guidelines or ESC guidelines
Exclusion Criteria:
1. Patients who cannot read or write
2. Expected survival \< 1 year
3. Pregnant or nursing subjects and those who plan pregnancy during the clinical investigation follow-up period
4. Participation in any concurrent clinical study without prior approval from the Sponsor
5. Inability or unwillingness to provide informed consent to participate in the study
6. Any known circumstances which may prevent the completion of protocol testing and data collection through the 6-month follow-up visit
7. Circumstances that may prevent data collection or completion of specified follow-up visits
8. Allergies to any device materials listed in the Instructions for Use (IFU)
9. Contraindication for temporary suspension of oral/systemic anticoagulation
10. Known history of lung disease with FEV1 \< 1.0 Liter
Device Related:
11. Implanted with or planned implantation of any device which delivers current in the body that may interfere with therapy delivery, including, but not limited to a pacemaker, LVAD or neurostimulator
12. Implanted with a subcutaneous ICD lead, subcutaneous coils/arrays, epicardial patches or epicardial pace/sense leads
13. Any known need for MRI prior to approval of MRI conditional labeling
Anatomy Related:
14. Known structural abnormalities of the heart that may increase risk of the Parasternal EV-ICD System procedure
15. Known obstructed or restricted pathway into the mediastinum for the Atala™ lead
16. Prior surgery with disruption of the lung, pericardium or connective tissue between the sternum and pericardium, including sternotomy of any type
17. Known significant anatomic derangement of or within the thorax (e.g., pectus excavatum, significant scoliosis)
18. History of thoracic radiation therapy or other medical treatments/conditions which may complicate the Parasternal EV-ICD System implant procedure
19. Known adhesions in the thorax or history of medical treatments, surgeries or conditions that increase the potential for adhesions in the thorax
20. Surgically corrected congenital heart disease (not including catheter-based procedures)
Cardiac Related:
21. Indication for permanent bradycardia pacing or cardiac resynchronization therapy
22. Decompensated heart failure
23. Currently on inotropic therapy
24. Known history of pericardial disease, pericarditis or mediastinitis
25. Risk factors associated with defibrillation testing:
* Severe aortic stenosis
* Current Intracardiac LA or LV thrombus
* Severe proximal three-vessel or left main coronary artery disease without revascularization
* Hemodynamic instability
* Unstable angina
* Recent stroke or transient ischemic attack (within the last 3 months)
* Known inadequate external defibrillation
* LVEF \< 20% (most recent assessment; must be within 180 days of consent)
* LVEDD \>70 mm (most recent assessment; must be within 180 days of consent)
Where it's running
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St. Bernards Heart and Vascular
Jonesboro, Arkansas, United States Recruiting -
Mount Sinai Medical Center of Florida
Miami Beach, Florida, United States Recruiting -
Emory University
Atlanta, Georgia, United States Recruiting -
Endeavor Health
Glenview, Illinois, United States Recruiting -
Baptist Health
Lexington, Kentucky, United States Recruiting -
John Hopkins Medical
Baltimore, Maryland, United States Recruiting
Show 29 more locations
-
Mayo Clinic
Rochester, Minnesota, United States Recruiting -
Northwell Health
Manhasset, New York, United States Recruiting -
Advocate/Atrium Health - Sanger Heart and Vascular
Charlotte, North Carolina, United States Recruiting -
Advocate/Atrium Health - Wake Forest Baptist
Winston-Salem, North Carolina, United States Recruiting -
The Carl & Edyth Lindner Center for Research and Education at The Christ Hospital
Cincinnati, Ohio, United States Recruiting -
Texas Cardiac Arrhythmia Research
Austin, Texas, United States Recruiting -
Haga Hospital
The Hague, Aa, Netherlands Recruiting -
Isala Hospital
Zwolle, Ab, Netherlands Recruiting -
Amsterdam University Medical Center
Amsterdam, Az, Netherlands Recruiting -
Erasmus Medical Center
Rotterdam, Gelderland, Netherlands Recruiting -
Medical Spectrum Twente
Enschede, Kz, Netherlands Recruiting -
Honor Health
Scottsdale, Arizona, United States Not yet recruiting -
UC San Diego Health
La Jolla, California, United States Not yet recruiting -
Providence Medical Foundation
Orange, California, United States Not yet recruiting -
Cedars-Sinai Medical Center
Santa Monica, California, United States Not yet recruiting -
MedStar Washington Hospital Center
Washington D.C., District of Columbia, United States Not yet recruiting -
AdventHealth
Orlando, Florida, United States Not yet recruiting -
Cooper Health
Voorhees Township, New Jersey, United States Not yet recruiting -
East Carolina Heart Institute at ECU
Greenville, North Carolina, United States Not yet recruiting -
North Carolina Heart and Vascular
Raleigh, North Carolina, United States Not yet recruiting -
Novant Health
Winston-Salem, North Carolina, United States Not yet recruiting -
University Hospitals of Cleveland
Cleveland, Ohio, United States Not yet recruiting -
OhioHealth Research Institute
Columbus, Ohio, United States Not yet recruiting -
Penn State Health Milton S. Hershey Medical Center
Hershey, Pennsylvania, United States Not yet recruiting -
University of Pennsylvania
Philadelphia, Pennsylvania, United States Not yet recruiting -
Medical University of South Carolina
Charleston, South Carolina, United States Not yet recruiting -
St. Antonius Hospital
Nieuwegein, Cm, Netherlands Not yet recruiting -
Maastricht University Medical Center
Maastricht, Hx, Netherlands Not yet recruiting -
University Medical Center Groningen
Groningen, Rb, Netherlands Not yet recruiting
Study contacts
- Study coordinator: Sarah Hase, BS, CCRA
- Email: sarah@atacor.com
- Phone: +1 949-545-9820
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.