Clinical trial Recruiting at 17 sites Interventional Ages 18 and up

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 typeInterventional
Ages18 Years and up
SexAll
Enrollment280 (estimated)
SponsorAtaCor Medical, Inc.
Industry-sponsored
Drugs / interventionsradiation
Locations35 sites (Scottsdale, Arizona and 34 other locations)
StatusRecruiting
StartedJuly 2, 2026
Main results expectedAugust 31, 2027
Study endsDecember 31, 2028
Registry record updatedOctober 9, 2026
Trial IDNCT07324031 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

  • 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

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Other studies for the same condition or treatment. Recruiting studies are listed first.

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  • Using Stellate Ganglion Block to Treat Arrhythmic Storm

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  • Registry for implantable cardiac devices

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    Recruiting Heinrich-Heine University, Duesseldorf · Düsseldorf · NCT03360227

How to take part

  1. Review the eligibility criteria above with your treating physician.
  2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
  3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.
Last reviewed 2026-11-14 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.