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Calcium Release Deficiency Syndrome (CRDS)DIAGNOSE CRDSNCT06188689

Evaluation of A Clinical Diagnostic Test for CRDS

A study testing Pacing in people with Calcium Release Deficiency Syndrome (CRDS), run by Population Health Research Institute at 20 sites in 7 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Calcium Release Deficiency Syndrome (CRDS) is a novel inherited arrhythmia syndrome secondary to RyR2 loss-of-function that confers a risk of sudden cardiac death. Diagnosis of CRDS presently requires cellular-based in vitro confirmation that an RyR2 variant causes loss-of-function. Read more about this study

Who is it for?
Any age
What is being tested?
Pacing
Could I receive a placebo?
No, everyone receives an active treatment
How many people
400 participants
Where
20 sitesin 7 countries
Study dates
2 Feb 2023to Mar 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Presence of an RyR2 variant confirmed to be loss-of-function on in vitro testing
  • Satisfy a clinical phenotype consistent with the Expert Consensus Statement
  • Presence of a confirmed or presumed pathogenic gain-of-function RyR2 variant OR homozygous or compound heterozygous for likely pathogenic/pathogenic CASQ2 variants
  • Cardiac arrest requiring cardioversion or defibrillation that remains unexplained following an ECG, echocardiogram, coronary assessment, cardiac MRI, and exercise treadmill test
  • Undergone genetic testing that includes screening of RyR2*
  • Undergoing an invasive electrophysiology study

Who cannot join

  • Unable to provide informed consent
  • Cohort 2: Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) Cases
  • Unable to provide informed consent
  • Use of a QT prolonging medication, aside from flecainide, at the time of the burst pacing maneuvers
  • Cohort 3: Survivors of Unexplained Cardiac Arrest (UCA)
  • Unable to provide informed consent
Show all 16Show fewer
  • Use of a QT prolonging medication at the time of the burst pacing maneuvers
  • Among survivors of UCA that possess a rare RyR2 variant in the absence of a CPVT phenotype, in vitro functional testing will be performed in order to confirm it is not loss- or gain-of-function (and will be arranged through the laboratory of Dr. Wayne Chen at the University of Calgary).
  • Cohort 4: SVT controls
  • Ventricular cardiomyopathy
  • Ventricular pre-excitation
  • Long QT syndrome
  • Use of a QT prolonging medication at the time of the EP study
  • Use of a Class I or Class III anti-arrhythmic drug at the time of the EP study
  • Known obstructive coronary artery disease (existing coronary stenosis >50%)
  • Unable to provide informed consent

Trial locations and contacts

20 sites in 7 countries. Contact the study team or a site near you to ask about taking part.

20 sites in 7 countries

Canada10 sites, 10 recruiting
  • University of Calgary

    Calgary, Alberta, T2N 1N4

    Project Manager, 905-521-2100, crds@phri.ca

    Erkan Ilhan, MD

    Recruiting
  • Alberta Health Services

    Edmonton, Alberta, T6G 2C8

    Project Manager, 905-521-2100, crds@phri.ca

    Joseph Atallah, MD CM, MSc

    Recruiting
  • Hamilton General Hospital

    Hamilton, Ontario, L8L 2X2

    Project Manager, 905-521-2100, crds@phri.ca

    Jason D Roberts, MD MAS

    Recruiting
  • London Health Sciences Centre - University Hospital

    London, Ontario, N6A 5A5

    Project Manager, 905-521-2100, crds@phri.ca

    Habib R Khan, MD

    Recruiting
  • Montréal Heart Institute

    Montreal, Quebec, H1T 1C8

    Project Manager, 905-521-2100, crds@phri.ca

    Rafik Tadros, MD PhD

    Recruiting
  • Ottawa Heart Institute

    Ottawa, Ontario, K1Y 4W7

    Project Manager, 905-521-2100, crds@phri.ca

    Simon Hansom, MD

    Recruiting
  • Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval

    Québec, Quebec, G1V 4G5

    Project Manager, 905-521-2100, crds@phri.ca

    Christian Steinberg, MD

    Recruiting
  • Toronto General Hospital

    Toronto, Ontario, M5G 2C4

    Project Manager, 905-521-2100, crds@phri.ca

    Michael H. Gollob, MD, FRCP(C)

    Recruiting
  • Children's & Women's Health Centre of British Columbia

    Vancouver, British Columbia, V6H 3N1

    Project Manager, 905-521-2100, crds@phri.ca

    Shubhayan Sanatani, MD

    Recruiting
  • The University of British Columbia

    Vancouver, British Columbia, V6T 1Z3

    Project Manager, 905-521-2100, crds@phri.ca

    Thomas M Roston, MD

    Recruiting

Other trials in Canada

United States4 sites, 4 recruiting
  • Boston Children's Hospital

    Boston, Massachusetts, 02115

    Project Manager, 905-521-2100, crds@phri.ca

    Dominic Abrams, MBBS, MD, MBA

    Recruiting
  • Mayo Clinic

    Rochester, Minnesota, 55905

    Project Manager, 905-521-2100, crds@phri.ca

    John Giudicessi, MD, PhD

    Recruiting
  • University of California

    San Francisco, California, 94143

    Project Manager, 905-521-2100, crds@phri.ca

    Vasanth Vedantham, MD, PhD

    Recruiting
  • University of Washington

    Seattle, Washington, 98195

    Project Manager, 905-521-2100, crds@phri.ca

    Uyanga Batnyam, MD

    Recruiting

Other trials in United States

Belgium2 sites, 2 recruiting
  • Universitair Ziekenhuis Brussel

    Brussels, 1090

    Project Manager, 905-521-2100, crds@phri.ca

    Luigi Pannone, MD

    Recruiting
  • Antwerp University Hospital

    Edegem, Antwerp, 2650

    Project Manager, 905-521-2100, crds@phri.ca

    Johan Saenen, MD, PhD

    Recruiting

Other trials in Belgium

Denmark1 site, 1 recruiting
  • Aarhus University Hospital

    Aarhus, DK-8200 N

    Project Manager, 905-521-2100, crds@phri.ca

    Henrik Jensen, MD

    Recruiting

Other trials in Denmark

France1 site, 1 recruiting
  • CHU de Bordeaux

    Bordeaux, New Aquitaine, 33404

    Project Manager, 905-521-2100, crds@phri.ca

    Frédéric Sacher, MD

    Recruiting

Other trials in France

Israel1 site, 1 recruiting
  • Shaare Zedek Medical Center

    Jerusalem, 9103102

    Project Manager, 905-521-2100, crds@phri.ca

    Ziv Dadon, MD

    Recruiting

Other trials in Israel

United Kingdom1 site, 1 recruiting
  • Oxford University Hospitals

    Oxford, Oxfordshire, OX3 9DU

    Project Manager, 905-521-2100, crds@phri.ca

    Julian Ormerod, BM, Bch, FRCP

    Recruiting

Other trials in United Kingdom

About this study

Official title: Evaluation of a Clinical Diagnostic Test for Calcium Release Deficiency Syndrome: The DIAGNOSE CRDS Study

Calcium Release Deficiency Syndrome (CRDS) is a novel inherited arrhythmia syndrome secondary to RyR2 loss-of-function that confers a risk of sudden cardiac death. Diagnosis of CRDS presently requires cellular-based in vitro confirmation that an RyR2 variant causes loss-of-function. We hypothesize that CRDS can be diagnosed clinically through evaluation of the repolarization response to brief tachycardia, mediated by cardiac pacing, and a subsequent pause.

Read the detailed description

RyR2 loss-of-function variants have recently been established as causative for a new disease termed calcium release deficiency syndrome (CRDS) that confers a risk of malignant ventricular arrhythmias and sudden cardiac death. RyR2 encodes the cardiac ryanodine receptor, the calcium release channel on the sarcoplasmic reticulum that mediates excitation-contraction coupling through calcium-induced calcium-release. In contrast to CRDS, pathogenic RyR2 gain-of-function variants result in an autosomal dominant form of catecholaminergic polymorphic ventricular tachycardia (CPVT). The adrenergic-mediated ventricular arrhythmias characteristic of CPVT can be readily reproduced on exercise stress testing (EST), making EST the standard clinical diagnostic tool for CPVT.

In contrast to CPVT, the CRDS clinical phenotype is concealed with standard cardiac testing tools and its diagnosis presently requires cellular-based in vitro confirmation that an RyR2 variant causes loss-of-function. Beyond the significant time delay associated with in vitro functional analysis, this testing requires specialized expertise that is not widely available and remains research-based, making it impractical for routine use in clinical care. In this overall context, it is likely that the vast majority of global CRDS cases have yet to be diagnosed.

A prior report of an "atypical CPVT" family carrying an RyR2-p.M4109R variant observed marked and transient repolarization changes following pacing mediated tachycardia and a subsequent pause. Since publication of this report, in vitro characterization of the RyR2-p.M4109R variant has confirmed its being loss-of-function and the familial diagnosis has been revised to CRDS. Driven by these observations and promising preliminary findings, the DIAGNOSE CRDS study seeks to further investigate this apparent electrocardiographic signature of CRDS following brief tachycardia and subsequent pause as a potential method to clinically diagnose the condition.

Being tested
Pacing
Keywords
cardiac arrhythmia, sudden cardiac death, cardiac ryanodine receptor, unexplained cardiac arrest
Medical subject headings
Arrhythmias, Cardiac, Death, Sudden, Cardiac

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PacingDiagnostic test

    1. Ventricular 10 beat burst at 500ms (120bpm)
    2. Ventricular 10 beat burst at 400ms (150bpm)
    3. Atrial 10 beat burst at 500ms (120bpm)
    4. Atrial 10 beat burst at 400ms (150bpm).
Study groups in NCT06188689
Study groupRoleWhat they receive
PacingExperimentalSeparate ventricular and atrial pacing trains will be administered at different cycle lengths and the ventricular repolarization response on the first sinus beat following the subsequent pause will be evaluated.
Receives: Diagnostic Test: Pacing

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. ΔT-wave amplitude value

    T-wave amplitude on first post-pause sinus beat subtracted by the T-wave amplitude on the last sinus beat prior to pacing

    Measured: At time of pacing maneuver

  2. ΔQT value

    Absolute QT value on first post-pause sinus beat subtracted by the absolute QT value on the last sinus beat prior to pacing

    Measured: At time of pacing maneuver

Secondary outcomes (2)
  1. Absolute QT value

    Absolute QT value on first post-pause sinus beat

    Measured: At time of pacing maneuver

  2. Absolute T-wave amplitude

    Absolute T-wave amplitude on first post-pause sinus beat

    Measured: At time of pacing maneuver

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Jan 2024
  2. Study start2 Feb 2023
  3. Primary completionDec 2027 (estimated)
  4. Study completionMar 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
400 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06188689
Sponsor's protocol ID
14546
Acronym
DIAGNOSE CRDS
Status last verified
May 2026
First submitted
18 Dec 2023
Last updated
22 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Sun B, Yao J, Ni M, Wei J, Zhong X, Guo W, Zhang L, Wang R, Belke D, Chen YX, Lieve KVV, Broendberg AK, Roston TM, Blankoff I, Kammeraad JA, von Alvensleben JC, Lazarte J, Vallmitjana A, Bohne LJ, Rose RA, Benitez R, Hove-Madsen L, Napolitano C, Hegele RA, Fill M, Sanatani S, Wilde AAM, Roberts JD, Priori SG, Jensen HK, Chen SRW. Cardiac ryanodine receptor calcium release deficiency syndrome. Sci Transl Med. 2021 Feb 3;13(579):eaba7287. doi: 10.1126/scitranslmed.aba7287.

    PubMed 33536282
  • Nof E, Belhassen B, Arad M, Bhuiyan ZA, Antzelevitch C, Rosso R, Fogelman R, Luria D, El-Ani D, Mannens MM, Viskin S, Eldar M, Wilde AA, Glikson M. Postpacing abnormal repolarization in catecholaminergic polymorphic ventricular tachycardia associated with a mutation in the cardiac ryanodine receptor gene. Heart Rhythm. 2011 Oct;8(10):1546-52. doi: 10.1016/j.hrthm.2011.05.016. Epub 2011 May 26.

    PubMed 21699856
  • Ormerod JOM, Ormondroyd E, Li Y, Taylor J, Wei J, Guo W, Wang R, Sarton CNS, McGuire K, Dreau HMP, Taylor JC, Ginks MR, Rajappan K, Chen SRW, Watkins H. Provocation Testing and Therapeutic Response in a Newly Described Channelopathy: RyR2 Calcium Release Deficiency Syndrome. Circ Genom Precis Med. 2022 Feb;15(1):e003589. doi: 10.1161/CIRCGEN.121.003589. Epub 2021 Dec 24.

    PubMed 34949103
  • Roston TM, Wei J, Guo W, Li Y, Zhong X, Wang R, Estillore JP, Peltenburg PJ, Noguer FRI, Till J, Eckhardt LL, Orland KM, Hamilton R, LaPage MJ, Krahn AD, Tadros R, Vinocur JM, Kallas D, Franciosi S, Roberts JD, Wilde AAM, Jensen HK, Sanatani S, Chen SRW. Clinical and Functional Characterization of Ryanodine Receptor 2 Variants Implicated in Calcium-Release Deficiency Syndrome. JAMA Cardiol. 2022 Jan 1;7(1):84-92. doi: 10.1001/jamacardio.2021.4458.

    PubMed 34730774
  • Ni M, Dadon Z, Ormerod JOM, Saenen J, Hoeksema WF, Antiperovitch P, Tadros R, Christiansen MK, Steinberg C, Arnaud M, Tian S, Sun B, Estillore JP, Wang R, Khan HR, Roston TM, Mazzanti A, Giudicessi JR, Siontis KC, Alak A, Acosta JG, Divakara Menon SM, Tan NS, van der Werf C, Nazer B, Vivekanantham H, Pandya T, Cunningham J, Gula LJ, Wong JA, Amit G, Scheinman MM, Krahn AD, Ackerman MJ, Priori SG, Gollob MH, Healey JS, Sacher F, Nof E, Glikson M, Wilde AAM, Watkins H, Jensen HK, Postema PG, Belhassen B, Chen SRW, Roberts JD. A Clinical Diagnostic Test for Calcium Release Deficiency Syndrome. JAMA. 2024 Jul 16;332(3):204-213. doi: 10.1001/jama.2024.8599.

    PubMed 38900490

Questions about this trial

What is this clinical trial studying?

A study testing Pacing in people with Calcium Release Deficiency Syndrome (CRDS), run by Population Health Research Institute at 20 sites in 7 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 22 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 sites in Canada, United States, Belgium, Denmark, France and 2 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Jason Roberts, MD MAS (905-297-3479 ext. 40632, jason.roberts@phri.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

ΔT-wave amplitude value (time frame: At time of pacing maneuver). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06188689, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Jul 2026.

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