Algorithm Using LINQ Sensors for Evaluation And Treatment of Heart Failure (ALLEVIATE-HF)

August 3, 2026 updated by: Medtronic Cardiac Rhythm and Heart Failure
The ALLEVIATE-HF study is a prospective, randomized, controlled, blinded, multi-site, interventional, investigational device exemption (IDE) pivotal study. The purpose of the study is to demonstrate the safety and efficacy of a patient management pathway that utilizes an integrated device diagnostic-based risk stratification algorithm to guide patient care in subjects with NYHA class II and III heart failure, and to demonstrate the safety of the Reveal LINQ™ system and procedure in the study population.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

The study will utilize the market released Reveal LINQ™ Insertable Cardiac Monitor with an investigational ALLEVIATE-HF RAMware download. The study will enroll up to 900 subjects at up to 75 sites in the US. Subjects will be followed until the last enrolled subject is followed for 7 months or until the end of the study, whichever occurs first, or until time of study exit or death as applicable, but no longer than 36 months.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
826

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • United States
    • Arizona
      • Mesa, Arizona, United States, 85282
        • Cardiovascular Associates of Mesa
    • Arkansas
      • Jonesboro, Arkansas, United States, 72410
        • Arrhythmia Research Group
    • California
      • Mission Viejo, California, United States, 92691
        • Saint Joseph Heritage Healthcare
      • Oxnard, California, United States, 93030
        • Cardiology Associates Medical Group
      • Stockton, California, United States, 95204
        • Saint Joseph's Medical Center
    • Colorado
      • Littleton, Colorado, United States, 80120
        • South Denver Cardiology Associates
    • Florida
      • Boca Raton, Florida, United States, 33486
        • FWD Clinical Research LLC
      • Brandon, Florida, United States, 33511
        • Bay Area Cardiology Associates PA
      • Ft. Pierce, Florida, United States, 34950
        • Florida Heart Center
      • Jacksonville, Florida, United States, 32207
        • Baptist Health
      • Jacksonville, Florida, United States, 32256
        • First Coast Cardiovascular Institute PA
      • Leesburg, Florida, United States, 34748
        • Citrus Cardiology Consultants PA
      • Pensacola, Florida, United States, 32501
        • Baptist Hospital
      • St. Petersburg, Florida, United States, 33709
        • Northside Hospital
      • Tallahassee, Florida, United States, 32308
        • Tallahassee Research Institute
    • Georgia
      • Savannah, Georgia, United States, 31404
        • Memorial Health University Medical Center
    • Illinois
      • Evanston, Illinois, United States, 60201
        • Northshore University Health System
      • Urbana, Illinois, United States, 61801
        • Carle Foundation Hospital
    • Indiana
      • Fort Wayne, Indiana, United States, 46845
        • Parkview Health
      • Indianapolis, Indiana, United States, 46260
        • Ascension Medical Group - Saint Vincent
    • Iowa
      • West Des Moines, Iowa, United States, 50266
        • Iowa Heart Center
    • Kansas
      • Kansas City, Kansas, United States, 66160
        • University of Kansas Medical Center
    • Kentucky
      • Edgewood, Kentucky, United States, 41017
        • Saint Elizabeth Healthcare
      • Louisville, Kentucky, United States, 40207
        • Baptist Healthcare System
      • Louisville, Kentucky, United States, 40217
        • Norton Healthcare
    • Minnesota
      • Robbinsdale, Minnesota, United States, 55422
        • North Memorial Health Heart & Vascular Center
    • Mississippi
      • Jackson, Mississippi, United States, 39216
        • University of Mississippi Medical Center
      • Tupelo, Mississippi, United States, 38801
        • Cardiology Associates of North Mississippi
    • Nebraska
      • Omaha, Nebraska, United States, 68124
        • CHI Health Creighton University Medical Center - Bergan Mercy
    • New Jersey
      • Voorhees Township, New Jersey, United States, 08043
        • Lourdes Cardiology Services
    • New Mexico
      • Albuquerque, New Mexico, United States, 87102
        • New Mexico Heart Institute PA
    • New York
      • New York, New York, United States, 10032
        • Columbia University Irving Medical Center/NYPH
      • Poughkeepsie, New York, United States, 12601
        • Hudson Valley Heart Center
      • Roslyn, New York, United States, 11576
        • Saint Francis Hospital
      • Stony Brook, New York, United States, 11794
        • Stony Brook University Hospital
    • North Carolina
      • Greensboro, North Carolina, United States, 27401
        • Cone Health
      • Wilmington, North Carolina, United States, 28401
        • Novant Health New Hanover Regional Medical Center
    • Ohio
      • Cincinnati, Ohio, United States, 45219
        • The Lindner Research Center
      • Columbus, Ohio, United States, 43213
        • Mount Carmel East
      • Columbus, Ohio, United States, 43214
        • OhioHealth Research and Innovation Institute (OHRI)
    • Pennsylvania
      • Doylestown, Pennsylvania, United States, 18901
        • Doylestown Health Cardiology a division of Doylestown Health Physicians
      • Philadelphia, Pennsylvania, United States, 19107
        • Cardiology Consultants of Philadelphia
    • South Carolina
      • Charleston, South Carolina, United States, 29425
        • Medical University of South Carolina
      • Columbia, South Carolina, United States, 29203
        • Prisma Health Midlands
    • Tennessee
      • Germantown, Tennessee, United States, 38138
        • The Stern Cardiovascular Foundation
      • Memphis, Tennessee, United States, 38104
        • University of Tennessee Methodist Physicians
    • Texas
      • Fort Worth, Texas, United States, 76104
        • Medical City Fort Worth
      • Tyler, Texas, United States, 75701
        • Tyler Cardiovascular Consultants
    • Virginia
      • Norfolk, Virginia, United States, 23507
        • Sentara Norfolk General Hospital
    • Washington
      • Seattle, Washington, United States, 98122
        • Swedish Medical Center Cherry Hill
      • Tacoma, Washington, United States, 98405
        • Saint Joseph Medical Center (Tacoma WA)
    • West Virginia
      • Charleston, West Virginia, United States, 25304
        • Charleston Area Medical Center (CAMC) Memorial Hospital
      • Morgantown, West Virginia, United States, 26506
        • West Virginia University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patient has NYHA Class II or III heart failure per most recent assessment, irrespective of left ventricular ejection fraction (LVEF)
  • Patient has documented recent history of symptomatic heart failure, defined as meeting any one of the following three criteria: 1. Hospital admission with primary diagnosis of HF within the last 12 months, OR 2. Intravenous HF therapy (e.g. IV diuretics/vasodilators) or ultrafiltration within the last 6 months, OR 3. Patient had the following BNP/NT-proBNP within the last 3 months: If LVEF ≥ 50%, then BNP> 150 pg/ml or NT-proBNP > 450 pg/ml OR If LVEF is <50%, then BNP> 300 pg/ml or NT-proBNP > 900 pg/ml
  • Patient is willing and able to comply with the protocol, including LINQ ICM insertion, CareLink transmissions (including adequate connectivity), study visits and remote care directions.
  • Patient is 18 years of age or older.
  • Patient has a life expectancy of 12 months or more.

Exclusion Criteria:

  • Patient is currently implanted with a cardiovascular implantable electronic device (CIED) (e.g. ICM, pacemaker, ICD, CRT-D or CRT-P device) or hemodynamic monitor.
  • Patient is receiving temporary or permanent mechanical circulatory support.
  • Patient had MI or PCI/CABG within past 90 days.
  • Patient has had a heart transplant, or is currently on heart transplant list.
  • Patient has severe valve stenosis on echocardiogram.
  • Patient has primary pulmonary hypertension (pre-capillary, WHO group 1,3,4,5).
  • Patient is on chronic intravenous inotropic drug therapy (e.g. dobutamine, milrinone).
  • Patient has severe renal impairment (eGFR <30 mL/min).
  • Patient has systolic blood pressure of < 90 mmHg at the time of enrollment.
  • Patient is on chronic renal dialysis.
  • Patient is unable to undergo one round of PRN medication intervention (i.e. 4 days of increased diuretics dose).
  • Patient has liver disease, defined as AST/ALT >5x normal, or bilirubin >2x normal.
  • Patient has serum albumin < 3 g/dL.
  • Patient has hypertrophic obstructive cardiomyopathy, constrictive pericarditis or amyloidosis.
  • Patient has complex adult congenital heart disease.
  • Patient has active cancer involving chemotherapy and/or radiation therapy.
  • Patient weighs more than 500 pounds.
  • Patient is pregnant or breastfeeding (all females of child-bearing potential must have a negative pregnancy test within 1 week of enrollment).
  • Patient is enrolled in another interventional study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Placebo Comparator: Observation Arm
Subjects will receive a Reveal LINQ™ Insertable Cardiac Monitor with an investigational ALLEVIATE-HF RAMware download, and will be managed per standard of care for heart failure management without visibility to the heart failure sensor data. Subjects will transition to the intervention arm after 13 months.
Device: Reveal LINQ™ Insertable Cardiac Monitor with investigational ALLEVIATE-HF RAMware download
Reveal LINQ™ Insertable Cardiac Monitor with investigational ALLEVIATE-HF RAMware download.
Experimental: Intervention Arm
Subjects will receive a Reveal LINQ™ Insertable Cardiac Monitor with an investigational ALLEVIATE-HF RAMware download, and will be managed using an integrated device diagnostic-based risk stratification algorithm combined with a clinical medication plan.
Device: Reveal LINQ™ Insertable Cardiac Monitor with investigational ALLEVIATE-HF RAMware download
Reveal LINQ™ Insertable Cardiac Monitor with investigational ALLEVIATE-HF RAMware download.
Other: Medication intervention
Risk status guided medication intervention.
Other: Additional Participants Included Only in Safety Set
Participants who were only randomized to an earlier version of the Clinical Investigational Plan and were only analyzed for the secondary safety outcome. The randomization under the previous version was not pertinent to the primary or secondary outcomes, and thus are combined into one group for the main analysis.
Other: Not Randomized to Device or Medication Intervention
No intervention was assigned due to not being randomized under the final version of the investigational plan
Other: Participants Not Included in Study Analyses
Patients who were, with one exception, exited prior to randomization. The exception was a patient who was ineligible for the study analyses due to being enrolled under the previous version of the investigational plan with a pre-existing LINQ device, and thus ineligible for the Analysis Set or the Safety Set.
Other: Not Randomized to Device or Medication Intervention
No intervention was assigned due to not being randomized under the final version of the investigational plan

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Safety of Patient Management Pathway - Proportion of PRN Medication Interventions With Associated PRN Medication Intervention Related Serious Adverse Events (SAEs)
Time Frame: From 6 weeks after installation of RAMware through the duration of follow-up for Intervention arm subjects, and from the conclusion of the 13-month randomized period through the duration of follow-up for Observation arm subjects, up to 3 years.
The proportion of PRN medication interventions with one or more associated medication intervention related serious SAEs as adjudicated by the independent Clinical Events Committee will be evaluated. The objective is met when the point estimate for the event rate is less than or equal to 0.05 (5%).
From 6 weeks after installation of RAMware through the duration of follow-up for Intervention arm subjects, and from the conclusion of the 13-month randomized period through the duration of follow-up for Observation arm subjects, up to 3 years.
Efficacy of Patient Management Pathway - Hierarchical Composite of Cardiovascular Death, Heart Failure (HF) Events, Change in Kansas City Cardiomyopathy Questionnaire (KCCQ) and Change in Six-minute Walk Test Distance
Time Frame: From 6 weeks after installation of RAMware to the end of the 13-month randomized period.
The win ratio for the hierarchical composite endpoint, defined as Intervention arm wins divided by Observation arm wins, will be evaluated using the Finkelstein-Schoenfeld test. Analysis will include subjects with at least one "high" HF risk status during the analysis period (i.e. between 42 and 395 days post-randomization, to exclude the 6-weeks after the installation of RAMware and include data occurring prior to the 13-month timepoint). HF event, as adjudicated by the independent Clinical Events Committee, is defined as an event requiring invasive HF therapy (e.g. IV or subcutaneous diuretics/vasodilators/inotropes) or ultrafiltration, and includes events with or without hospitalization. The Clinical Composite Score is used as KCCQ measure. The primary efficacy objective is met when the win ratio is significantly larger than 1.0, with a p-value below 0.05.
From 6 weeks after installation of RAMware to the end of the 13-month randomized period.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Safety of Reveal LINQ™ System and Procedure - Percentage of Subjects With Freedom From Experiencing System or Procedure Related Serious Adverse Events
Time Frame: From time of Reveal LINQ™ device insertion attempt to 6 months post insertion attempt.
Freedom from Reveal LINQ™ system and procedure related serious adverse events (SAEs) as adjudicated by the independent Clinical Events Committee will be evaluated. The objective is met when freedom from system and procedure related SAEs at 6 months is greater than or equal to 95%.
From time of Reveal LINQ™ device insertion attempt to 6 months post insertion attempt.
Efficacy of Patient Management Pathway - Hierarchical Composite of Cardiovascular Death, HF Events, Change in KCCQ, Change in Six-minute Walk Test Distance, and Change in Device-measured Activity and Night Heart Rate
Time Frame: From 6 weeks after installation of RAMware to the end of the 13-month randomized period.
The win ratio for the hierarchical composite endpoint, defined as Intervention arm wins divided by Observation arm wins, will be evaluated using the Finkelstein-Schoenfeld test. Analysis will include subjects with at least one "high" HF risk status during the analysis period (i.e. between 42 and 395 days post-randomization, to exclude the 6-weeks after the installation of RAMware and include data occurring prior to the 13-month timepoint). HF event, as adjudicated by the independent Clinical Events Committee, is defined as an event requiring invasive HF therapy (e.g. IV or subcutaneous diuretics/vasodilators/inotropes) or ultrafiltration, and includes events with or without hospitalization. The Clinical Composite Score is used as KCCQ measure. The secondary efficacy objective is met when the win ratio is significantly larger than 1.0, with a p-value below 0.05.
From 6 weeks after installation of RAMware to the end of the 13-month randomized period.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Medtronic Cardiac Rhythm and Heart Failure

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Javed Butler, MD, Baylor Scott and White Health

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 3, 2020

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
June 2, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
June 2, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 24, 2020

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 26, 2020

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
June 30, 2020

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
August 26, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 3, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • ALLEVIATE-HF

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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