- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03775161
V-LAP™ Left Atrium Monitoring systEm for Patients With Chronic sysTOlic & Diastolic Congestive heaRt Failure (VECTOR-HF)
A First in Human Multi-center, Open Label, Prospective Study to Evaluate the Safety, Usability and Performance of the V-LAP™ System
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Ischemic or non-ischemic cardiomyopathy and documented heart failure for at least 6 months.
- ACC/AHA Stage C, NYHA Class III or ambulatory Class IV HF documented at Baseline Visit.
- Receiving maximally tolerated medical therapy for heart failure as indicated per ACC/AHA or ESC Heart Failure Guidelines (guideline-directed medical therapy or GDMT), such as diuretic, angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), beta-blocker (BB), and mineralocorticoid receptor blocker (MRB) for at least 3 months prior to the Baseline visit.
- Receiving rhythm management device therapy as recommended by the ACC/AHA or ESC Guidelines. Specifically: cardiac resynchronization therapy (CRT) should be implanted for at least 90 days prior to enrollment; an implanted cardioverter-defibrillator (ICD) or a pacemaker should be implanted at least 30 days prior to enrollment. If subject is clinically contraindicated for these therapies this criterion may be waived.
- Have a minimum of one (1) prior hospital admission within the last 12-months for acute worsening of HF associated with signs/symptoms of congestion of at least one (1) calendar date change duration requiring treatment with an intravenous diuretic. If CRT device previously implanted, the heart failure hospitalization must be ≥ 30 days after CRT implantation. Alternatively, if patients have not had a HF hospitalization within the prior 12-months, they must have a corrected* elevated Brain Natriuretic Peptide (BNP) level of at least 300pg/ml or an N-terminal pro-BNP (NT-proBNP) level of at least 1,500pg/ml, according to local measurement, within 30-days of the Baseline Visit. *Thresholds for NT-proBNP will be corrected for body mass index (BMI) using a 4% reduction per BMI unit over 20 kg/m2, If patient is on ARNI, NT-proBNP should be used exclusively.
Provide informed consent for study participation and be willing and able to comply with the required tests, treatment instructions and follow-up visits.
-
Exclusion Criteria:
- Age <18 or >85 years old.
- Patients who are NYHA class IV not ambulatory and ACC stage D.
- Patients with evidence/history of an intra-cardiac thrombus or history of stroke, transient ischemic attack, systemic or pulmonary thromboembolism, deep vein thrombosis (DVT), within the last 6 months.
- Patients with a resting systolic blood pressure <90 or >180 mmHg and/ or Severe pulmonary hypertension with a pulmonary artery systolic pressure of ≥70 mm/Hg on screening baseline echocardiogram.
- Left ventricular end-diastolic diameter (LVEDD) > 8cm.
- Have an atrial septal defect or patent foramen ovale with more than trace shunting on color Doppler or intravenous bubble study or surgical or interventional correction of congenital heart disease involving atrial septum including placement of a PFO or ASD closure device and have a hypermobile septum or a septal aneurysm
- Patients with untreated severe valve lesions, which are indicated for surgical or percutaneous intervention, severe regurgitant (grade 4+) valve lesions, active valvular vegetations, atrial myxoma, hypertrophic cardiomyopathy with significant resting or provoked subaortic gradient, acute myocarditis, tamponade, or large pericardial effusion, constrictive pericarditis, infiltrative cardiomyopathy (including cardiac sarcoidosis, amyloidosis, and hemochromatosis), or congenital heart disease, as cause of HF.
- Uncontrolled tachyarrhythmia or bradycardia (heart rate <45).
- Intractable HF with resting symptoms despite maximal medical therapy (ACC/AHA HF Stage D), including patients receiving continuous or intermittent outpatient IV vasoactive medications (e.g., IV inotropes, IV vasodilators), patients treated with a ventricular assist device (VAD).
- Intolerant to diuretics, ACEI and ARB and beta-blocker medical therapy for patients classified as HFrEF (EF ≤40%).
- The presence of an acute coronary syndrome (ACS), percutaneous coronary intervention (PCI), rhythm management system revision, lead extraction, or cardiac or other major surgery within the preceding 90 days.
- Patients not eligible for emergency open-heart, thoracic or vascular surgery.
- Women of childbearing age
- Patients with a life expectancy that is shorter than 12 months, or those who have received a cardiac transplant or are listed for cardiac transplantation and likely to be transplanted within 12 months.
- Have coagulopathy or uninterruptible anticoagulation therapy or contraindication for all of the forms of antiplatelet/anticoagulant treatments anticipated in the protocol
- Have an estimated glomerular filtration rate <25 ml/min/1.73 m2 by the MDRD method or on dialysis.
- Hepatic impairment with at least one liver Function Test (transaminases, total bilirubin, or alkaline phosphatase) ≥ 3 times upper limit of normal.
- Gastrointestinal bleeding in the last 6 months
- Have severe chronic pulmonary disease requiring continuous home oxygen, chronic oral steroid therapy, hospitalization for exacerbation during prior 6 months, or has severe obstructive physiology on PFTs (FEV1/FVC <0.70 and FEV1 < 50% normal).
- Patients who have an active infection requiring systemic antibiotics or an elevated white blood count (above the local laboratory reference ranges)
- Have a history of active drug addiction, active alcohol abuse, or psychiatric hospital admission for psychosis within the prior 2 years.
- Are currently participating in a clinical investigation that includes an active treatment arm.
- Subject otherwise not appropriate for study as determined by the investigator. The reasons must be documented.
Patients contraindicated for trans-septal puncture, TEE or ICE.
Intra Procedural Exclusion Criteria:
(Intra Procedural Exclusion Criteria will be determined immediately after intracardiac echocardiography or transesophageal echocardiography determination of left atrial anatomy and just before trans-septal puncture)
- Anatomical anomaly on TEE or ICE that precludes implantation of the V-LAPIM across the interatrial septum (Fossa Ovalis) including: Septal thickness at fossa > 5 mm, FO Dimension <16mm, ASD or PFO with more than a trace amount of shunting, Intra- cardiac thrombus felt to be acute and not present on prior exams and Abnormal septum, e.g. a hypermobile septum or a septal aneurysm.
- Inadequate vascular access for implantation of V-LAPIM or are unable to tolerate an RHC.
- Hemodynamic at time of Index Procedure including: Severe pulmonary hypertension defined as PASP>70 mmHg or PVR >4.0 Woods Units (mmHg L-1 min-1); Resting systolic Blood Pressure <90 or >180 mmHg, not corrected with IV fluid administration or vasodilators, respectively.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: V-LAP™ System
Percutaneous implantation of the V-LAP™ implant by right heart catheterization (RHC) approach and daily LAP measurements at home
|
Delivery of the V-LAP™ implant via a catheter-based approach in a trans-septal puncture procedure, deploying it in the inter-atrial septum.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Safety Endpoint: Study (Device and/ or system) related Major Adverse Cardiac and Neurological Events (MACNE)
Time Frame: Up to three months post-procedure
|
(as defined in the protocol), as by the independent Clinical Events Committee
|
Up to three months post-procedure
|
Usability of the Delivery System
Time Frame: Intraoperative (Implantation)
|
Ability to successfully deliver (to the interatrial septum) and deploy the V-LAPIM using the V-LAPDL and acutely perform initial pressure measurement.
|
Intraoperative (Implantation)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Performance communication
Time Frame: Up to three months post-procedure
|
Freedom from failure of the V-LAP system to obtain the left atrial pressure (LAP) measurement from the sensory implant and transmit the LAP data to the V-LAP Data Display
|
Up to three months post-procedure
|
Performance accuracy
Time Frame: At index (baseline) and at three months
|
LAP accuracy validation, concordance of the V-LAP implant measurement with pulmonary capillary wedge pressure (PCWP) measurement
|
At index (baseline) and at three months
|
Usability Assessment
Time Frame: Up to 24 months post procedure
|
Usability Assessment of the V-LAP system will be measured by questionnaires that will be completed by the investigator, patient and medical team.
|
Up to 24 months post procedure
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
NYHA functional class
Time Frame: Up to 24 months post procedure
|
Change in NYHA functional class ranking during the study compare to baseline
|
Up to 24 months post procedure
|
KCCQ score
Time Frame: Up to 24 months post procedure
|
Change in KCCQ score at 6, 12 and 24 months vs. baseline.
|
Up to 24 months post procedure
|
Heart failure hospitalization rate
Time Frame: Up to 60 months post procedure
|
Heart failure hospitalization rate at 6, 12, 24, 36, 48, and 60 months (rate is calculated as the number of hospitalizations over individual patient follow-up duration).
|
Up to 60 months post procedure
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Horst Sievert, Prof. Dr., Director and Founder of CardioVasculäres Centrum Frankfurt
- Principal Investigator: Carlo Di Mario, Professor, University of Florence and Careggi University Hospital
- Principal Investigator: Francisco Leyva, Professor, Consultant Cardiologist, Queen Elizabeth Hospital
Publications and helpful links
General Publications
- D Ancona G, Murero M, Feickert S, Kaplan H, Oner A, Ortak J, Ince H. Implantation of an Innovative Intracardiac Microcomputer System for Web-Based Real-Time Monitoring of Heart Failure: Usability and Patients' Attitudes. JMIR Cardio. 2021 Apr 21;5(1):e21055. doi: 10.2196/21055.
- D'Amario D, Restivo A, Canonico F, Rodolico D, Mattia G, Francesco B, Vergallo R, Trani C, Aspromonte N, Crea F. Experience of remote cardiac care during the COVID-19 pandemic: the V-LAP device in advanced heart failure. Eur J Heart Fail. 2020 Jun;22(6):1050-1052. doi: 10.1002/ejhf.1900. Epub 2020 Jun 26. No abstract available.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CLC-0001
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Heart Failure
-
Tufts Medical CenterMetro West Medical CenterCompletedCongestive Heart Failure | Diastolic Heart Failure | Systolic Heart FailureUnited States
-
Manipal UniversityUnknownHeart Failure | Decompensated Heart Failure | Acute Heart Failure | Diastolic Heart Failure | Systolic Heart FailureIndia
-
Abbott Medical DevicesCompletedHeart Failure | Heart Failure, Diastolic | Heart Failure, Systolic | Heart Failure NYHA Class II | Heart Failure NYHA Class III | Heart Failure With Reduced Ejection Fraction | Heart Failure NYHA Class IV | Heart Failure With Normal Ejection Fraction | Heart Failure; With Decompensation | Heart Failure...United States, Canada
-
VA Eastern Colorado Health Care SystemNational Institute on Aging (NIA)CompletedHeart Failure | Heart Failure, Diastolic | Heart Failure, Systolic | Heart Failure With Reduced Ejection Fraction | Heart Failure With Preserved Ejection Fraction | Heart Failure; With Decompensation | Heart Failure,Congestive | Heart Failure AcuteUnited States
-
Lancaster General HospitalLouise von Hess Medical Research InstituteEnrolling by invitationDiastolic Heart FailureUnited States
-
University Hospital, MontpellierCompletedHeart Failure | Diastolic Heart Failure | Systolic Heart Failure Stage CFrance
-
Wake Forest UniversityCompletedHeart Failure, Congestive | Heart Failure With Preserved Ejection Fraction
-
Wake Forest UniversityNational Institute on Aging (NIA)CompletedHeart Failure, Congestive | Diastolic Heart FailureUnited States
-
US Department of Veterans AffairsCompleted
-
Giresun UniversityIstanbul University - Cerrahpasa (IUC)RecruitingHeart Failure | Diastolic Heart Failure | Systolic Heart FailureTurkey
Clinical Trials on V-LAP™ System
-
Vectorious Medical Technologies Ltd.Not yet recruiting
-
Vectorious Medical Technologies Ltd.Recruiting
-
Vectorious Medical Technologies Ltd.Recruiting
-
Apollo Endosurgery, Inc.Completed
-
Apollo Endosurgery, Inc.CompletedMorbid ObesityUnited States
-
InamedMassachusetts Veterans Epidemiology Research and Information CenterUnknownInflammation | Liver Function | Glycemic Control | Epworth Sleepiness Scale | Iron and Bone Turnover | SF-36 | IW-QOL Lite HRQoL
-
Cardiovascular Research Foundation, New YorkDickson Advanced Analytics GroupCompletedCoronary Artery DiseaseUnited States
-
Apollo Endosurgery, Inc.CompletedObesityUnited Kingdom, Australia, United States, Italy, Canada, Belgium
-
Summa Health SystemWithdrawnObesity | Renal FailureUnited States
-
Sino Medical Sciences Technology Inc.CompletedCoronary Artery Disease | Stable Angina Pectoris | Unstable Angina PectorisChina