V-LAP™ Left Atrium Monitoring systEm for Patients With Chronic sysTOlic & Diastolic Congestive heaRt Failure (VECTOR-HF)

August 3, 2023 updated by: Vectorious Medical Technologies Ltd.

A First in Human Multi-center, Open Label, Prospective Study to Evaluate the Safety, Usability and Performance of the V-LAP™ System

The purpose of the trial is to evaluate the safety, usability and performance of the V-LAP™ System in adult subjects with New York Heart Association (NYHA) Class III Heart Failure.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

The trial is designed to demonstrate that the V-LAP™ implant can be positioned in the interatrial septum, and that Sensor pressure measurements correlate to standardized methods of intra-cardiac pressure measurements post-sensor implant and at the 3 month follow up visit. Safety will be monitored by the occurrence of adverse events throughout the trial.

Study Type

Interventional

Enrollment (Estimated)

45

Phase

  • 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 Locations

      • Frankfurt, Germany, 60389
        • CardioVasculäres Centrum Frankfurt
      • Florence, Italy, 50134
        • Careggi University Hospital Trust

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

Ages Eligible for Study

16 years to 83 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Ischemic or non-ischemic cardiomyopathy and documented heart failure for at least 6 months.
  2. ACC/AHA Stage C, NYHA Class III or ambulatory Class IV HF documented at Baseline Visit.
  3. 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.
  4. 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.
  5. 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.
  6. 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:

  1. Age <18 or >85 years old.
  2. Patients who are NYHA class IV not ambulatory and ACC stage D.
  3. 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.
  4. 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.
  5. Left ventricular end-diastolic diameter (LVEDD) > 8cm.
  6. 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
  7. 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.
  8. Uncontrolled tachyarrhythmia or bradycardia (heart rate <45).
  9. 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).
  10. Intolerant to diuretics, ACEI and ARB and beta-blocker medical therapy for patients classified as HFrEF (EF ≤40%).
  11. 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.
  12. Patients not eligible for emergency open-heart, thoracic or vascular surgery.
  13. Women of childbearing age
  14. 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.
  15. Have coagulopathy or uninterruptible anticoagulation therapy or contraindication for all of the forms of antiplatelet/anticoagulant treatments anticipated in the protocol
  16. Have an estimated glomerular filtration rate <25 ml/min/1.73 m2 by the MDRD method or on dialysis.
  17. Hepatic impairment with at least one liver Function Test (transaminases, total bilirubin, or alkaline phosphatase) ≥ 3 times upper limit of normal.
  18. Gastrointestinal bleeding in the last 6 months
  19. 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).
  20. Patients who have an active infection requiring systemic antibiotics or an elevated white blood count (above the local laboratory reference ranges)
  21. Have a history of active drug addiction, active alcohol abuse, or psychiatric hospital admission for psychosis within the prior 2 years.
  22. Are currently participating in a clinical investigation that includes an active treatment arm.
  23. Subject otherwise not appropriate for study as determined by the investigator. The reasons must be documented.
  24. 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)

  25. 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.
  26. Inadequate vascular access for implantation of V-LAPIM or are unable to tolerate an RHC.
  27. 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

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: 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:
  • Echocardiography

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

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

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

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

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)

January 8, 2019

Primary Completion (Estimated)

December 1, 2024

Study Completion (Estimated)

December 1, 2024

Study Registration Dates

First Submitted

December 10, 2018

First Submitted That Met QC Criteria

December 12, 2018

First Posted (Actual)

December 13, 2018

Study Record Updates

Last Update Posted (Actual)

August 8, 2023

Last Update Submitted That Met QC Criteria

August 3, 2023

Last Verified

August 1, 2023

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)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

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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