- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04441203
Patient SELF-management With HemodynamIc Monitoring: Virtual Heart Failure Clinic and Outcomes (SELFIe-HF)
Patient SELF-management With HemodynamIc Monitoring: Virtual Heart Failure Clinic and Outcomes (the SELFIe-HF Trial): Program
Study Overview
Detailed Description
This will be a single center, prospective, randomized, open-label blinded-endpoint (PROBE) trial in which the treatment group will be implanted with a CardioMEMS HF sensor and managed using remote access to hemodynamics compared to a non-implanted control group. Patients with at least one hospitalization for HF (≥1) in the previous year (12 months) will be randomized into two groups, regardless of LVEF:
Usual care with the specialized multidisciplinary HF clinic team (Non-implanted Control) or Hemodynamic monitoring, less intense HF clinic follow-up, and remote follow-up by a nurse clinician and patient empowerment with access to the PAP data (CardioMEMS group).
Primary and secondary endpoints will be compared between groups after 12 months of follow-up and within groups comparing baseline parameters with 12 month follow-up measurements.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Anique Ducharme, MD
- Phone Number: 3947 5143763330
- Email: anique.ducharme@umontreal.ca
Study Contact Backup
- Name: Hélène Brown, BSc CCRP
- Phone Number: 3931 5143763330
- Email: helene.brown@icm-mhi.org
Study Locations
-
-
Quebec
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Montreal, Quebec, Canada, H1T 1C8
- Recruiting
- Montreal Heart Institute
-
Contact:
- Christine Henri, MD
- Phone Number: 3947 514-376-3330
- Email: henri_christine@hotmail.com
-
Contact:
- Helene Brown, RN. B.Sc.
- Phone Number: 3931 514-376-3330
- Email: helene.brown@icm-mhi.org
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Male or female ≥ 18 years old.
- Symptomatic HF (NYHA III) with recent heart failure admission in the previous year (12 months). OR
- Patient with at least one ER visit or unplanned HF clinic requiring iv diuretics within 12 months will be eligible if they have in addition a N-terminal pro-BNP (NT-proBNP) level > 800pg/ml at screening AND NYHA Class II on diuretics (furosemide ≥ 40mg qd), III or ambulatory IV.
- HF with reduced or preserved EF of at least 3 months duration.
- Minimum technological knowledge either with a smartphone or iPAD for use of the self-management application, including access to internet.
Anatomical criteria
- PA branch diameter between 7 mm - 15 mm
- For BMI >35, distance from patient's back to target PA<10cm
Exclusion Criteria:
- Recent cardiovascular event: Acute coronary syndrome (STEMI/NSTEMI; a small rise in the troponin level would be expected in this population and is not a contraindication for enrolment); Percutaneous Coronary Intervention (PCI), new cardiac rhythm management (CRM) device (pacemaker, ICD and CRT), CRM system revision, lead extraction or cardiac or other major surgery or transient ischemic attack or stroke within 2 months (3 months of stabilization after CRT or cardiac surgery);
- Scheduled cardiac surgery;
- History of pulmonary embolism or recurrent deep vein thrombosis;
- Persistent NYHA Class IV and ACC/AHA HF Stage D, patients implanted with a ventricular assist device (VAD), or patients listed for cardiac transplantation and likely to be transplanted within 12 months;
- Coexisting severe stenotic valve lesions, endocarditis, obstructive hypertrophic cardiomyopathy, acute myocarditis, tamponade, or large pericardial effusion;
Clinically too unstable to be followed remotely; this includes but is not limited to:
- Resting systolic blood pressure < 80 or > 180 mmHg;
- Resting heart rate > 100 bpm;
- Stage IV or V chronic kidney disease (Estimated Glomerular Filtration Rate (eGFR) that remains < 30 mL/min/1.73m2 by MDRD) or nonresponsive to diuretic therapy or on chronic renal dialysis;
- Severe pulmonary hypertension with systolic pulmonary artery pressure ≥80 mmHg;
- Pulmonary hypertension other than group II PH;
- Anemia requiring transfusions, iron infusions, or hemoglobin below 100;
- Coagulopathy or uninterruptible anticoagulation therapy or contraindication to antiplatelet/anticoagulant treatments anticipated in the protocol;
- Intolerance to aspirin or clopidogrel;
- Active infection requiring systemic antibiotics;
- Unwillingness to sign informed consent or to attend the outpatient clinic;
- Participation in another research trial with intervention;
- Discharge to a chronic care facility or residence in an outlying area;
- Pregnant or lactating women or women of childbearing potential who are not protected from pregnancy by an accepted method of contraception, such as the oral contraceptive pill, an intrauterine device or surgical sterilization. If necessary a negative urine or blood test will be performed before randomization
- Any condition that in the opinion of the investigator would jeopardize the evaluation for efficacy or safety or be associated with poor adherence to the protocol, including cognitive decline.
- Life expectancy <1 year;
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Control
Heart failure clinic follow up
|
|
Active Comparator: CardioMems
The treatment group will be implanted with a CardioMEMS HF sensor and managed using remote access to hemodynamics compared to a non-implanted control group.
|
novel implantable sensor inserted into the right pulmonary artery that measures pulmonary artery pressures (PAP) in patients with HF, the CardioMEMS™ HF System
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
first occurrence of any component of the composite event
Time Frame: 12 months
|
acute decompensated heart failure requiring emergency department consultation
|
12 months
|
Number of Participants with unplanned intravenous heart failure therapy in an outpatient clinic
Time Frame: 12 months
|
unplanned intravenous heart failure therapy in an outpatient clinic
|
12 months
|
Number of Participants with hospital admission for heart failure
Time Frame: 12 months
|
hospital admission for heart failure
|
12 months
|
Number of Participants with cardiovascular (CV) death
Time Frame: 12 months
|
cardiovascular (CV) death
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time to the first occurrence of the individual components of the primary endpoint
Time Frame: 12 months
|
Acute decompensated heart failure that requires emergency department consultation and/or unplanned intravenous heart failure therapy in an outpatient clinic
|
12 months
|
Number of Participants with CV death
Time Frame: 12 months
|
CV death
|
12 months
|
Change in Quality of life
Time Frame: 12 months
|
Quality of life questionnaire
|
12 months
|
Change in functional capacity between baseline and 12-months
Time Frame: 12 months
|
NYHA functional class (Kansas city cardiomyopathy questionnaire)
|
12 months
|
Change in 6 minutes walk distance
Time Frame: 12 months
|
6 minutes walk distance test
|
12 months
|
Number of Participants with device-related endpoints
Time Frame: 12 months
|
Safety: adverse events related to the device
|
12 months
|
Number of successful patient contacts
Time Frame: 12 months
|
Number of successful patient contacts
|
12 months
|
Pulmonary artery pressures changes mesured by the CardioMems device
Time Frame: 12 months
|
Pulmonary artery pressures changes mesured by the CardioMems device
|
12 months
|
Cost-effectiveness
Time Frame: 12 months
|
cost-effectiveness ratio
|
12 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Anique Ducharme, Montreal Heart Institute
- Study Director: Jean Rouleau, MD, Montreal Heart Institute
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
- MHICC-2018-001
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.
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