Remote Monitoring and Optimization of Heart Failure Therapy (REMODEL-HF)

June 1, 2026 updated by: Zoll Medical Corporation

Heart failure is a condition in which the heart cannot pump blood effectively, often leading to symptoms such as shortness of breath and fluid retention. After hospitalization for heart failure, patients remain at high risk of worsening symptoms, emergency visits, and hospital readmission.

This study is designed to evaluate whether using a wearable monitoring device, called the Heart Failure Management System (HFMS), can help improve the management of patients after a recent hospitalization for heart failure.

Participants in this study will be randomly assigned to one of two groups. One group will receive standard medical care alone. The other group will receive standard medical care in combination with the HFMS device. The HFMS device is worn on the body and continuously collects information such as heart rate, breathing, activity level, and signs of fluid accumulation. These data are reviewed by the clinical care team and may help detect early worsening of heart failure.

Participants will wear the device for 90 days (if assigned to the device group) and will be followed for up to one year. During the study, information will be collected on serious health events such as death, hospitalizations, emergency visits, and changes in heart failure status, as well as quality of life.

The goal of this study is to determine whether this monitoring approach can improve outcomes for patients with heart failure by enabling earlier and more effective clinical management.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

The REMODEL-HF study is a prospective, multi-center, randomized, open-label clinical investigation designed to evaluate whether the use of HFMS in addition to usual care improves clinical outcomes in patients recently hospitalized for acute heart failure.

Approximately 800 participants will be enrolled and randomized in a 1:1 ratio to either: standard of care alone (control group), or standard of care plus HFMS-guided management (intervention group).

The primary objective is to determine whether HFMS-guided management results in improved overall clinical outcomes compared to usual care. Outcomes of interest include major clinical events such as cardiovascular death and heart failure hospitalization, as well as earlier indicators of clinical deterioration and changes in relevant biomarkers.

Study Type

Interventional

Enrollment (Estimated)

800

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 Contact

  • Name: Manon Lemaire, Master
  • Phone Number: +33 (0)6 33 57 18 52
  • Email: mlemaire@zoll.com

Study Contact Backup

  • Name: Lars Weber, PhD
  • Phone Number: +49 (0) 151 611 404 98
  • Email: lweber@zoll.com

Study Locations

  • France
    • Grand Est
      • Nancy, Grand Est, France, 54000
        • CHU Nancy
        • Contact:
        • Principal Investigator:
          • Nicolas Girerd, Professor
  • Germany
      • Giessen, Germany, 35390
        • Justus-Liebig University Giessen
        • Contact:
        • Principal Investigator:
          • Brigit Assmus, MD
  • Italy
      • Roma, Italy
        • Policlinico Casilino
        • Contact:
  • Netherlands
      • Utrecht, Netherlands
        • UMC Utrecht
  • Poland
      • Warsaw, Poland
        • PIM MSWiA Hospital
        • Contact:
        • Principal Investigator:
          • Agnieszka Pawlak, Professor
  • Spain
      • Madrid, Spain
        • Hospital Universitario 12 de Octubre
        • Contact:
  • Sweden
      • Uppsala, Sweden
        • Uppsala University Hospital
        • Contact:
  • Switzerland
      • Zurich, Switzerland
        • University Zurich
        • Contact:
  • United Kingdom
      • Southampton, United Kingdom
        • Southampton University Hospital NHS Foundation Trust
        • Contact:
        • Principal Investigator:
          • Peter COWBURN, MD

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age ≥18 years
  • Ability and willingness to provide written informed consent and comply with study procedures
  • Hospital admission for acute heart failure with dyspnea at rest and pulmonary congestion on chest X-ray, and other signs and/or symptoms of heart failure such as edema and/or positive rales on auscultation.
  • All measures within 24 hours prior to randomization of systolic blood pressure ≥ 100 mmHg, and of heart rate ≥ 60 bpm.
  • All measures within 24 hours prior to randomization of serum potassium ≤ 5.5 mEq/L (mmol/L).

  • Biomarker criteria for persistent congestion:

    • NT-proBNP >1500 pg/mL at the time of admission, and;
    • NT-proBNP >1000 pg/mL >=3 days after initial admission measure
  • At 1 week prior to admission, either (a) ≤ ½ the optimal dose of ACEi/ARB/ARNi (see Table) prescribed, no beta-blocker prescribed, and ≤ ½ the optimal dose of MRA prescribed or (b) no ACEi/ARB/ARNi prescribed, ≤ ½ the optimal dose of beta-blocker prescribed, and ≤ ½ the optimal dose of MRA prescribed. All study participants prescribed per label and commercially fit with the HFMS device will be eligible for enrollment.

Exclusion Criteria:

  • Age < 18 years
  • Clearly documented intolerance to high doses (≥50% of target dose) of beta-blockers.
  • Clearly documented intolerance to high doses (≥50% of target dose) of RAS blockers (both ACEi and ARB).
  • Mechanical ventilation (not including CPAP/BIPAP) in the 24 hours prior to Screening.
  • Significant pulmonary disease contributing substantially to the patients' dyspnea such as FEV1< 1 liter or need for chronic systemic or nonsystemic steroid therapy, or any kind of primary right heart failure such as precapillary pulmonary hypertension or chronic thromboembolic pulmonary hypertension.
  • Cardiac surgery within 3 months prior to Screening
  • Index Event (admission for AHF) triggered primarily by a correctable etiology such as significant arrhythmia (e.g., sustained ventricular tachycardia, or atrial fibrillation/flutter with sustained ventricular response >130 beats per minute, or bradycardia with sustained ventricular arrhythmia <45 beats per minute), severe anemia, acute coronary syndrome, pulmonary embolism, planned admission for device implantation or severe nonadherence leading to very significant fluid accumulation prior to admission and brisk diuresis after admission. Troponin elevations without other evidence of an acute coronary syndrome are not excluded.
  • Uncorrected thyroid disease, active myocarditis, or known amyloid, sarcoidosis, or hypertrophic obstructive cardiomyopathy.
  • History of heart transplant or on a transplant list, or using or planned to be implanted with a ventricular assist device.
  • Adhesive allergy/sensitivity (e.g., acrylic adhesives).
  • Compromised skin at the device application site (wound, severe dermatitis, etc.) .
  • Having a prescribed wearable cardioverter defibrillator
  • Pulmonary artery pressure implant (e.g. CardioMems)
  • Expected survival <1 year

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: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Control Group
Participants receive standard medical care for heart failure according to local clinical practice without use of the HFMS device.
Active Comparator: Intervention Group
Participants receive standard medical care in addition to remote monitoring using the Heart Failure Management System (HFMS). Clinical teams review device data and may adjust treatment based on observed trends and alerts.
Device: Wearable Monitoring Device for Heart Failure

Participants assigned to the intervention group will use a noninvasive wearable physiological monitoring device (Heart Failure Management System, HFMS) designed to continuously collect data related to cardiopulmonary status, including heart rate, respiratory parameters, activity levels, and indicators of fluid status (Thoraic Fluid Index = TFI).

Clinical care teams perform regular reviews of device-derived data and may respond to alerts or trends suggestive of worsening heart failure.

Based on these data, the care team may adjust patient management, including modification of guideline-directed medical therapy or scheduling of follow-up assessments. The device does not deliver therapy and is used to support clinical decision-making in the outpatient management of heart failure.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Hierarchical Composite Outcome (Win Ratio)
Time Frame: 90 days
A hierarchical composite outcome comparing the intervention and control groups using a win ratio approach. The components are prioritized as follows: (1) cardiovascular death, (2) heart failure hospitalization, (3) Unplanned visit (emergency room or other emergency facilities) requiring intravenous diuretic treatment, and (4) change in NT-proBNP concentration. Participants are compared pairwise, with outcomes evaluated sequentially according to this hierarchy.
90 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proportion of Participants Achieving Target Doses of Guideline-Directed Medical Therapy (GDMT)
Time Frame: 90 days
Percentage of participants reaching target doses of guideline-directed medical therapy for heart failure during the first 90 days after randomization.
90 days
Quality of Life Assessed by KCCQ-12
Time Frame: Baseline, 90 days,180 days and 365 days
Change in health-related quality of life measured using validated questionnaire : the Kansas City Cardiomyopathy Questionnaire (KCCQ-12)
Baseline, 90 days,180 days and 365 days
Time to First Clinical Event Composite
Time Frame: Up to 365 days
Time to First Occurrence of Cardiovascular Death, Heart Failure Hospitalization, or Unplanned Visit Requiring Intravenous Diuretic Treatment
Up to 365 days
Quality of Life Assessed by EQ-5D-5L
Time Frame: Baseline, 90 days,180 days and 365 days
Change in health-related quality of life measured using validated questionnaire : the EQ-5D-5L
Baseline, 90 days,180 days and 365 days
Hierarchical Composite Outcome (Win Ratio at 1 Year)
Time Frame: 365 days
Hierarchical composite outcome using the same win ratio methodology as the primary endpoint, evaluated at 1 year.
365 days
Cardiovascular Death
Time Frame: 90 days and 365 days
Occurrence of death due to cardiovascular causes.
90 days and 365 days
Heart Failure Hospitalization
Time Frame: 90 days and 365 days
Occurrence of hospitalization due to heart failure.
90 days and 365 days
Unplanned Visit Requiring Intravenous Diuretic Treatment
Time Frame: 90 days and 365 days
Occurrence of an unplanned visit requiring intravenous diuretic treatment. Scheduled or planned intravenous diuretic treatments are not considered events.
90 days and 365 days
NT-proBNP Response
Time Frame: Baseline to 90 days
Change in NT-proBNP concentration from baseline. Response defined as ≥30% decrease from baseline.
Baseline to 90 days

Collaborators and Investigators

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

Sponsor

Zoll Medical Corporation

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 (Estimated)

October 1, 2026

Primary Completion (Estimated)

August 1, 2028

Study Completion (Estimated)

August 1, 2029

Study Registration Dates

First Submitted

May 18, 2026

First Submitted That Met QC Criteria

June 1, 2026

First Posted (Actual)

June 3, 2026

Study Record Updates

Last Update Posted (Actual)

June 3, 2026

Last Update Submitted That Met QC Criteria

June 1, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 90d0278
  • 101253160 (Other Grant/Funding Number: Granting Authority :Innovative Health Initiative Joint Undertaking (IHI JU) and Funding Program: Horizon Europe)

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.

Yes

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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