Mitral Insufficiency Reduction With Biventricular Pacing (MiRBi)
Prospective.Randomized, Blinded, Crossover Chronic IDE Study of the Effects of Pacing on Mitral Regurgitation in Patients Without Standard Indications for Cardiac Resynchronization Therapy
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Undersøgelsestype
Undersøgelsestype
Tilmelding (Forventet)
Tilmelding
Fase
Fase
- Fase 1
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Helbert Acosta, MD
- Telefonnummer: 309-236-0810
- E-mail: mirbiacosta@gmail.com
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Patient is at least 18 years of age
Patients with moderate-to-severe or severe functional MR.
- EROA > 40 mm2 and an MR/LA > 40% (severe)
- 30 ≤ EROA ≤ 40 mm2 and 30 ≤ MR/LA ≤ 40% (moderate-to-severe)
- Baseline rates of 50-90 beats per minute (patients with sinus rhythm) or AF
- QRS < 120 ms
- LVEF < 35%
- Willing to sign informed consent
- On standard stable heart failure medical regimen (beta blockers and ACE-I or ARBs) for at least 1 month before randomization, if tolerated
- Patient has the ability to understand the requirements of the study, including consent for use and disclosure of research-related information
- Patient has the ability to comply with study procedures and protocol, including required study visits
Exclusion Criteria:
- candidate for CRT or has a previously implanted CRT device
- previously implanted implantable pulse generators (IPG) or implantable cardioverter defibrillator (ICD) with at least 10 % pacing in the right ventricle
- patient has life expectancy <6 months
- patient is pregnant
- significant aortic stenosis
- uncontrolled hypertension
- mitral valve stenosis
- severe mitral valve calcification
- ruptured chordae tendinae or papillary muscle
- mitral valve leaflet disorders (i.e. endocarditis, lupus, tumors, rheumatic heart disease)
- chronic mitral leaflet degeneration (ie. Marfans)
- previous valve replacement or surgery
- IV inotropes or IV vasodilators
- candidate for mitral valve repair or replacement surgery within the next 6 months
- patient has in-hospital acute coronary syndrome (ACS) (NSTEMI/STEMI) prior to randomization
- patient has planned or elective percutaneous coronary intervention (PCI) or other non-cardiac surgery prior to randomization
- patient is currently enrolled in an investigational drug or device study
- patient is clinically unstable per PI assessment
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Crossover opgave
- Maskning: Enkelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Andet: CRT ON
After implant, patients will be randomized to CRT pacing ON vs OFF in crossover fashion with 3 months in each period
|
The chronic effect of CRT pacing on the degree of MR in pts with severe-to-moderate or severe functional MR.
The treatment being studied is CRT pacing therapy with standard of care LV lead placement.
Patients will be randomized to CRT pacing ON vs. OFF and followed for a total of up to 8 months.
This includes two 3-month crossover periods for each pacing modality (CRT ON and CRT OFF) and a 6-week washout period between these periods.
|
|
Andet: CRT- OFF
After implant, patients will be randomized to CRT pacing OFF vs ON in crossover fashion with 3 months in each period
|
The chronic effect of CRT pacing on the degree of MR in pts with severe-to-moderate or severe functional MR.
The treatment being studied is CRT pacing therapy with standard of care LV lead placement.
Patients will be randomized to CRT pacing ON vs. OFF and followed for a total of up to 8 months.
This includes two 3-month crossover periods for each pacing modality (CRT ON and CRT OFF) and a 6-week washout period between these periods.
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Chronic(8 months post-implant) benefit of MR reduction
Tidsramme: Chronic
|
To show that CRT pacing in patients with severe functional MR who are not currently indicated for CRT will demonstrate chronic(8 months post-implant) benefit of MR reduction (via echo measured MR/LA area and ERO per American Society of Echo guidelines)
|
Chronic
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
To compare MR Severity (ERO and MR/LA area), heart volume and dimensions via echo and clinical symptoms between two pacing modalities
Tidsramme: Chronic
|
Secondary objectives will compare MR severity (ERO and MR/LA area), heart volume and dimensions via echo (LA and LV), LVEF via echo (Simpson's method and clinical sypmtoms (NYHA class, QOL, 6MHW distance) between the two pacing modalities (CRT ON and OFF)
|
Chronic
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Patrick Hranitzky, MD, Duke University
- Ledende efterforsker: Helbert Acosta, MD, Trinity Medical Center
- Ledende efterforsker: Adam A Berman, MD, Augusta University
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Forventet)
Primær færdiggørelse
Studieafslutning (Forventet)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- MiRBi- Acosta
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