POsition of Leads in Advanced heaRt Failure: the POLAR Study (POLAR)
POsition of Leads in Advanced heaRt Failure: the POLAR Study - A 6 Month, Observational, Mult-centered, Blinded, Randomized Study to Determine if Lead Positioning in the Lateral Wall of LV in Patients Meeting Criteria for CRT Plays a Role in Determining Myocardial Function and Affect the Severity of Mitral Regurgitation
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Undersøgelsestype
Undersøgelsestype
Tilmelding (Forventet)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Sergio Thal, M.D.
- Telefonnummer: 4624 520-792-1450
- E-mail: sergio.thal@va.gov
Undersøgelse Kontakt Backup
- Navn: Elizabeth Juneman, M.D.
- Telefonnummer: 4624 520-792-1450
- E-mail: elizabeth.juneman@va.gov
Studiesteder
-
-
Arizona
-
Tucson, Arizona, Forenede Stater, 85723
- Rekruttering
- Southern Arizona VA Health Care System
-
Kontakt:
- Sergio Thal, M.D.
- Telefonnummer: 4624 520-792-1450
- E-mail: sergio.thal@va.gov
-
Kontakt:
- Elizabeth Juneman, M.D.
- Telefonnummer: 4624 520-792-1450
- E-mail: elizabeth.juneman@va.gov
-
Ledende efterforsker:
- Sergio Thal, M.D.
-
Underforsker:
- Elizabeth Juneman, M.D.
-
Underforsker:
- Hoang Thai, M.D.
-
-
Kentucky
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Lexington, Kentucky, Forenede Stater, 40502
- Rekruttering
- Lexington VA Medical Center
-
Kontakt:
- Samy Elayi, M.D.
- Telefonnummer: 859-233-4511
-
Ledende efterforsker:
- Samy Elayi, M.D.
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Subject meets the general indications for an implantable cardioverter defibrillator (ICD) with LV systolic function ≤ 35% as defined by echocardiography.
- Subject has moderate or severe heart failure, defined as NYHA Class III-IV for at least 90 days prior to enrollment.
- Subject has optimal pharmacological heart failure therapy for at least 30 days prior to enrollment.
- Subject has a 12-lead electrocardiogram (ECG) obtained no more than 90 days prior to enrollment documenting a sinus rate > 50 bpm and PR interval < 320 ms measured from any two leads.
- 12 lead ECG with left bundle brunch block morphology and a QRS duration of at least 120 msec.
- Subject has creatinine < 2.5 mg/dL obtained no more than 30 days prior to enrollment.
- Subject has left ventricular ejection fraction < 35% by echocardiogram no more than 1 year prior to enrollment.
- Subject is willing and capable of undergoing a device implant and participating in all testing associated with this clinical investigation.
- Subject has a life expectancy of more than 180 days, per physician discretion.
- Subject is age 18 or above, or of legal age to give informed consent specific to state and national law.
Exclusion Criteria:
- Subject has right bundle branch block morphology on a 12-lead ECG obtained no more than 90 days prior to enrollment.
- Subject had previous cardiac resynchronization therapy, a previous coronary venous lead, or meets the general indications for anti-bradycardia pacing defined as ventricular pacing > 40% by pacemaker interrogation.
- Subject has a neuromuscular, orthopedic, or other non-cardiac condition that prevents normal, unsupported walking.
- Subject has an atrial tachyarrhythmia that is permanent (i.e., does not terminate spontaneously and cannot be terminated with medical intervention) or persistent (i.e., can be terminated with medical intervention, but does not terminate spontaneously) within 30 days prior to enrollment.
- Subject currently requires dialysis.
- Subject has severe chronic obstructive pulmonary disease (COPD), defined as FEV1/FVC < 60%, or as defined by a physician.
- Subject has had a myocardial infarction within 30 days prior to enrollment or coronary artery disease (CAD) in which surgical or percutaneous correction was performed within 30 days prior to enrollment.
- Subject has hypertrophic obstructive cardiomyopathy or infiltrative cardiomyopathy (e.g., amyloidosis, sarcoidosis).
- Subject is on IV inotropic agents.
- Subject has any mitral valve prosthesis, or a mechanical aortic or tricuspid prosthesis
- Subject is enrolled in any concurrent study, without Medtronic written approval, which may confound the results of this study.
- Subject is pregnant or planning to get pregnant.
- Subject requires oxygen for medical reasons other than CHF.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Tredobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Aktiv komparator: Postero-lateral
Left ventricular lateral wall lead position
|
A device implant procedure will be performed under the standard of care technique with the right ventricular lead at the right ventricular apex and the left ventricular lead targeting or postero-lateral area of the LV based on pre-procedure randomization.
|
|
Aktiv komparator: Antero-lateral
Left ventricular lateral wall lead position
|
A device implant procedure will be performed under the standard of care technique with the right ventricular lead at the right ventricular apex and the left ventricular lead targeting or antero-lateral area of the LV based on pre-procedure randomization.
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Change (reduction) in left ventricular end systolic volume (LVESV)
Tidsramme: 3 and 6 months
|
3 and 6 months
|
|
Change in 6 minute walk tests
Tidsramme: 6 weeks, 3 and 6 months
|
6 weeks, 3 and 6 months
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Myocardial performance as measured by myocardial performance index (MPI)
Tidsramme: 6 months
|
6 months
|
|
|
Papillary muscle velocity as determined by tissue doppler
Tidsramme: 6 months
|
6 months
|
|
|
Progression of mitral regurgitation
Tidsramme: 6 months
|
as measured by regurgitant volume, mitral regurgitation fraction and effective regurgitant orifice area
|
6 months
|
|
Minnesota living heart failure survey
Tidsramme: 6 weeks, 3 and 6 months
|
6 weeks, 3 and 6 months
|
|
|
Chronic heart failure hospitalizations
Tidsramme: Monitored during study participation ~ 6 months
|
Monitored during study participation ~ 6 months
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Sergio Thal, M.D., Southern Arizona VA Health Care System
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Forventet)
Primær færdiggørelse
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
- PIIT1A
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