REsynkroniseringssammenligning i LBBB og normal eller mildt reduceret ventrikulær funktion med CRT (REINVENT-CRT) (REINVENT)
REsynkroniseringssammenligning i LBBB og normal eller let reduceret ventrikulær funktion med CRT (REINVENT-CRT), et fase I prospektivt randomiseret kontrolleret forsøg
Primary Objective - To determine if implantation of a permanent CRT pacing device (with LB-CRT, or conventional BiV-CRT with a coronary sinus LV lead) can improve electromechanical function, HF symptoms, and natriuretic peptide levels among patients with symptomatic HF, LVEF > 35%, and LBBB.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
This pilot study will be a multicenter randomized controlled trial involving 20 medically stable outpatients with heart failure (HF), preserved or mildly reduced LVEF (>35%), and LBBB. Patients will undergo implantation of a Medtronic Percepta CRT-P with an atrial lead, left bundle branch area pacing (LBBap) lead, and a LV lead. They will then be randomly allocated in a 1:1 fashion to usual care plus LB-CRT (DDD 60-130, LV lead turned off) (active intervention #1) or usual care plus BIV-CRT (DDD 60- 130, LV lead turned on) (active intervention #2).
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
-
-
North Carolina
-
Durham, North Carolina, Forenede Stater, 27710
- Duke University Medical Center
-
-
Virginia
-
Falls Church, Virginia, Forenede Stater, 22042
- Inova Health System
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Barn
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Ability to understand and the willingness to sign a written informed consent form and HIPAA Authorization.
- Stated willingness to comply with all study procedures and availability for the duration of the study
- Male or female aged ≥18 years
- Strict LBBB defined as QRS duration ≥130ms in women and ≥140ms in men, a QS or rS complex in V1 and V2, as well as notching or QRS slurring in mid-QRS in ≥2 contiguous leads.
- NYHA II/III, ambulatory NYHA IV, or NYHA I HF with any prior history of HF symptom decompensation requiring hospitalization, ED visit, or outpatient visit for care with IV diuretic
- LVEF >35% by clinically obtained echocardiogram overread by the study core-lab
- Demonstration of adequate echocardiographic images to allow for assessment of endpoints
- On a stable guideline directed HF medical regimen
- For females of reproductive potential: use of a highly effective contraception for at least 1 month prior to screening and agreement to use such a method during study participation
- Ability to understand and the willingness to sign a written informed consent form and HIPAA Authorization.
Exclusion Criteria:
- Patients with anticipated addition or titration of HF medical therapies (ACE/ARB/ARNI, beta blocker, MRA, SGLT2 inhibitor) during the duration of the study
- Treatment with another investigational drug or other intervention within 3 months
- Current unrevascularized coronary artery disease, unstable angina, acute MI, CABG, or PCI within the past 3 months
- Significant non-functional mitral or aortic valvular disease (severe stenosis or regurgitation)
- Significant structural heart [including hypertrophic cardiomyopathy (septal thickness ≥15 mm) or infiltrative cardiomyopathy (eg. amyloid)]
- Current moderate to severe pulmonary hypertension (right ventricular systolic pressure of ≥40 mmHg)
- Oxygen dependent chronic lung disease
- Prolonged episodes of AF (>3 days or an AF burden >10%) within the preceding 3 months
- Presence of cardiac pacemaker or implantable cardioverter defibrillator
- Prior mechanical tricuspid valve replacement
- Pregnancy or lactation due to concerns about the effect of radiation from the pacemaker implantation procedure on the fetus
- Known allergic reactions to components of the pacemaker or leads
- Febrile illness within 3 days of trial enrollment
- Parents/guardians or participants who, in the opinion of the Investigator, may be non-compliant with study schedules or procedures.
- Control Participant Exclusion Criteria: same
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Andet
- Tildeling: Randomiseret
- Interventionel model: Crossover opgave
- Maskning: Dobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Sequence 1
LB-CRT - Left Bundle Cardiac Resynchronization Therapy, Participants will spend 3 months in this group |
LB-CRT (DDD 60-130, LV lead turned off) (active intervention #1) BIV-CRT (DDD 60- 130, LV lead turned on) (active intervention #2). |
|
Eksperimentel: Sequence 2
BiV-CRT - Biventricular Pacing Cardiac Resynchronization Therapy. Participants will spend 3 months in this group |
LB-CRT (DDD 60-130, LV lead turned off) (active intervention #1) BIV-CRT (DDD 60- 130, LV lead turned on) (active intervention #2). |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in myocardial performance index (MPI) as compared to Baseline
Tidsramme: Baseline and 3 month treatment period after each pacing mode
|
Myocardial performance index (MPI), a global measure of cardiac performance is defined using tissue Doppler imaging. |
Baseline and 3 month treatment period after each pacing mode
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Brett Atwater, MD, Inova Health Care Services
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
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
- U22-04-4739
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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