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Mitral Insufficiency Reduction With Biventricular Pacing (MiRBi)

1. december 2010 opdateret af: Trinity Medical Center, Illinois

Prospective.Randomized, Blinded, Crossover Chronic IDE Study of the Effects of Pacing on Mitral Regurgitation in Patients Without Standard Indications for Cardiac Resynchronization Therapy

The purpose of this study is to show that CRT(Cardiac Resynchronization Therapy) pacing in patients with severe functional MR (Mitral Regurgitation) who are not currently indicated for CRT will demonstrate chronic benefit of MR reduction( via echo measured MR/LA area and ERO per American Society of ECHO guidelines) and to show that CRT pacing is safe in these patients.

Studieoversigt

Status

Ukendt

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Approximately 50 patients will be randomized, followed and analyzed in this prospective study. Patients who meet all inclusion and no exclusion criteria will be enrolled and implanted with a CRT system. Baseline evaluation, which includes clinical symptom evaluation and an echocardiogram, will be performed at the time of randomization, which should occur as soon after device implant as possible but no later than 2 week post -implant. The baseline echocardiogram should be acquired prior to the device being programmed to the randomized setting. Repeat echocardiograms and scheduled follow-up evaluations will be performed at the end of each 3 month crossover period.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

50

Fase

  • Fase 1

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

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

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Crossover opgave
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / 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
Enhed: CRT pacing
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
Enhed: CRT pacing
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

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

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

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Trinity Medical Center, Illinois

Samarbejdspartnere

Massachusetts General Hospital
Duke University
Augusta University
Medtronic

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

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. januar 2011

Primær færdiggørelse (Forventet)

1. januar 2012

Studieafslutning (Forventet)

1. januar 2013

Datoer for studieregistrering

Først indsendt

10. november 2010

Først indsendt, der opfyldte QC-kriterier

16. november 2010

Først opslået (Skøn)

17. november 2010

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

2. december 2010

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. december 2010

Sidst verificeret

1. november 2009

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • MiRBi- Acosta

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Mitral regurgitation

Kliniske forsøg med CRT pacing

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Qatar

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

Abonner