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POsition of Leads in Advanced heaRt Failure: the POLAR Study (POLAR)

23. januar 2012 opdateret af: Sergio Thal, M.D.

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

The primary objective is to determine if lead positioning in the lateral wall of the left ventricle in patients meeting criteria for cardiac resynchronization therapy plays a role in determining myocardial function and affects the severity of mitral regurgitation.

Studieoversigt

Detaljeret beskrivelse

This is a 6 month, multi-centered, blinded, randomized study. Approximately 60 patients will join this study. Two groups, based on lead position, will be studied with thirty (30) patients randomized into each group.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

60

Fase

  • Ikke anvendelig

Kontakter og lokationer

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

Studiesteder

    • Arizona
      • Tucson, Arizona, Forenede Stater, 85723
        • Rekruttering
        • Southern Arizona VA Health Care System
        • Kontakt:
        • Kontakt:
        • Ledende efterforsker:
          • Sergio Thal, M.D.
        • Underforsker:
          • Elizabeth Juneman, M.D.
        • Underforsker:
          • Hoang Thai, M.D.
    • Kentucky
      • 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

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:

  • 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

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: Parallel tildeling
  • Maskning: Tredobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / 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

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

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

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

Efterforskere

  • Ledende efterforsker: Sergio Thal, M.D., Southern Arizona VA Health Care System

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. september 2010

Primær færdiggørelse (Forventet)

1. marts 2013

Datoer for studieregistrering

Først indsendt

12. januar 2012

Først indsendt, der opfyldte QC-kriterier

23. januar 2012

Først opslået (Skøn)

24. januar 2012

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

24. januar 2012

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

23. januar 2012

Sidst verificeret

1. januar 2012

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • PIIT1A

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 Hjertefejl

Kliniske forsøg med Postero-lateral

Abonner