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Stimulation diaphragmatique synchronisée dans l'insuffisance cardiaque symptomatique (RECOVER-HF)

19 octobre 2026 mis à jour par: VisCardia Inc.

RECOVER-HF - Étude randomisée, multicentrique et en double aveugle sur la stimulation diaphragmatique synchronisée (SDS) pour l'amélioration de l'insuffisance cardiaque symptomatique à fraction d'éjection réduite

RECOVER HF is a clinical study designed to evaluate the safety and efficacy of Synchronized Diaphragmatic Stimulation delivered using the VisONE System in the treatment of patients with heart failure.

Aperçu de l'étude

Statut

Recrutement

Les conditions

Intervention / Traitement

Description détaillée

Symptomatic Diaphragmatic Stimulation (SDS) is a novel extra-cardiac device for patients who have symptomatic heart failure. Elevated intracardiac pressures are the hallmark of heart failure (HF) and a key pathological driver of disease progression and limited exertional capacity. The degree of cardiac pressure elevation is determined by preload, afterload, and pericardial restraint. The pericardium restrains the heart, and the degree of restraint is determined by the pericardial structure itself and the intrathoracic pressure. This aspect of HF pathophysiology is among the fundamental drivers behind the SDS therapy concept. SDS induces a temporal modulation of intrathoracic pressure.. When synchronized with the cardiac cycle, SDS may improve cardiac filling, cardiovascular pressure conditions, and cardiac performance

RECOVER HF is a prospective, randomized, doubled-blinded study of Synchronized Diaphragmatic Stimulation (SDS) delivered in an imperceptible manner in subjects with heart failure defined as New York Heart Association (NYHA) functional class II/III, left-ventricular ejection fraction (LVEF) <=40%, and QRS duration <=130ms despite receiving the appropriate heart failure guideline directed medical therapy (GDMT). All subjects will receive an implanted VisONE System. Two-weeks post implant subjects will be randomized in a 1:1 ratio into a SDS therapy active or control (SDS therapy inactive) arm with both arms receiving GDMT. At 6 months the control arm will have SDS therapy activated with all patients receiving therapy and GDMT throughout the remainder of the study period. The study will be conducted at up to 30 investigational sites in the United States and several outside the U.S. These centers will enroll subjects with the goal of randomizing approximately 270 subjects who meet the entry criteria.

Type d'étude

Interventionnel

Inscription (Estimé)

270

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

Sauvegarde des contacts de l'étude

Lieux d'étude

  • Géorgie
      • Tbilisi, Géorgie, 0159
        • Recrutement
        • Tbilisi Heart and Vascular Clinic
        • Chercheur principal:
          • Tamaz Shaburishvili, MD
        • Contact:
          • Tamaz Shaburishvili, MD
          • Numéro de téléphone: 0322 157 159
  • États-Unis
    • Indiana
      • Indianapolis, Indiana, États-Unis, 46260
        • Recrutement
        • Ascension St. Vincent Hospital
        • Contact:
        • Chercheur principal:
          • Sangita Sudharshan, MD
    • Oklahoma
      • Tulsa, Oklahoma, États-Unis, 74136
        • Recrutement
        • Saint Francis Hospital
        • Chercheur principal:
          • Ralph D Ensley, MD
        • Contact:
          • Ralph D Ensley, MD
          • Numéro de téléphone: (918) 494-8500
    • Pennsylvania
      • Philadelphia, Pennsylvania, États-Unis, 19104
        • Recrutement
        • University of Pennsylvania
        • Chercheur principal:
          • Aditya Parikh, MD
        • Contact:
          • Aditya Parikh, MD
          • Numéro de téléphone: (215) 615-4949
    • Texas
      • Houston, Texas, États-Unis, 77030
        • Recrutement
        • Baylor College of Medicine
        • Chercheur principal:
          • Ajith Nair, MD
        • Contact:

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  • NYHA classes II/III on optimal Guideline Directed Medical Therapy (GDMT) for 3 months
  • EF≤ 40%
  • At the time of consent, willing and able to comply with protocol requirements, including attending all required visits
  • Willing to participate in the study and able to sign an informed consent form
  • ≥18 years of age at the time of consent

Exclusion Criteria:

  • Baseline 6-minute walk test > 500 meters or < 200 meters

  • NT-proBNP< 250 if on loop diuretics, or NT-proBNP < 500 if not on loop diuretics

  • Supine resting heart rate > 140 bpm

  • Systolic blood pressure < 80 mmHg or > 170 mmHg

  • Serum creatinine > 2.5 mg/dL

  • Serum hepatic function 3x ULN

  • Any of the following within the previous 3 months: unstable angina, AMI, CABG, PTCA, CVA/TIA, AF (episodes > 24 hours), symptomatic NSVT or DCCV

  • Any inotropic drug treatment within the previous 3 months

  • Bradycardia (heart rate < 50 beats/min), atrial arrhythmias with rates > 100 beats/min, sustained ventricular tachycardia or frequent ventricular ectopy >10% present during screening

  • Significant uncontrolled symptomatic bradyarrhythmia, atrial fibrillation, unstable ventricular arrhythmias or frequent ventricular ectopy > 10% documented within the previous 3 months

  • Reversible non-ischemic cardiomyopathy

  • Valvular disease requiring intervention within the next 12 months or presence of significant valve disease as determined by the site cardiologist as:

    1. Greater than mild mitral valve stenosis
    2. Greater than moderate mitral valve regurgitation
    3. Greater than mild tricuspid valve stenosis
    4. Greater than moderate-severe tricuspid valve regurgitation
    5. Greater than moderate aortic stenosis
    6. Greater than moderate aortic regurgitation
    7. Greater than mild-moderate pulmonic stenosis
    8. Greater than moderate pulmonic regurgitation

  • Severe primary pulmonary disease, including pulmonary arterial hypertension. PAP sys >70 mmHg at rest

  • Severe COPD, other respiratory or lung diseases where FEV1 < 50%

  • Presence of more than small pleural effusion or history of pleural drainage within the previous 6 months

  • Known history of diaphragmatic paralysis or suspicion confirmed by unilateral or bilateral elevation of the diaphragm on chest x-ray

  • Pericardial disease

  • Non-cardiac condition substantially impairing ambulation of 6-minute hall walk test interpretation

  • Existing diaphragmatic stimulation for respiration assist

  • Present LVAD, Baroreflex Activation Therapy, Cardiac Contractility Modulation or interatrial shunt devices; temporary mechanical cardiac assist devices (current or within the previous 3 months)

  • Contraindications to laparoscopic access to the diaphragm, as determined by the implanting physician

  • Known intra-abdominal pathology which could increase the risk of laparoscopic access to the diaphragm.

  • Previous open laparotomy within 1 year

  • Previous thoracic or abdominal organ transplant

  • Drug induced immuno-suppression

  • Body mass index > 40

  • Enrollment in a concurrent investigation / clinical study

  • Having a life expectancy of <1 year due to any condition

  • Pregnant or planning a pregnancy during the study period

  • Known allergies to implantable device materials

  • History of systemic infection requiring the use of intravenous antibiotics within the previous 3 months

  • Received cardiac resynchronization therapy (CRT) within six months of randomization, or is actively receiving CRT

  • Currently have a Class I indication for a cardiac resynchronization therapy (CRT) device according to AHA/ACC/ESC guidelines for the treatment of congestive heart failure

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Quadruple

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Device and Medical Management

  • Subjects will be implanted with the VisONE System programmed to deliver SDS (Therapy On) and receive optimal, stable, Guideline Directed Medical Therapy (GDMT) for heart failure (American Heart Association [AHA] / American College of Cardiology [ACC] guidelines) including those drugs to be determined by the subject's physician

  • Assigned Interventions:

    • Device: VisONE System (SDS)
    • Drug: Medical Management
Dispositif: Synchronized Diaphragmatic Stimulation

Implantable Pulse Generator system providing cardiac-gaited stimulation of the diaphragm and thereby influence cardiovascular properties relevant in heart failure.

Autres noms:
  • FDS
  • Stimulation diaphragmatique asymptomatique
  • Annonces
  • VisONE FDS
Comparateur factice: Medical Management

  • Subjects will be implanted with the VisONE System programmed not to deliver SDS (Therapy Off) and receive optimal, stable, Guideline Directed Medical Therapy (GDMT) for heart failure (American Heart Association [AHA] / American College of Cardiology [ACC] guidelines) including those drugs to be determined by the subject's physician

  • Assigned Interventions:

    • Drug: Medical Management
Dispositif: Synchronized Diaphragmatic Stimulation

Implantable Pulse Generator system providing cardiac-gaited stimulation of the diaphragm and thereby influence cardiovascular properties relevant in heart failure.

Autres noms:
  • FDS
  • Stimulation diaphragmatique asymptomatique
  • Annonces
  • VisONE FDS

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Left ventricular End-Systolic Volume (LVESV)
Délai: 6 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger percent improvement in LVESV at 6 months post-randomization from baseline than medical management alone.
6 months
Six Minute Hall Walk (6MHW)
Délai: 6 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger improvement in 6MHW at 6 months post-randomization from baseline than medical management alone.
6 months
Minnesota Living with Heart Failure quality of Life Score (MLWHF QOL)
Délai: 6 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger improvement in MLWHF QOL at 6 months post-randomization from baseline than medical management alone.
6 months
Major Adverse Respiratory and Cardiovascular Events (MARCE)
Délai: 6 months

To demonstrate the safety of the VisONE System by analyzing Major Adverse Respiratory and Cardiovascular Events (MARCE) occurring within 6 months post implant for the rate, severity and association with the device or procedure (goal >70% freedom):

  • Cardiovascular Death
  • Stroke
  • Cardiac Arrest
  • Interaction with cardiac rhythm device requiring permanent termination of SDS therapy
  • Acute Heart Failure Decompensation
  • Infection requiring device/lead explant
  • Diaphragmatic dysfunction leading to a clinically significant reduction is respiratory function
  • Inadequate SDS therapy delivery requiring surgical intervention
  • Injury to abdominal organs requiring surgical intervention
  • Pneumothorax
  • Hemothorax
6 months

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Left Ventricular Ejection Fraction (LVEF)
Délai: 6 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger improvement in LVEF at 6 months post-randomization from baseline than medical management alone.
6 months
N-Terminal Pro Brain Natriuretic Peptide (NT-proBNP)
Délai: 6 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger reduction in NT-proBNP (log-10 transformed) at 6 months post-randomization from baseline than medical management alone.
6 months
Left ventricular End-Systolic Volume (LVESV)
Délai: 12 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger percent improvement in LVESV at 12 months post-randomization from baseline than medical management alone.
12 months
Six Minute Hall Walk (6MHW)
Délai: 12 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger improvement in 6MHW at 12 months post-randomization from baseline than medical management alone.
12 months
Minnesota Living with Heart Failure quality of Life Score (MLWHF QOL)
Délai: 12 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger improvement in MLWHF QOL at 12 months post-randomization from baseline than medical management alone.
12 months
Left Ventricular Ejection Fraction (LVEF)
Délai: 12 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger improvement in LVEF at 12 months post-randomization from baseline than medical management alone.
12 months
N-Terminal Pro Brain Natriuretic Peptide (NT-proBNP)
Délai: 12 months

To demonstrate that treatment with the VisONE System (SDS) plus GDMT results in a larger reduction in NT-proBNP (log-10 transformed) at 12 months post-randomization from baseline than medical management alone.
12 months

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

VisCardia Inc.

Collaborateurs

Duke Clinical Research Institute
Clinical Accelerator

Les enquêteurs

  • Chercheur principal: Lee R Goldberg, MD, University of Pennsylvania

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

8 juillet 2026

Achèvement primaire (Estimé)

1 juillet 2028

Achèvement de l'étude (Estimé)

1 décembre 2029

Dates d'inscription aux études

Première soumission

6 août 2024

Première soumission répondant aux critères de contrôle qualité

9 août 2024

Première publication (Réel)

14 août 2024

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

23 octobre 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

19 octobre 2026

Dernière vérification

1 octobre 2026

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • VisCardia H03_22

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Oui

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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