Beoordeling van gecombineerd CCM- en ICD-apparaat in HFrEF (INTEGRA-D)
Beoordeling van de veiligheid en werkzaamheid van een gecombineerde cardiale contractiliteitsmodulatie en een implanteerbaar cardioverter-defibrillatorapparaat voor proefpersonen met hartfalen en een verminderde ejectiefractie
The goal of this clinical trial is to demonstrate that the OPTIMIZER® Integra CCM-D System (the "CCM-D System") can safely and effective convert induced ventricular fibrillation (VF) and spontaneous ventricular tachycardia and/or ventricular fibrillation (VT/VF) episodes in subjects with Stage C or D heart failure who remain symptomatic despite being on guideline-directed medical therapy (GDMT), are not indicated for cardiac resynchronization therapy (CRT), and have heart failure with reduced left ventricular ejection fraction (LVEF ≤40%).
Eligible subjects will be implanted with the CCM-D System. A subset of subjects will be induced into ventricular fibrillation "on the table" in the implant procedure room. During the follow-up period, inappropriate shock rate and device-related complications will be evaluated. The follow-up period is expected to last at least two years.
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Fase
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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Arizona
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Glendale, Arizona, Verenigde Staten, 85306
- Phoenix Heart
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Mesa, Arizona, Verenigde Staten, 85208
- Southwest Cardiovascular Associates
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Mesa, Arizona, Verenigde Staten, 85206
- CardioVascular Associates of Mesa
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Phoenix, Arizona, Verenigde Staten, 85016
- Arizona Heart Rhythm
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Phoenix, Arizona, Verenigde Staten, 85032
- CVC Cardiovascular Consultants
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Phoenix, Arizona, Verenigde Staten, 85306
- Phoenix Heart
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Scottsdale, Arizona, Verenigde Staten, 85258
- Honor Health
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California
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Los Angeles, California, Verenigde Staten, 90033
- University of Southern California
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Los Angeles, California, Verenigde Staten, 90048
- Cedars Sinai Medical Center
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Connecticut
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Hartford, Connecticut, Verenigde Staten, 06102
- Hartford HealthCare
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Florida
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Fort Lauderdale, Florida, Verenigde Staten, 33316
- Broward Health Medical Center
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Miami, Florida, Verenigde Staten, 33173
- Baptist Health South Florida
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Miami Beach, Florida, Verenigde Staten, 33140
- Mount Sinai Medical Center Miami Beach
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Orlando, Florida, Verenigde Staten, 32803
- Advent Health Orlando
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Iowa
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West Des Moines, Iowa, Verenigde Staten, 50266
- Iowa Heart Center
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Kansas
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Kansas City, Kansas, Verenigde Staten, 66103
- University of Kansas Medical Center
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Kentucky
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Lexington, Kentucky, Verenigde Staten, 40503
- Baptist Health Lexington
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Massachusetts
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Boston, Massachusetts, Verenigde Staten, 02114
- Massachusetts General Hospital
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Missouri
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Kansas City, Missouri, Verenigde Staten, 64111
- Saint Luke's Hospital
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St Louis, Missouri, Verenigde Staten, 63136
- St. Louis Heart and Vascular
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St Louis, Missouri, Verenigde Staten, 63106
- St. Louis VA
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New Jersey
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Browns Mills, New Jersey, Verenigde Staten, 08015
- Deborah Heart and Lung Center
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Cherry Hill, New Jersey, Verenigde Staten, 08034
- Virtua
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Hackensack, New Jersey, Verenigde Staten, 07601
- Hackensack University Medical Center
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Haddon Heights, New Jersey, Verenigde Staten, 08035
- The Heart House - Cardiovascular Associates of the Delaware Valley
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Newark, New Jersey, Verenigde Staten, 07103
- Rutgers New Jersey Medical School
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New York
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New York, New York, Verenigde Staten, 10065
- Weill Cornell Medicine
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New York, New York, Verenigde Staten, 10016
- NYU Langone
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New York, New York, Verenigde Staten, 10029
- Mount Sinai New York
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New York, New York, Verenigde Staten, 10032
- Columbia University Medical Center / NewYork-Presbyterian
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North Carolina
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Chapel Hill, North Carolina, Verenigde Staten, 27599
- University of North Carolina
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Charlotte, North Carolina, Verenigde Staten, 28277
- Sanger Heart and Vascular Institute
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Ohio
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Cleveland, Ohio, Verenigde Staten, 44195
- Cleveland Clinic
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Cleveland, Ohio, Verenigde Staten, 44106
- Louis Stokes Cleveland VA Medical Center
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Columbus, Ohio, Verenigde Staten, 43210
- The Ohio State University Wexner Medical Center
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Oklahoma
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Tulsa, Oklahoma, Verenigde Staten, 74136
- St. Francis Tulsa
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Oregon
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Portland, Oregon, Verenigde Staten, 97239
- Portland VA Medical Center
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Pennsylvania
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Bethlehem, Pennsylvania, Verenigde Staten, 18015
- St. Luke's Bethlehem
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Bryn Mawr, Pennsylvania, Verenigde Staten, 19010
- Bryn Mawr Medical Specialists Association
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Lancaster, Pennsylvania, Verenigde Staten, 17602
- Lancaster General Hospital
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Philadelphia, Pennsylvania, Verenigde Staten, 19140
- Temple University
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Philadelphia, Pennsylvania, Verenigde Staten, 19104
- Penn Presbyterian
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Pittsburgh, Pennsylvania, Verenigde Staten, 15212
- Allegheny General Hospital
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Pittsburgh, Pennsylvania, Verenigde Staten, 15219
- University of Pittsburgh Medical Center
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South Carolina
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Greenville, South Carolina, Verenigde Staten, 29601
- Prisma Health
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Tennessee
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Germantown, Tennessee, Verenigde Staten, 38138
- Stern Cardiovascular Foundation
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Texas
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Austin, Texas, Verenigde Staten, 78705
- Texas Cardiac Arrhythmia Research Foundation
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Dallas, Texas, Verenigde Staten, 75230
- Medical City Dallas
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Dallas, Texas, Verenigde Staten, 75390
- UT Southwestern
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Fort Worth, Texas, Verenigde Staten, 76104
- Medical City Fort Worth
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Houston, Texas, Verenigde Staten, 77030
- Houston Methodist
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Houston, Texas, Verenigde Staten, 77030
- Houston VA Hospital
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Houston, Texas, Verenigde Staten, 77030
- UT Memorial Hermann
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Tyler, Texas, Verenigde Staten, 75702
- Christus Trinity Clinic
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Virginia
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Lynchburg, Virginia, Verenigde Staten, 24501
- Centra Health
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Richmond, Virginia, Verenigde Staten, 23298
- Virginia Commonwealth University
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Richmond, Virginia, Verenigde Staten, 23225
- Chippenham Hospital
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Washington
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Seattle, Washington, Verenigde Staten, 98122
- Swedish
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Seattle, Washington, Verenigde Staten, 98108
- Seattle VA
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Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
Individuals must meet all the following:
- Patient is aged 18 years or older;
- Patient meets the Stage C or D criteria of the Universal Definition of Heart Failure ;
- Patient has HFrEF (LVEF ≤40%);
- Patient is on GDMT for heart failure;
- Patient has a Class I or Class II indication for an ICD
- Patient has a reasonable expectation of meaningful survival of > 1 year;
- Patient has either non-ischemic cardiomyopathy or ischemic cardiomyopathy and is at least 40 days post-MI, if an MI occurred;
- Patient is willing to give informed consent, available for scheduled study follow-up visits, and able to complete all testing described in the study protocol at the investigational site location.
Exclusion Criteria:
An individual who meets any of the following criteria will be excluded from participation in this study:
- Patients should not have severe AI or AS, and should not have MS; additionally, patients undergoing DE testing should not have severe MR;
- Patients who have undergone mitral valve repair or clip within 90 days prior to study consent;
- Cardiac surgery within 90 days or a PCI procedure within 30 days prior to study consent;
- Prior heart transplant or ventricular assist device;
- Implanted mechanical tricuspid valve;
- PR interval greater than 375ms or advanced AV block;
- In situ S-ICD, pacemaker, or CRT device;
- Indicated for CRT;
- End stage renal disease, currently on dialysis, or with other major medical disorder (e.g. liver failure, terminal cancer);
- Indicated for permanent bradyarrhythmia pacing;
- Unstable angina pectoris within 30 days prior to study consent;
- Pregnant or planning to become pregnant during the study;
- Participating in another cardiac investigational device or drug study at the same time (or within 30 days prior to study consent); Note: Registries and other observational studies are acceptable.
- Other criteria that preclude Optimizer INTEGRA CCM-D implantation and/or CCM therapy, as determined by Investigator.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
|
Experimenteel: CCM-D Implant
The subject is implanted with the CCM-D device. |
The CCM-D System is an implantable cardiac device system that combines cardiac contractility modulation and implantable cardioverter defibrillator (ICD) modules into one device. CCM-D is also known as a "Cardiac Contractility Modulation - Defibrillator". All 300 subjects will be implanted with the CCM-D System and followed for a period of at least two years. |
Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Device Effectiveness in Converting Induced Ventricular Fibrillation (Primary Efficacy Objective)
Tijdsspanne: Implant
|
Evaluate the device effectiveness in converting induced VF at the time of implantation. |
Implant
|
|
Device-related Complications (Primary Safety Objective)
Tijdsspanne: Implant to 6 months
|
Evaluate device-related complications through 6-months (excluding lead-related complications). |
Implant to 6 months
|
Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Inappropriate Shock Rate out to 6-months (Secondary Safety Objective)
Tijdsspanne: Implant to 6 months
|
Evaluate the incidence of inappropriate ICD shocks through the time when the last subject enrolled completes the 6-month visit. |
Implant to 6 months
|
Andere uitkomstmaten
Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Inappropriate Shock Rate out to 2-years
Tijdsspanne: Implant to 2 years
|
Evaluate the device effectiveness in converting spontaneous VT/VF through the time when the last subject enrolled completes the 6-month visit. Each subject will be followed for 2-years after implant to capture additional spontaneous episodes that may occur. |
Implant to 2 years
|
|
Charging non-compliance
Tijdsspanne: Implant to 2 years
|
Evaluate subject charging non-compliance defined as >14 days between interval charging sessions, overall and frequency of non-compliance in the same subject. |
Implant to 2 years
|
|
Longitudinal levels of activity
Tijdsspanne: Implant to 2 years
|
Track longitudinal levels of activity weekly via OPTIhome (when available) and identification of trends. |
Implant to 2 years
|
|
Battery degradation and longevity
Tijdsspanne: Implant to 2 years
|
Assess battery degradation and longevity either remotely or during an in-person follow-up at 2 years (+/- 60 days) by recording QHR battery voltage as measured by the Integra CCM-D IPG. The measurement under nominal conditions is expected to be 2.85V or higher, consistent with a 20-year device longevity. |
Implant to 2 years
|
|
Compare worsening heart failure events pre- and post-implant
Tijdsspanne: 12 months prior to implant and 12 months post-implant
|
Track unscheduled cardiovascular-related healthcare encounters from 12 months prior to implant, if available, to 12 months post-implant |
12 months prior to implant and 12 months post-implant
|
|
All-cause mortality
Tijdsspanne: 1 and 2 years post-implant
|
Assess all-cause mortality using Seattle Heart Failure Model (SHFM) and comorbidity burden as a predictive comparator at 1 year and 2 years post-implant |
1 and 2 years post-implant
|
|
Kansas City Cardiomyopathy Questionnaire (KCCQ)
Tijdsspanne: Baseline to 6-months
|
Compare change in subject's perception of their heart failure symptoms, as measured by KCCQ, from baseline to 6 months. |
Baseline to 6-months
|
|
EQ-5D-5L
Tijdsspanne: Baseline to 6-months
|
Compare change in subject's perception of their health status, as measured by the EQ-5D-5L, from baseline to 6 months. |
Baseline to 6-months
|
|
Six Minute Walk Distance (6MWD)
Tijdsspanne: Baseline to 6 months
|
Compare change in functional capacity, as measured by 6MWD, from baseline to 6 months. |
Baseline to 6 months
|
Medewerkers en onderzoekers
Sponsor
Sponsor
Onderzoekers
Onderzoekers
- Hoofdonderzoeker: Nir Uriel, MD, Columbia University
- Hoofdonderzoeker: Niraj Varma, MD, PhD, The Cleveland Clinic
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Studie start
Primaire voltooiing (Werkelijk)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
Andere studie-ID-nummers
- RG_PRO_345
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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