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Synkronisert diafragmastimulering ved symptomatisk hjertesvikt (RECOVER-HF)

19. oktober 2026 oppdatert av: VisCardia Inc.

RECOVER-HF - Randomisert, multisenter, dobbeltblindet studie av synkronisert diafragmastimulering (SDS) for forbedring av symptomatisk redusert ejeksjonsfraksjon hjertesvikt

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.

Studieoversikt

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Antatt)

270

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Studiesteder

    • Indiana
      • Indianapolis, Indiana, Forente stater, 46260
        • Rekruttering
        • Ascension St. Vincent Hospital
        • Ta kontakt med:
        • Hovedetterforsker:
          • Sangita Sudharshan, MD
    • Oklahoma
      • Tulsa, Oklahoma, Forente stater, 74136
        • Rekruttering
        • Saint Francis Hospital
        • Hovedetterforsker:
          • Ralph D Ensley, MD
        • Ta kontakt med:
          • Ralph D Ensley, MD
          • Telefonnummer: (918) 494-8500
    • Pennsylvania
      • Philadelphia, Pennsylvania, Forente stater, 19104
        • Rekruttering
        • University of Pennsylvania
        • Hovedetterforsker:
          • Aditya Parikh, MD
        • Ta kontakt med:
          • Aditya Parikh, MD
          • Telefonnummer: (215) 615-4949
    • Texas
      • Houston, Texas, Forente stater, 77030
        • Rekruttering
        • Baylor College of Medicine
        • Hovedetterforsker:
          • Ajith Nair, MD
        • Ta kontakt med:
      • Tbilisi, Georgia, 0159
        • Rekruttering
        • Tbilisi Heart and Vascular Clinic
        • Hovedetterforsker:
          • Tamaz Shaburishvili, MD
        • Ta kontakt med:
          • Tamaz Shaburishvili, MD
          • Telefonnummer: 0322 157 159

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Firemannsrom

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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

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

Andre navn:
  • SDS
  • Asymptomatisk diafragmastimulering
  • ADS
  • VisONE SDS
Sham-komparator: 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

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

Andre navn:
  • SDS
  • Asymptomatisk diafragmastimulering
  • ADS
  • VisONE SDS

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Left ventricular End-Systolic Volume (LVESV)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Left Ventricular Ejection Fraction (LVEF)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Etterforskere

  • Hovedetterforsker: Lee R Goldberg, MD, University of Pennsylvania

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

8. juli 2026

Primær fullføring (Antatt)

1. juli 2028

Studiet fullført (Antatt)

1. desember 2029

Datoer for studieregistrering

Først innsendt

6. august 2024

Først innsendt som oppfylte QC-kriteriene

9. august 2024

Først lagt ut (Faktiske)

14. august 2024

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

23. oktober 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

19. oktober 2026

Sist bekreftet

1. oktober 2026

Mer informasjon

Begreper knyttet til denne studien

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Ja

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