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Estimulação diafragmática sincronizada na insuficiência cardíaca sintomática (RECOVER-HF)

19 de outubro de 2026 atualizado por: VisCardia Inc.

RECOVER-HF - Estudo randomizado, multicêntrico e duplo-cego de estimulação diafragmática sincronizada (SDS) para melhoria da insuficiência cardíaca com fração de ejeção reduzida sintomática

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.

Visão geral do estudo

Descrição detalhada

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.

Tipo de estudo

Intervencional

Inscrição (Estimado)

270

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Estude backup de contato

Locais de estudo

    • Indiana
      • Indianapolis, Indiana, Estados Unidos, 46260
        • Recrutamento
        • Ascension St. Vincent Hospital
        • Contato:
        • Investigador principal:
          • Sangita Sudharshan, MD
    • Oklahoma
      • Tulsa, Oklahoma, Estados Unidos, 74136
        • Recrutamento
        • Saint Francis Hospital
        • Investigador principal:
          • Ralph D Ensley, MD
        • Contato:
          • Ralph D Ensley, MD
          • Número de telefone: (918) 494-8500
    • Pennsylvania
      • Philadelphia, Pennsylvania, Estados Unidos, 19104
        • Recrutamento
        • University of Pennsylvania
        • Investigador principal:
          • Aditya Parikh, MD
        • Contato:
          • Aditya Parikh, MD
          • Número de telefone: (215) 615-4949
    • Texas
      • Houston, Texas, Estados Unidos, 77030
        • Recrutamento
        • Baylor College of Medicine
        • Investigador principal:
          • Ajith Nair, MD
        • Contato:
      • Tbilisi, Geórgia, 0159
        • Recrutamento
        • Tbilisi Heart and Vascular Clinic
        • Investigador principal:
          • Tamaz Shaburishvili, MD
        • Contato:
          • Tamaz Shaburishvili, MD
          • Número de telefone: 0322 157 159

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

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

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Quadruplicar

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: 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.

Outros nomes:
  • SDS
  • Estimulação diafragmática assintomática
  • ANÚNCIOS
  • VisONE SDS
Comparador Falso: 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.

Outros nomes:
  • SDS
  • Estimulação diafragmática assintomática
  • ANÚNCIOS
  • VisONE SDS

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Left ventricular End-Systolic Volume (LVESV)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Left Ventricular Ejection Fraction (LVEF)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Investigadores

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

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

8 de julho de 2026

Conclusão Primária (Estimado)

1 de julho de 2028

Conclusão do estudo (Estimado)

1 de dezembro de 2029

Datas de inscrição no estudo

Enviado pela primeira vez

6 de agosto de 2024

Enviado pela primeira vez que atendeu aos critérios de CQ

9 de agosto de 2024

Primeira postagem (Real)

14 de agosto de 2024

Atualizações de registro de estudo

Última Atualização Postada (Real)

23 de outubro de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

19 de outubro de 2026

Última verificação

1 de outubro de 2026

Mais Informações

Termos relacionados a este estudo

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Sim

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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