Reducing Decompensation Events Utilizing Intracardiac Pressures in Patients With Chronic Heart Failure (HF) (REDUCEhf)

NCT ID: NCT00354159

Last Updated: 2012-08-09

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

442 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-04-30

Study Completion Date

2011-01-31

Brief Summary

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The purpose of this clinical research study is to evaluate the safety and effectiveness of the investigational implantable hemodynamic monitor (IHM), and of the IHM in combination with an implantable cardioverter defibrillator (ICD). The investigational IHM has the ability to record and report the force with which the heart pumps blood (heart pressures). When combined with the ICD, the device has the additional ability to send a strong electrical impulse, or shock, to the heart when it detects dangerously fast heartbeats to return it to a normal rhythm. The IHM and IHM/ICD are implanted surgically just under the skin in the upper chest area. This study will also determine how doctors use the information related to heart pressures in the management of heart failure.

Detailed Description

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Conditions

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Heart Failure

Keywords

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Implantable cardioverter defibrillator Intracardiac pressures

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Treatment Arm

Physicians have access to device-based hemodynamic monitor information to guide patient management

Group Type EXPERIMENTAL

Implantable Hemodynamic Monitor (Chronicle® IHM), and IHM in combination with single chamber ICD (Chronicle ICD)

Intervention Type DEVICE

Surgical implantation of hemodynamic device (IHM), or IHM/ICD, and intracardiac leads.

Control Arm

Physicians do not have access to device-based hemodynamic monitor information to guide patient management

Group Type PLACEBO_COMPARATOR

Implantable Hemodynamic Monitor (Chronicle® IHM), and IHM in combination with single chamber ICD (Chronicle ICD)

Intervention Type DEVICE

Surgical implantation of hemodynamic device (IHM), or IHM/ICD, and intracardiac leads.

Interventions

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Implantable Hemodynamic Monitor (Chronicle® IHM), and IHM in combination with single chamber ICD (Chronicle ICD)

Surgical implantation of hemodynamic device (IHM), or IHM/ICD, and intracardiac leads.

Intervention Type DEVICE

Other Intervention Names

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Chronicle® IHM, Chronicle® ICD

Eligibility Criteria

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Inclusion Criteria

* Subjects with heart failure that only sometimes interferes with daily activities (New York Heart Association \[NYHA\] Class II (1)) or subjects with heart failure which severely limits daily activities (NYHA Class III (2)) at baseline
* Subject has appropriate medical therapy for heart failure (such as diuretic, angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) and beta blocker) for at least three months prior to the baseline evaluation.
* Subject has been on stable medications maximized to the subject's tolerance of ACE or ARB and beta blockers as determined by the study investigator for at least 30 days prior to baseline evaluation. (Stable is defined as no more than a 100% increase or a 50% decrease in dose.) If a subject is intolerant of ACE, ARB or beta blockers documented evidence must be available.
* Subject has had at least one heart failure-related hospitalization or at least one heart failure-related emergency department or urgent care visit necessitating heart failure-related intravenous therapy (e.g. diuretic administration) within 12 months prior to the baseline evaluation
* To be considered for Chronicle ICD: Subject has, or is at risk of having, a heart beat that is too fast and his/her doctor has determined he/she needs an implantable cardioverter defibrillator (ICD).

1. Class II Subjects with cardiac disease resulting in slight limitation of physical activity. They are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea, or angina.
2. Class III Subjects with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary activity causes fatigue, palpitation, dyspnea, or angina.

Exclusion Criteria

* Subjects with severe heart failure who should always be resting (NYHA Class IV(3)) or Stage D(4) refractory heart failure.
* Subjects with severe renal dysfunction.
* Subjects with severe non-cardiac condition limiting 12-month survival.
* Subjects in concurrent studies that may confound the results.

(3)Class IV Subjects with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of heart failure or the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.

(4)Stage D refractory heart failure: Patients who have marked symptoms at rest despite maximal medical therapy (e.g., those who are recurrently hospitalized or cannot be safely discharged from the hospital without specialized interventions)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medtronic Cardiac Rhythm and Heart Failure

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Phillip Adamson, MD

Role: STUDY_CHAIR

Oklahoma Heart Hospital

Michael Gold, MD

Role: STUDY_CHAIR

Medical University of South Carolina

Locations

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University of Alabama at Birmingham (UAB)

Birmingham, Alabama, United States

Site Status

Scripps Green Hospital

La Jolla, California, United States

Site Status

Loma Linda University Medical Center

Loma Linda, California, United States

Site Status

Long Beach Memorial

Long Beach, California, United States

Site Status

Cedars-Sinai Medical Center

Los Angeles, California, United States

Site Status

Doctors Medical Center Modesto

Modesto, California, United States

Site Status

Yale University, School of Medicine

New Haven, Connecticut, United States

Site Status

Christiana Care Hospital

Newark, Delaware, United States

Site Status

University of FL Shands

Gainesville, Florida, United States

Site Status

Mayo Clinic Jacksonville

Jacksonville, Florida, United States

Site Status

Crawford Long/Emory University Hospitals

Atlanta, Georgia, United States

Site Status

Midwest Heart Foundation

Lombard, Illinois, United States

Site Status

Genesis Hospital Midwest Cardiovascular Research Foundation

Davenport, Iowa, United States

Site Status

Iowa Heart Center

West Des Moines, Iowa, United States

Site Status

Brigham & Women's Hospital

Boston, Massachusetts, United States

Site Status

Lahey Clinic Medical Center

Burlington, Massachusetts, United States

Site Status

University of Massachusetts Memorial Medical Center

Worcester, Massachusetts, United States

Site Status

St Joseph Mercy Hospital

Ann Arbor, Michigan, United States

Site Status

University of Michigan

Ann Arbor, Michigan, United States

Site Status

Henry Ford Hospital

Detroit, Michigan, United States

Site Status

Mercy Hospital Metropolitan Cardiology Consultants

Coon Rapids, Minnesota, United States

Site Status

North Mississippi Medical Center

Tupelo, Mississippi, United States

Site Status

Mid America Heart Institute/St. Lukes

Kansas City, Missouri, United States

Site Status

Washington University School of Medicine

St Louis, Missouri, United States

Site Status

Bryan LGH Heart Institute

Lincoln, Nebraska, United States

Site Status

Morristown Memorial Hospital

Morristown, New Jersey, United States

Site Status

Mt Sinai Medical Center

New York, New York, United States

Site Status

Carolinas Medical Center

Charlotte, North Carolina, United States

Site Status

Presbyterian Hospital Mid Carolinas Cardiology

Charlotte, North Carolina, United States

Site Status

Forsyth Medical Center

Winston-Salem, North Carolina, United States

Site Status

The Christ Hospital

Cincinnati, Ohio, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

Ohio State University

Columbus, Ohio, United States

Site Status

University of Oklahoma

Oklahoma City, Oklahoma, United States

Site Status

Oklahoma Heart Hospital

Oklahoma City, Oklahoma, United States

Site Status

Lehigh Valley Heart Specialists

Allentown, Pennsylvania, United States

Site Status

Lancaster Heart & Stroke Foundation

Lancaster, Pennsylvania, United States

Site Status

Drexel University College of Medicine

Philadelphia, Pennsylvania, United States

Site Status

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Allegheny General Hospital

Pittsburgh, Pennsylvania, United States

Site Status

Lankenau Hospital

Wynnewood, Pennsylvania, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

Spartanburg Regional

Spartanburg, South Carolina, United States

Site Status

Baptist Hospital

Nashville, Tennessee, United States

Site Status

St Thomas

Nashville, Tennessee, United States

Site Status

Baylor Research Institute

Dallas, Texas, United States

Site Status

UT Southwestern Medical Center

Dallas, Texas, United States

Site Status

Fletcher Allen Health Care

Burlington, Vermont, United States

Site Status

University of Virginia Health System

Charlottesville, Virginia, United States

Site Status

Inova Fairfax Hospital

Falls Church, Virginia, United States

Site Status

Sentara Norfolk General Hospital

Norfolk, Virginia, United States

Site Status

University of Wisconsin Hospital & Clinics

Madison, Wisconsin, United States

Site Status

Countries

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Canada United States

References

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Reiter MJ, Stromberg KD, Whitman TA, Adamson PB, Benditt DG, Gold MR. Influence of intracardiac pressure on spontaneous ventricular arrhythmias in patients with systolic heart failure: insights from the REDUCEhf trial. Circ Arrhythm Electrophysiol. 2013 Apr;6(2):272-8. doi: 10.1161/CIRCEP.113.000223. Epub 2013 Mar 20.

Reference Type DERIVED
PMID: 23515265 (View on PubMed)

Adamson PB, Conti JB, Smith AL, Abraham WT, Aaron MF, Aranda JM Jr, Baker J, Bourge RC, Warner-Stevenson L, Sparks B. Reducing events in patients with chronic heart failure (REDUCEhf ) study design: continuous hemodynamic monitoring with an implantable defibrillator. Clin Cardiol. 2007 Nov;30(11):567-75. doi: 10.1002/clc.20250.

Reference Type DERIVED
PMID: 18000962 (View on PubMed)

Other Identifiers

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103

Identifier Type: -

Identifier Source: org_study_id