REPLACE: Implantable Cardiac Pulse Generator Replacement Registry

NCT ID: NCT00395447

Last Updated: 2015-04-14

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

Total Enrollment

1744 participants

Study Classification

OBSERVATIONAL

Study Start Date

2007-07-31

Study Completion Date

2009-06-30

Brief Summary

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The objective of this study is to prospectively estimate the all-cause complication rates at 6-months for patients undergoing generator replacement due to elective replacement indicator (ERI), advisory, or upgrade without a planned system modification or with a planned system modification. Secondarily, this study aims to compare the influence of baseline variables contributing to the all-cause complication rates for subjects undergoing generator replacement.

Detailed Description

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Device replacements occur for many reasons, including elective replacement indication (ERI), manufacturer advisory, and upgrade.

Recently pacemaker and implantable cardioverter (ICD) advisories have created a dilemma for both physicians and patients. While the risk of device malfunction is low, replacement rates following an advisory are usually high and complication rates following device replacement are not widely known. One retrospective analysis of ICD advisories in Canada reported an 18.3% replacement rate, and subsequent 8.1% complication rate directly related to the replacement.

Device replacements also occur in order to upgrade an existing system. Clinical studies have shown that cardiac resynchronization therapy (CRT) significantly reduces all-cause mortality and hospitalization in patients with advanced heart failure (HF). As a result of expanding indications for this therapy, many standard ICD patients are being upgraded to CRT-D systems. Complication rates related to upgrades of these systems are also not widely known.

To our knowledge, the risk of complications following a device replacement has not been studied prospectively in any patient population. Limited data are available to guide physicians when weighing the risks and benefits of device replacement.

This is a prospective multi-center study. 1750 patients at 100 clinical sites will be enrolled prior to generator replacement. Patients will be implanted and followed for 6 months to assess any complications related to the replacement procedure.

Patients with any legally marketed device for explant can be enrolled. The replacement device can be from any manufacturer.

Conditions

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Device Replacement Elective Replacement (ERI) Device Advisory Device Upgrade Postoperative Complications

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Straight-forward Device Replacement

Subject with a straight-forward device replacement without lead revisions or additions.

Straight-forward Device Replacement

Intervention Type PROCEDURE

Device Replacement with Upgrade

Subjects with a device replacement and planned lead upgrade, revision, or addition.

Device Replacement with Upgrade

Intervention Type PROCEDURE

Interventions

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Straight-forward Device Replacement

Intervention Type PROCEDURE

Device Replacement with Upgrade

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Is able to give informed consent
* Is identified for generator replacement without system modification or generator replacement including planned system modification, regardless of generator manufacturer
* Is clinically stable to tolerate the surgical procedure
* Age 18 years or greater
* Is geographically stable and able to return to the investigational site for follow-up care through the six-month visit

Exclusion Criteria

* Inability or unwillingness to give informed consent
* Current system infection requiring generator explantation or lead extraction
* Generator replacement requiring planned lead extraction
* Participating in another cardiovascular investigational drug or device registry
* A life expectancy of less than six months
* Expected to receive a heart transplant within 6 months
* All vulnerable subjects as defined by the FDA Office of Human Research Protection or the local IRB providing oversight
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Biotronik, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jeanne Poole, MD

Role: PRINCIPAL_INVESTIGATOR

University of Washington

Locations

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University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

Mesa Cardiovascular

Mesa, Arizona, United States

Site Status

Stanislaus Cardiology

Modesto, California, United States

Site Status

Desert Cardiology

Rancho Mirage, California, United States

Site Status

Mercy General Hospital

Sacramento, California, United States

Site Status

UCSD Medical Center

San Diego, California, United States

Site Status

UCSF

San Francisco, California, United States

Site Status

Penrose Hospital

Colorado Springs, Colorado, United States

Site Status

Aurora Denver Cardiology

Denver, Colorado, United States

Site Status

George Washington University

Washington D.C., District of Columbia, United States

Site Status

Manatee Memorial

Bradenton, Florida, United States

Site Status

Halifax Medical Center

Daytona Beach, Florida, United States

Site Status

Baptist Jacksonville

Jacksonville Beach, Florida, United States

Site Status

Mt. Sinai Medical Center

Miami Beach, Florida, United States

Site Status

Wuesthoff Hospital

Rockledge, Florida, United States

Site Status

Bayfront Medical Center

St. Petersburg, Florida, United States

Site Status

University of South Florida

Tampa, Florida, United States

Site Status

Florida Medical Center

Zephyrhills, Florida, United States

Site Status

Piedmont Hospital

Atlanta, Georgia, United States

Site Status

Emory University Clinic

Atlanta, Georgia, United States

Site Status

The University of Chicago

Chicago, Illinois, United States

Site Status

Loyola University

Maywood, Illinois, United States

Site Status

University of Kansas Hospital

Kansas City, Kansas, United States

Site Status

Central Baptist

Lexington, Kentucky, United States

Site Status

Louisiana Heart

Lafayette, Louisiana, United States

Site Status

Tulane University

New Orleans, Louisiana, United States

Site Status

University of Maryland

Baltimore, Maryland, United States

Site Status

Midatlantic Cardiovascular Associates

Baltimore, Maryland, United States

Site Status

Union Memorial Hospital

Baltimore, Maryland, United States

Site Status

Shady Grove Adventist

Rockville, Maryland, United States

Site Status

Tufts University

Boston, Massachusetts, United States

Site Status

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

New England Cardiovascular Specialists

Boston, Massachusetts, United States

Site Status

Lahey Clinic

Burlington, Massachusetts, United States

Site Status

North Shore Medical Center

Salem, Massachusetts, United States

Site Status

University of Michigan

Ann Arbor, Michigan, United States

Site Status

St. Joseph Mercy Hospital

Ypsilanti, Michigan, United States

Site Status

Forrest General Hospital

Hattiesburg, Mississippi, United States

Site Status

Mid America Heart

Kansas City, Missouri, United States

Site Status

Barnes Jewish Hospital

St Louis, Missouri, United States

Site Status

Heart Consultants Omaha

Omaha, Nebraska, United States

Site Status

Alegent Hospitals

Omaha, Nebraska, United States

Site Status

Creighton University

Omaha, Nebraska, United States

Site Status

St. Barnabas

West Orange, New Jersey, United States

Site Status

Buffalo Heart Group

Buffalo, New York, United States

Site Status

St. Luke's Roosevelt Hospital

New York, New York, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

Forsyth Medical Center

Winston-Salem, North Carolina, United States

Site Status

University of Cincinnati

Cincinnati, Ohio, United States

Site Status

University Hospitals Cleveland

Cleveland, Ohio, United States

Site Status

Heart and Vascular Center, MetroHealth MC

Cleveland, Ohio, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

OU Medical Center Presbyterian

Oklahoma City, Oklahoma, United States

Site Status

Hillcrest Medical Center

Tulsa, Oklahoma, United States

Site Status

Sacred Heart Medical Center

Eugene, Oregon, United States

Site Status

Oregon Health Sciences University

Portland, Oregon, United States

Site Status

Abington Medical Specialists

Abington, Pennsylvania, United States

Site Status

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Thomas Jefferson University

Philadelphia, Pennsylvania, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

South Carolina Heart Center

Columbia, South Carolina, United States

Site Status

Pee Dee Cardiology

Florence, South Carolina, United States

Site Status

Spartanburg Regional Medical Center

Spartanburg, South Carolina, United States

Site Status

Vanderbilt University

Nashville, Tennessee, United States

Site Status

Amarillo Heart

Amarillo, Texas, United States

Site Status

Christus Spohn

Corpus Christi, Texas, United States

Site Status

UT Southwestern

Dallas, Texas, United States

Site Status

Heart Center of North Texas

Fort Worth, Texas, United States

Site Status

Sentara Norfolk General Hospital

Norfolk, Virginia, United States

Site Status

University of Washington

Seattle, Washington, United States

Site Status

CAMC Memorial Hospital

Charleston, West Virginia, United States

Site Status

Countries

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United States

References

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Chung MK, Holcomb RG, Mittal S, Steinberg JS, Gleva MJ, Mela T, Uslan DZ, Mitchell K, Poole JE; REPLACE Investigators. REPLACE DARE (Death After Replacement Evaluation) score: determinants of all-cause mortality after implantable device replacement or upgrade from the REPLACE registry. Circ Arrhythm Electrophysiol. 2014 Dec;7(6):1048-56. doi: 10.1161/CIRCEP.114.001671. Epub 2014 Sep 14.

Reference Type DERIVED
PMID: 25221331 (View on PubMed)

Uslan DZ, Gleva MJ, Warren DK, Mela T, Chung MK, Gottipaty V, Borge R, Dan D, Shinn T, Mitchell K, Holcomb RG, Poole JE. Cardiovascular implantable electronic device replacement infections and prevention: results from the REPLACE Registry. Pacing Clin Electrophysiol. 2012 Jan;35(1):81-7. doi: 10.1111/j.1540-8159.2011.03257.x. Epub 2011 Nov 11.

Reference Type DERIVED
PMID: 22077194 (View on PubMed)

Poole JE, Gleva MJ, Mela T, Chung MK, Uslan DZ, Borge R, Gottipaty V, Shinn T, Dan D, Feldman LA, Seide H, Winston SA, Gallagher JJ, Langberg JJ, Mitchell K, Holcomb R; REPLACE Registry Investigators. Complication rates associated with pacemaker or implantable cardioverter-defibrillator generator replacements and upgrade procedures: results from the REPLACE registry. Circulation. 2010 Oct 19;122(16):1553-61. doi: 10.1161/CIRCULATIONAHA.110.976076. Epub 2010 Oct 4.

Reference Type DERIVED
PMID: 20921437 (View on PubMed)

Other Identifiers

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REPLACE

Identifier Type: -

Identifier Source: org_study_id

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