Influence of Home Monitoring on the Clinical Status of Heart Failure Patients With an Impaired Left Ventricular Function

NCT ID: NCT00538356

Last Updated: 2014-12-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

720 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-07-31

Study Completion Date

2013-08-31

Brief Summary

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Re-hospitalizations or deaths by worsening heart failure are often preceded by distinct trends of clinical parameters such as atrial or ventricular arrhythmia, activity, heart rate variability, or ventricular ectopy. The Home Monitoring™ capability offered by BIOTRONIK active implants has the potential to detect some of these trends early and thus to offer the possibility to intervene in time for prevention of fatal worsening of heart failure.

To investigate the predictive value of Home Monitoring parameters, patients with symptomatic heart failure and reduced ejection fraction receiving an implantable cardioverter-defibrillator (ICD) or an ICD in combination with cardiac resynchronization therapy (CRT-D) will be randomized between prospective patient management by Home Monitoring analysis or standard care. The influence of Home Monitoring on the clinical status of heart failure patients will be assessed.

Detailed Description

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Hospital admissions or deaths by worsening heart failure are often preceded by distinct trends of clinical parameters such as heart rhythm disturbances, daily physical activity of a patient, or mean heart rates.

The Home Monitoring™ capability offered by many BIOTRONIK implants has the potential to detect some of these trends early. During Home Monitoring surveillance, medical and technical data from an ICD or CRT device are sent to a modified mobile phone, the so-called Cardio Messenger. This device transmits the data via a mobile phone network to the BIOTRONIK service center. There, the data are put into an easily accessible form and can then be viewed by the physician online via the internet on a secure website. Additionally, the occurrence of heart rhythm disturbances or device problems will be transmitted by fax, SMS or email.

This unique system allows the attending physician to monitor each patient very closely and to react early enough to prevent worsening of heart failure at an early stage, to optimize therapy, and to secure the correct functioning of the implant.

The goal of IN-TIME is thus to analyze the impact of a regular Home Monitoring evaluation on the health status of heart failure patients receiving such an implant as part of their therapy.

A total of 720 patients with heart failure symptoms and a severely reduced pumping function receiving an ICD or a CRT-D device from up to 50 European clinical centers will be enrolled into the study. About 4 weeks after discharge from the implanting hospital, patients will be randomly assigned to prospective patient management by Home Monitoring or standard care groups. Patients in the Home Monitoring group will be monitored at least once per week, patients in the control group will not be monitored during the study, but their transmitted Home Monitoring data will be analyzed after their ending of participation in the study.

The health status of patients will be measured using the well established "Packer Score". This score is a combined measurement of death rates, hospital admission rates, heart failure symptom classification and quality of life. Patients will be classified at their end of study participation as worsened, unchanged, or improved based on these parameters. To this end, the health status of participating patients will be determined regularly during further outpatient follow ups. These will take place at regular intervals due to the standard care.

Additionally, some special parameters sent to the physician via Home Monitoring will be analyzed whether they could possibly predict an imminent worsening of a patient's health - leading to an unplanned hospital visit - so that it could perhaps be prevented in the future.

Patients remain within the study for 12 months after randomization or until their participation is ended prematurely, e.g. by withdrawal of their consent, a low data transmission rate, or death.

Conditions

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Ventricular Fibrillation Ventricular Tachycardia Congestive Heart Failure

Keywords

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Heart failure Rehospitalization: Packer composite score Home Monitoring Cardiac resynchronization therapy Implantable cardioverter-defibrillator

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Home Monitoring

ICD or CRT-D with Home Monitoring feature activated Home Monitoring data will be analyzed regularly and patients will be contacted and scheduled for additional follow-up after predefined events

Group Type EXPERIMENTAL

ICD or CRT-D with Home Monitoring feature activated

Intervention Type DEVICE

Standard care + patient management by Home Monitoring

Control

ICD or CRT-D with Home Monitoring feature deactivated Patients will be treated as per standard of care in each participating clinic

Group Type ACTIVE_COMPARATOR

ICD or CRT-D with Home Monitoring feature deactivated

Intervention Type DEVICE

Standard care

Interventions

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ICD or CRT-D with Home Monitoring feature deactivated

Standard care

Intervention Type DEVICE

ICD or CRT-D with Home Monitoring feature activated

Standard care + patient management by Home Monitoring

Intervention Type DEVICE

Other Intervention Names

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Biotronik Home Monitoring Home Monitoring Service Center

Eligibility Criteria

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Inclusion Criteria

* Indication for single chamber ICD, dual chamber ICD or CRT-D
* Chronic heart failure (≥ 3 months)
* NYHA Class II or III for 1 month prior to screening
* LVEF ≤ 35% within 3 months prior to screening
* Indication for therapy with diuretics
* Patient informed consent

Exclusion Criteria

* Uncontrolled hypertension
* NYHA class I or IV
* Permanent atrial fibrillation
* Life expectancy \< 1 year
* Restrictive, infiltrative or hypertrophic cardiomyopathy, constrictive pericarditis, acute myocarditis
* Severe mitral regurgitation
* Symptomatic aortic stenosis
* Tricuspid valve replacement
* Known drug or alcohol abuse
* Expected non-compliance
* Pregnancy
* Participation in another telemonitoring concept
* Participation in another study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Biotronik SE & Co. KG

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Gerhard Hindricks, Prof. Dr.

Role: STUDY_CHAIR

Herzzentrum Leipzig, Germany

Locations

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Sydney Adventist Hospital

Wahroonga, , Australia

Site Status

Universitätsklinik für Innere Medizin

Innsbruck, , Austria

Site Status

Institute of Clinical and Experimental Medicine

Prague, , Czechia

Site Status

Hospital Na Homolce

Prague, , Czechia

Site Status

Aalborg Hospital

Aalborg, , Denmark

Site Status

Århus Universitetshospital, Skejby Sygehus

Århus N, , Denmark

Site Status

Gentofte Hospital

Hellerup, , Denmark

Site Status

Odense Universitets Hospital

Odense, , Denmark

Site Status

Zentralklinik Bad Berka

Bad Berka, , Germany

Site Status

Herz- und Gefäßklinikum Bad Neustadt GmbH

Bad Neustadt an der Saale, , Germany

Site Status

Bad Segeberger Kliniken GmbH

Bad Segeberg, , Germany

Site Status

Vivantes Klinikum Neukölln

Berlin, , Germany

Site Status

Vivantes Klinikum am Urban

Berlin, , Germany

Site Status

Universitätsklinikum Charité Campus Benjamin Franklin

Berlin, , Germany

Site Status

Vivantes Humboldt Klinikum

Berlin, , Germany

Site Status

Städtische Kliniken Bielefeld

Bielefeld, , Germany

Site Status

Universitätsklinikum Bonn

Bonn, , Germany

Site Status

Klinikum Coburg gGmbH

Coburg, , Germany

Site Status

Klinikum Lippe-Detmold

Detmold, , Germany

Site Status

Westdeutsches Herzzentrum des Universitätsklinikums Essen

Essen, , Germany

Site Status

Universitätsklinikum Gießen und Marburg

Giessen, , Germany

Site Status

Medizinische Hochschule

Hanover, , Germany

Site Status

Universitätsklinikum des Saarlandes

Homburg/Saar, , Germany

Site Status

Klinikum St. Georg gGmbH

Leipzig, , Germany

Site Status

Herzzentrum der Universität Leipzig

Leipzig, , Germany

Site Status

Universitätsklinik Schleswig-Holstein

Lübeck, , Germany

Site Status

St. Marienhospital Lünen GmbH

Lünen, , Germany

Site Status

Klinikum Schwabing, Kardiologie

Munich - Schwabing, , Germany

Site Status

Kardiologische Gemeinschaftspraxis Dr. Mühling

München, , Germany

Site Status

Stiftsklinik Augustinum, Innere Medizin / Kardiologie

München, , Germany

Site Status

Klinikum der Universität München Großhadern

München, , Germany

Site Status

Herzzentrum München-Bogenhausen

München, , Germany

Site Status

Kardiologische Gemeinschaftspraxis Dr. Predel, Dr. Heinrich

Nordhausen, , Germany

Site Status

St. Vincenz Krankenhaus GmbH

Paderborn, , Germany

Site Status

Klinikum Pirna GmbH

Pirna, , Germany

Site Status

Barzilai Medical Center

Ashkelon, , Israel

Site Status

Rabin Medical Center

Petah Tikva, , Israel

Site Status

Chaim Sheba Medical Center

Tel Litwinsky, , Israel

Site Status

P. Stradins Clinical University Hospital, Latvian Centre of Cardiology

Riga, , Latvia

Site Status

Countries

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Greece Australia Austria Czechia Denmark Germany Israel Latvia

References

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Arya A, Block M, Kautzner J, Lewalter T, Mortel H, Sack S, Schumacher B, Sogaard P, Taborsky M, Husser D, Hindricks G; IN-TIME investigators. Influence of Home Monitoring on the clinical status of heart failure patients: Design and rationale of the IN-TIME study. Eur J Heart Fail. 2008 Nov;10(11):1143-8. doi: 10.1016/j.ejheart.2008.08.004. Epub 2008 Sep 19.

Reference Type BACKGROUND
PMID: 18805053 (View on PubMed)

Hindricks G, Taborsky M, Glikson M, Heinrich U, Schumacher B, Katz A, Brachmann J, Lewalter T, Goette A, Block M, Kautzner J, Sack S, Husser D, Piorkowski C, Sogaard P; IN-TIME study group*. Implant-based multiparameter telemonitoring of patients with heart failure (IN-TIME): a randomised controlled trial. Lancet. 2014 Aug 16;384(9943):583-590. doi: 10.1016/S0140-6736(14)61176-4.

Reference Type DERIVED
PMID: 25131977 (View on PubMed)

Other Identifiers

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There is no secondary ID

Identifier Type: -

Identifier Source: secondary_id

HS042

Identifier Type: -

Identifier Source: org_study_id