Hemodynamically Guided Home Self-Therapy in Severe Heart Failure Patients (HOMEOSTASIS)

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

71 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-03-31

Study Completion Date

2008-06-30

Brief Summary

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This study is a feasibility study of the HeartPOD™ Heart Failure Management System with DynamicRx® (HeartPOD system) in patients with severe chronic congestive heart failure. The device being studied in this trial monitors heart function and alerts the patient and physician of necessary changes to medication. The study will assess the safety, reliability, and preliminary efficacy of the HeartPOD™ system.

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Detailed Description

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Direct cardiac measurements may provide an accurate, reliable and medically acceptable way of informing patients and physicians of worsening CHF prior to the development of symptoms. This may enable physicians to take preventative measures and avoid hospitalization.

This is a feasibility study to assess the safety, reliability, and preliminary efficacy of the HeartPOD™ Heart Failure Management System with DynamicRx®. This feasibility study will be performed in two phases. The first phase will enroll 20 patients at sites in Australia and New Zealand and the second phase will enroll 20 patients at sites in the U.S.

Conditions

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Heart Failure

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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HeartPOD™ System

Implantation of HeartPOD™ Heart Failure Management System with DynamicRx®

Group Type EXPERIMENTAL

HeartPOD™ System

Intervention Type DEVICE

HeartPOD™ device with DynamicRx® automatically measures left heart pressures throughout the day.

Interventions

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HeartPOD™ System

HeartPOD™ device with DynamicRx® automatically measures left heart pressures throughout the day.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age \> 18 and \< 85.
* Documented history of congestive heart failure resulting from ischemic or non-ischemic cardiomyopathy with systolic or diastolic dysfunction of at least 6 months duration.
* Patients with LVEF \< 40% should receive maximally tolerated doses of ACE-I (or ARB if ACE-I is not tolerated), beta blockers, and anti-aldosterone therapy. The combination of hydralazine and nitrates should be considered in the persistently symptomatic African American patient.
* A history of NYHA Class II (OUS only), III or IV symptoms.
* Minimum of one (1) prior hospital admission within the last 12 months for exacerbation of CHF or one (1) presentation to the Emergency Department or Clinic requiring parenteral diuretic, vasodilator, inotrope, nesiritide, or equivalent treatment.
* Female subjects of childbearing potential must have a negative pregnancy test within seven (7) days before the procedure.
* Central venous vascular access.
* Capable of Valsalva maneuver with airway pressure \> 40 mm Hg for 10 seconds.
* The subject and the treating physician agree that the subject will comply with all required post-procedure follow-up, and that the patient is capable of correct device use as outlined in the protocol.
* Written informed consent.

Exclusion Criteria

* Intractable HF with resting symptoms despite maximal medical therapy or active listing for cardiac transplantation (\< 6 months survival expected).
* Resting systolic blood pressure \< 90 or \> 180 mmHg.
* Acute MI, unstable ischemic syndrome within the last 6 weeks.
* Percutaneous coronary intervention (PCI) or cardiac surgery performed or planned within 6 weeks.
* Coexisting stenotic valve lesions, vegetations, hypertrophic cardiomyopathy, amyloidosis or other infiltrative heart disease, constrictive, restrictive disease, tamponade, or moderate or large pericardial effusion.
* Subject has a history of deep venous thrombosis or pulmonary embolism.
* Surgical correction of congenital heart disease involving atrial septum.
* CVA or TIA within 6 months. History of uncorrected cerebral vascular disease.
* Atrial or ventricular thrombus, tumor or systemic thromboembolism.
* Chronic atrial fibrillation.
* Symptomatic bradyarrhythmia or sustained VT/VF unless successfully treated with cardiac rhythm management device for 6 weeks.
* Atrial septal defect or patent foramen ovale \> 2 mm in diameter.
* Life expectancy \< 1 year from malignancy, primary pulmonary hypertension, renal, hepatic, or neurological condition, etc.
* Gastrointestinal bleeding during the last 6 months.
* Coagulopathy or uninterruptible anticoagulation therapy or unable to take antiplatelet medications.
* Creatinine \> 2.5 gm/dl
* Temperature \> 37.8C or white blood cell count (WBC) \> 13,000/mm3.
* The subject is currently participating in an investigational drug or another device study that has not completed the primary endpoint or that clinically interferes with the current study endpoints.

Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No