Chronicle Offers Management to Patients With Advanced Signs and Symptoms of Heart Failure (COMPASS-HF)

NCT ID: NCT00643279

Last Updated: 2023-12-22

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

277 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-03-31

Study Completion Date

2013-04-30

Brief Summary

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COMPASS-HF was a prospective, two-arm, randomized (1:1), multi-center, parallel controlled study. The purpose of the randomized study was to test the safety of an implantable hemodynamic monitor (IHM) and pressure sensor lead. The premise of this study was to compare the effectiveness of a novel heart failure management strategy based on information obtained from the IHM system in reducing heart failure morbidity compared to a strategy based on standard medical care alone.

Detailed Description

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COMPASS-HF was a prospective, two-arm, randomized (1:1), multi-center, parallel controlled study. The purpose of the randomized study was to test the safety of an implantable hemodynamic monitor (IHM) and pressure sensor lead. The premise of this study was to compare the effectiveness of a novel heart failure management strategy based on information obtained from the IHM system in reducing heart failure morbidity compared to a strategy based on standard medical care alone.

After baseline evaluation and verification that entrance criteria were met, all subjects were implanted with a Chronicle IHM and pressure sensor lead. Following successful implantation, subjects were randomized to either the CHRONICLE group or CONTROL group. Subjects randomized to the CHRONICLE group were managed using Chronicle, specifically trended RV and estimated PA pressure, heart rate and activity data, whereas subjects randomized to the CONTROL group were treated conventionally without the use of the Chronicle data. In the case that implantation was not successful, subjects were exited from the study if no procedure related adverse events were identified; procedure related adverse events were followed through to resolution before the subject were withdrawn from the study.

Subjects remained randomized until their six month clinic visit had been completed. Following the subject's six month visit, clinicians were granted access to the CONTROL subject's trended Chronicle data on the Chronicle website, and subjects were seen in the clinic for a protocol-required visit every six months until exit from the study.

Conditions

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Heart Failure

Keywords

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implantable hemodynamic monitor Intracardiac pressures

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

SINGLE

Participants

Study Groups

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CHRONICLE

Subjects randomized to the CHRONICLE group were managed using data from an implantable hemodynamic monitoring (IHM) device, including trended right ventricular (RV) and estimated pulmonary arterial (PA) pressures, heart rate and activity data. The Chronicle IHM device does not provide therapy, but rather provides intracardiac diagnostic information about the patient which the physician can utilize to manage the patient and the patients heart failure.

Group Type EXPERIMENTAL

Chronicle Implantable Hemodynamic Monitor

Intervention Type DEVICE

Surgical implantation of chronic ambulatory implantable hemodynamic monitoring (IHM) device and intracardiac pressure sensing lead. The implantable hemodynamic monitoring device captures intracardiac hemodynamic information about the patient including trended right ventricular (RV) and estimated pulmonary arterial (PA) pressures, heart rate and activity data. The IHM device does not provide therapy, but rather provides intracardiac diagnostic information about the patient which the physician can utilize to manage the patient and the patients heart failure.

CONTROL

Subjects randomized to the CONTROL group implanted with the Chronicle implantable hemodynamic monitoring (IHM) device, but the intracardiac diagnostic information was blinded to both the patient and the physician during the randomized period of the study. Subjects were managed conventionally with standard of care. Physicians and patients have access to the intracardiac data after the randomized period of the study is over, at 6 months.

Group Type PLACEBO_COMPARATOR

Standard of Care

Intervention Type OTHER

Surgical implantation of chronic ambulatory implantable hemodynamic monitoring (IHM) device and intracardiac pressure sensing lead, but physician and patient access to the intracardiac information provided by the device is restricted until the end of the randomized period of the study, at 6 months. Patients and patients heart failure are managed conventionally per standard of care.

Interventions

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Chronicle Implantable Hemodynamic Monitor

Surgical implantation of chronic ambulatory implantable hemodynamic monitoring (IHM) device and intracardiac pressure sensing lead. The implantable hemodynamic monitoring device captures intracardiac hemodynamic information about the patient including trended right ventricular (RV) and estimated pulmonary arterial (PA) pressures, heart rate and activity data. The IHM device does not provide therapy, but rather provides intracardiac diagnostic information about the patient which the physician can utilize to manage the patient and the patients heart failure.

Intervention Type DEVICE

Standard of Care

Surgical implantation of chronic ambulatory implantable hemodynamic monitoring (IHM) device and intracardiac pressure sensing lead, but physician and patient access to the intracardiac information provided by the device is restricted until the end of the randomized period of the study, at 6 months. Patients and patients heart failure are managed conventionally per standard of care.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Subjects with heart failure classified as New York Heart Association (NYHA) Class III and IV
* Subject has been managed with standard medical therapy for heart failure (such as diuretic, angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blockers (ARB), and beta-blocker for at least 3 months prior to the baseline evaluation
* Subject must have at least one heart failure-related hospitalization or emergency department visit requiring intravenous treatment within 6 months prior to baseline evaluation

Exclusion Criteria

* Subjects who are likely to be transplanted within 6 months from randomization or will remain hospitalized until transplantation
* Subjects with severe COPD or restrictive airway disease (recommended FEV1 less than or equal to 1 liter or 50% predicted)
* Subjects who are on continuous positive inotropic therapy
* Subjects with known atrial or ventricular septal defects
* Subjects with mechanical right heart valves
* Subjects with stenotic tricuspid or pulmonary valves
* Subjects with a presently implanted non-compatible pacemaker or ICD
* Subjects with cardiac resynchronization therapy which has not achieved optimal programming for more than 3 months
* Subjects with a major cardiovascular event within 3 months prior to baseline evaluation
* Subjects with a severe non-cardiac condition limiting 6 month survival
* Subjects with a primary diagnosis of pulmonary artery hypertension
* Subjects with serum creatinine greater than or equal to 3.5 mg/dL or on chronic renal dialysis
* Subjects enrolled in concurrent studies that may confound the results of this study
* Women who are pregnant or with child bearing potential and who are not on a reliable form of birth control
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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Robert Bourge, MD

Role: PRINCIPAL_INVESTIGATOR

The University of Alabama at Birmingham

Locations

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University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

Loma Linda University Medical Center

Loma Linda, California, United States

Site Status

UCLA Medical Center

Los Angeles, California, United States

Site Status

University of Southern California

Los Angeles, California, United States

Site Status

University of Florida - Shands

Gainesville, Florida, United States

Site Status

Crawford LongHospital

Atlanta, Georgia, United States

Site Status

Prairie Heart Institute

Springfield, Illinois, United States

Site Status

Parkview Memorial Hospital

Fort Wayne, Indiana, United States

Site Status

New England Medical Center

Boston, Massachusetts, United States

Site Status

St. Paul Heart

Saint Paul, Minnesota, United States

Site Status

Mid America Heart Institute

Kansas City, Missouri, United States

Site Status

Robert Wood Johnson Medical Center

New Brunswick, New Jersey, United States

Site Status

Newark Beth Israel

Newark, New Jersey, United States

Site Status

New York Presbyterian - Columbia

New York, New York, United States

Site Status

Duke University

Chapel Hill, North Carolina, United States

Site Status

University of Cincinnati

Cincinnati, Ohio, United States

Site Status

The Ohio State University

Columbus, Ohio, United States

Site Status

Oklahoma Cardiovascular Associates

Oklahoma City, Oklahoma, United States

Site Status

University of Oklahoma

Oklahoma City, Oklahoma, United States

Site Status

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Temple University Hospital

Philadelphia, Pennsylvania, United States

Site Status

University of Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

Baptist Memorial Hospital

Germantown, Tennessee, United States

Site Status

St. Thomas Hospital

Nashville, Tennessee, United States

Site Status

St. Luke's Episcopal Hospital/Texas Heart

Houston, Texas, United States

Site Status

LDS Hospital

Salt Lake City, Utah, United States

Site Status

University of Washington Medical Center

Seattle, Washington, United States

Site Status

Countries

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United States

References

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Zile MR, Adamson PB, Cho YK, Bennett TD, Bourge RC, Aaron MF, Aranda JM Jr, Abraham WT, Stevenson LW, Kueffer FJ. Hemodynamic factors associated with acute decompensated heart failure: part 1--insights into pathophysiology. J Card Fail. 2011 Apr;17(4):282-91. doi: 10.1016/j.cardfail.2011.01.010. Epub 2011 Feb 26.

Reference Type DERIVED
PMID: 21440865 (View on PubMed)

Other Identifiers

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COMPASS-HF

Identifier Type: -

Identifier Source: org_study_id