Trial Outcomes & Findings for Clinical effecT of Heart Failure Management Via Home Monitoring With a Focus on Atrial Fibrillation (effecT) (NCT NCT00811382)

NCT ID: NCT00811382

Last Updated: 2024-08-29

Results Overview

Clinical composite outcome based on the days lost due to cardiovascluar mortality, cardiovascular hospitalization and inappropriate ICD therapy during an observational period of 12 months.

Recruitment status

TERMINATED

Study phase

NA

Target enrollment

163 participants

Primary outcome timeframe

12 months

Results posted on

2024-08-29

Participant Flow

Participant milestones

Participant milestones
Measure
1: Access to HMSC
Full functionality of the Home Monitoring System for an early optimization of CRT and management of AF with a full access for the treating physician to the HMSC Home Monitoring (CRT and AF therapy with Home Monitoring feature): CRT and AF therapy according to medical guidelines, where the physician receives relevant daily data from the implant via Home Monitoring
2: No Access to HMSC
Limited access of the treating physician to the HMSC where only events regarding implant and lead status will be generated and sent to the physician. Home Monitoring (CRT and AF therapy, without Home Monitoring): CRT and AF therapy according to medical guidelines, without daily data transmission from the implant via Home Monitoring (except for the safety data on device integrity)
Overall Study
STARTED
88
75
Overall Study
COMPLETED
88
75
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Clinical effecT of Heart Failure Management Via Home Monitoring With a Focus on Atrial Fibrillation (effecT)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
1: Access to HMSC
n=88 Participants
Full functionality of the Home Monitoring System for an early optimization of CRT and management of AF with a full access for the treating physician to the HMSC. Home Monitoring (CRT and AF therapy with Home Monitoring feature): CRT and AF therapy according to medical guidelines, where the physician receives relevant daily data from the implant via Home Monitoring.
2: No Access to HMSC
n=75 Participants
Limited access of the treating physician to the HMSC where only events regarding implant and lead status will be generated and sent to the physician. Home Monitoring (CRT and AF therapy, without Home Monitoring): CRT and AF therapy according to medical guidelines, without daily data transmission from the implant via Home Monitoring (except for the safety data on device integrity).
Total
n=163 Participants
Total of all reporting groups
New York Heart Association functional class (NYHA class)
Class III
75 Participants
n=5 Participants
67 Participants
n=7 Participants
142 Participants
n=5 Participants
Age, Continuous
68.7 years
STANDARD_DEVIATION 8.5 • n=5 Participants
67.3 years
STANDARD_DEVIATION 10 • n=7 Participants
68.1 years
STANDARD_DEVIATION 9.2 • n=5 Participants
Sex: Female, Male
Female
21 Participants
n=5 Participants
16 Participants
n=7 Participants
37 Participants
n=5 Participants
Sex: Female, Male
Male
67 Participants
n=5 Participants
59 Participants
n=7 Participants
126 Participants
n=5 Participants
Height,centimeter (cm)
172 cm
STANDARD_DEVIATION 9 • n=5 Participants
171 cm
STANDARD_DEVIATION 8 • n=7 Participants
172 cm
STANDARD_DEVIATION 9 • n=5 Participants
Weight, kilogram (kg)
82 kg
STANDARD_DEVIATION 16 • n=5 Participants
81 kg
STANDARD_DEVIATION 15 • n=7 Participants
81 kg
STANDARD_DEVIATION 15 • n=5 Participants
Body Mass Index (BMI)
27.6 kg/m^2
STANDARD_DEVIATION 4.4 • n=5 Participants
27.6 kg/m^2
STANDARD_DEVIATION 4.4 • n=7 Participants
27.6 kg/m^2
STANDARD_DEVIATION 4.4 • n=5 Participants
New York Heart Association functional class (NYHA class)
Class I
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
New York Heart Association functional class (NYHA class)
Class II
7 Participants
n=5 Participants
5 Participants
n=7 Participants
12 Participants
n=5 Participants
New York Heart Association functional class (NYHA class)
Class IV
6 Participants
n=5 Participants
3 Participants
n=7 Participants
9 Participants
n=5 Participants
Cardiomyopathy
Ischemic
49 participants
n=5 Participants
40 participants
n=7 Participants
89 participants
n=5 Participants
Cardiomyopathy
Non-ischemic
39 participants
n=5 Participants
35 participants
n=7 Participants
74 participants
n=5 Participants
Left ventricular ejection fraction (LVEF)
27 Percentage %
STANDARD_DEVIATION 7 • n=5 Participants
26 Percentage %
STANDARD_DEVIATION 7 • n=7 Participants
27 Percentage %
STANDARD_DEVIATION 7 • n=5 Participants
Left Ventricular End-Systolic Volume (LVESV)
135 ml
STANDARD_DEVIATION 58 • n=5 Participants
159 ml
STANDARD_DEVIATION 70 • n=7 Participants
146 ml
STANDARD_DEVIATION 64 • n=5 Participants
Left atrial diameter (LAD)
49 mm
STANDARD_DEVIATION 10 • n=5 Participants
48 mm
STANDARD_DEVIATION 8 • n=7 Participants
48 mm
STANDARD_DEVIATION 9 • n=5 Participants
Mitral regurgitation
Mild
38 Participants
n=5 Participants
39 Participants
n=7 Participants
77 Participants
n=5 Participants
Mitral regurgitation
Moderate
28 Participants
n=5 Participants
15 Participants
n=7 Participants
43 Participants
n=5 Participants
Mitral regurgitation
Severe
3 Participants
n=5 Participants
2 Participants
n=7 Participants
5 Participants
n=5 Participants
Mitral regurgitation
No regurgitation
17 Participants
n=5 Participants
17 Participants
n=7 Participants
34 Participants
n=5 Participants
Mitral regurgitation
not reported
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
History of VT/VF
Patients with VT/VF
22 patients
n=5 Participants
15 patients
n=7 Participants
37 patients
n=5 Participants
History of VT/VF
Patients with No VT/VF
66 patients
n=5 Participants
60 patients
n=7 Participants
126 patients
n=5 Participants
QRS duration
158 ms
STANDARD_DEVIATION 24 • n=5 Participants
159 ms
STANDARD_DEVIATION 26 • n=7 Participants
158 ms
STANDARD_DEVIATION 25 • n=5 Participants
Heart Rate
71 beats/min
STANDARD_DEVIATION 14 • n=5 Participants
68 beats/min
STANDARD_DEVIATION 16 • n=7 Participants
70 beats/min
STANDARD_DEVIATION 15 • n=5 Participants
AV (atrioventricular) Block
No relevant finding
36 patients
n=5 Participants
32 patients
n=7 Participants
68 patients
n=5 Participants
AV (atrioventricular) Block
First Degree
23 patients
n=5 Participants
17 patients
n=7 Participants
40 patients
n=5 Participants
AV (atrioventricular) Block
Second Degree
2 patients
n=5 Participants
3 patients
n=7 Participants
5 patients
n=5 Participants
AV (atrioventricular) Block
Third Degree
9 patients
n=5 Participants
4 patients
n=7 Participants
13 patients
n=5 Participants
AV (atrioventricular) Block
Other
18 patients
n=5 Participants
19 patients
n=7 Participants
37 patients
n=5 Participants
Rhythm at enrollment
Sinus Rhythm
75 patients
n=5 Participants
66 patients
n=7 Participants
141 patients
n=5 Participants
Rhythm at enrollment
AF
4 patients
n=5 Participants
6 patients
n=7 Participants
10 patients
n=5 Participants
Rhythm at enrollment
Other
9 patients
n=5 Participants
3 patients
n=7 Participants
12 patients
n=5 Participants
Non-CV (cardiovascular) Morbidity at Enrollment
Diabetes mellitus
35 patients
n=5 Participants
20 patients
n=7 Participants
55 patients
n=5 Participants
Non-CV (cardiovascular) Morbidity at Enrollment
Renal insufficiency
15 patients
n=5 Participants
10 patients
n=7 Participants
25 patients
n=5 Participants
Non-CV (cardiovascular) Morbidity at Enrollment
COPD
18 patients
n=5 Participants
13 patients
n=7 Participants
31 patients
n=5 Participants
Non-CV (cardiovascular) Morbidity at Enrollment
Thyroid disease
15 patients
n=5 Participants
9 patients
n=7 Participants
24 patients
n=5 Participants
Non-CV (cardiovascular) Morbidity at Enrollment
Hepatic disease
2 patients
n=5 Participants
1 patients
n=7 Participants
3 patients
n=5 Participants
Non-CV (cardiovascular) Morbidity at Enrollment
Mental disorder
4 patients
n=5 Participants
2 patients
n=7 Participants
6 patients
n=5 Participants
Non-CV (cardiovascular) Morbidity at Enrollment
Other
28 patients
n=5 Participants
19 patients
n=7 Participants
47 patients
n=5 Participants
History of AF
Paroxysmal
60 patients
n=5 Participants
47 patients
n=7 Participants
107 patients
n=5 Participants
History of AF
Persistent
21 patients
n=5 Participants
19 patients
n=7 Participants
40 patients
n=5 Participants
History of AF
no History of AF
7 patients
n=5 Participants
9 patients
n=7 Participants
16 patients
n=5 Participants
Ventricular Rate during AF
104 beats/min
STANDARD_DEVIATION 33 • n=5 Participants
100 beats/min
STANDARD_DEVIATION 32 • n=7 Participants
102 beats/min
STANDARD_DEVIATION 33 • n=5 Participants
Days since AF is known
1222 days
STANDARD_DEVIATION 2076 • n=5 Participants
644 days
STANDARD_DEVIATION 930 • n=7 Participants
974 days
STANDARD_DEVIATION 1701 • n=5 Participants
History of pharmacological cardioversion
successful
15 patients
n=5 Participants
9 patients
n=7 Participants
24 patients
n=5 Participants
History of pharmacological cardioversion
not successful
5 patients
n=5 Participants
3 patients
n=7 Participants
8 patients
n=5 Participants
History of pharmacological cardioversion
not tried
61 patients
n=5 Participants
54 patients
n=7 Participants
115 patients
n=5 Participants
History of pharmacological cardioversion
not reported
7 patients
n=5 Participants
9 patients
n=7 Participants
16 patients
n=5 Participants
History of electrical cardioversion
successful
30 patients
n=5 Participants
24 patients
n=7 Participants
54 patients
n=5 Participants
History of electrical cardioversion
not successful
1 patients
n=5 Participants
0 patients
n=7 Participants
1 patients
n=5 Participants
History of electrical cardioversion
not tried
50 patients
n=5 Participants
42 patients
n=7 Participants
92 patients
n=5 Participants
History of electrical cardioversion
not reported
7 patients
n=5 Participants
9 patients
n=7 Participants
16 patients
n=5 Participants
History of atrial ablation
successful ablation
0 patients
n=5 Participants
0 patients
n=7 Participants
0 patients
n=5 Participants
History of atrial ablation
partly successful
3 patients
n=5 Participants
3 patients
n=7 Participants
6 patients
n=5 Participants
History of atrial ablation
not successful
3 patients
n=5 Participants
1 patients
n=7 Participants
4 patients
n=5 Participants
History of atrial ablation
not tried
75 patients
n=5 Participants
62 patients
n=7 Participants
137 patients
n=5 Participants
History of atrial ablation
not reported
7 patients
n=5 Participants
9 patients
n=7 Participants
16 patients
n=5 Participants
History AV node ablation
successful
0 patients
n=5 Participants
1 patients
n=7 Participants
1 patients
n=5 Participants
History AV node ablation
not successful
1 patients
n=5 Participants
0 patients
n=7 Participants
1 patients
n=5 Participants
History AV node ablation
not tried
80 patients
n=5 Participants
65 patients
n=7 Participants
145 patients
n=5 Participants
History AV node ablation
not reported
7 patients
n=5 Participants
9 patients
n=7 Participants
16 patients
n=5 Participants
AF treatment at enrollment
Rate control
16 patients
n=5 Participants
14 patients
n=7 Participants
30 patients
n=5 Participants
AF treatment at enrollment
Rhythm control
47 patients
n=5 Participants
37 patients
n=7 Participants
84 patients
n=5 Participants
AF treatment at enrollment
No AF treatment
21 patients
n=5 Participants
17 patients
n=7 Participants
38 patients
n=5 Participants
AF treatment at enrollment
not reported
4 patients
n=5 Participants
7 patients
n=7 Participants
11 patients
n=5 Participants
Medication at Enrollment
ACE inhibitor or ARB
72 patients
n=5 Participants
63 patients
n=7 Participants
135 patients
n=5 Participants
Medication at Enrollment
Amiodarone
36 patients
n=5 Participants
36 patients
n=7 Participants
72 patients
n=5 Participants
Medication at Enrollment
Beta blocker
69 patients
n=5 Participants
63 patients
n=7 Participants
132 patients
n=5 Participants
Medication at Enrollment
Calcium channel blocker
5 patients
n=5 Participants
3 patients
n=7 Participants
8 patients
n=5 Participants
Medication at Enrollment
Digitalis
13 patients
n=5 Participants
6 patients
n=7 Participants
19 patients
n=5 Participants
Medication at Enrollment
Sotalol
5 patients
n=5 Participants
2 patients
n=7 Participants
7 patients
n=5 Participants
Medication at Enrollment
Other antiarrhythmic
1 patients
n=5 Participants
1 patients
n=7 Participants
2 patients
n=5 Participants
Medication at Enrollment
Anticoagulants
61 patients
n=5 Participants
54 patients
n=7 Participants
115 patients
n=5 Participants
Medication at Enrollment
Antiplatelet
39 patients
n=5 Participants
25 patients
n=7 Participants
64 patients
n=5 Participants
Medication at Enrollment
Lipid-lowering drug
63 patients
n=5 Participants
47 patients
n=7 Participants
110 patients
n=5 Participants
Medication at Enrollment
Nitrate
7 patients
n=5 Participants
4 patients
n=7 Participants
11 patients
n=5 Participants
Medication at Enrollment
Spironolactone
42 patients
n=5 Participants
28 patients
n=7 Participants
70 patients
n=5 Participants
Medication at Enrollment
Other diuretic
72 patients
n=5 Participants
63 patients
n=7 Participants
135 patients
n=5 Participants
Medication at Enrollment
Other medication
23 patients
n=5 Participants
21 patients
n=7 Participants
44 patients
n=5 Participants

PRIMARY outcome

Timeframe: 12 months

Clinical composite outcome based on the days lost due to cardiovascluar mortality, cardiovascular hospitalization and inappropriate ICD therapy during an observational period of 12 months.

Outcome measures

Outcome measures
Measure
1: Access to HMSC
n=88 Participants
Full functionality of the Home Monitoring System for an early optimization of CRT and management of AF with a full access for the treating physician to the HMSC Home Monitoring (CRT and AF therapy with Home Monitoring feature): CRT and AF therapy according to medical guidelines, where the physician receives relevant daily data from the implant via Home Monitoring
2: No Access to HMSC
n=75 Participants
Limited access of the treating physician to the HMSC where only events regarding implant and lead status will be generated and sent to the physician. Home Monitoring (CRT and AF therapy, without Home Monitoring): CRT and AF therapy according to medical guidelines, without daily data transmission from the implant via Home Monitoring (except for the safety data on device integrity)
Days Lost
15.1 Days lost per patient
Standard Deviation 52.5
16.0 Days lost per patient
Standard Deviation 47.8

SECONDARY outcome

Timeframe: 12 months

Population: Endpoint was not evaluated because of the insignificant result for the primary hypothesis and early study discontinuation due to low enrollment

Analysis of the fraction of patients with worsened composite clinical score in the two treatment arms.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 months

Population: Endpoint was not evaluated because of the insignificant result for the primary hypothesis and early study discontinuation due to low enrollment

Analysis of the change in left ventricular end-systolic volume, left atrial diameter, left ventricular EF, and the degree of mitral regurgitation from enrollment to the end of the follow-up in the two treatment arms

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 12 months

Population: Endpoint was not evaluated because of the insignificant result for the primary hypothesis and early study discontinuation due to low enrollment

The proportion of patients in sinus rhythm or with paroxysmal AF, persistant AF, or permanet AF at the end of the Follow-Up, without statistical evaluation and analysis of AF/AT (atrial tachycardia) burden based on the home monitoring data

Outcome measures

Outcome data not reported

Adverse Events

1: Access to HMSC

Serious events: 45 serious events
Other events: 6 other events
Deaths: 0 deaths

2: No Access to HMSC

Serious events: 41 serious events
Other events: 8 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
1: Access to HMSC
n=88 participants at risk
Full functionality of the Home Monitoring System for an early optimization of cardiac resynchronization therapy and management of atrial fibrillation with a full access for the treating physician to the Home Monitoring Service Center Home Monitoring (Cardiac resynchronization therapy and atrial fibrillation therapy with Home Monitoring feature): Cardiac resynchronization therapy and atrial fibrillation therapy according to medical guidelines, where the physician receives relevant daily data from the implant via Home Monitoring
2: No Access to HMSC
n=75 participants at risk
Limited access of the treating physician to the HMSC where only events regarding implant and lead status will be generated and sent to the physician. Home Monitoring (Cardiac resynchronization therapy and atrial fibrillation therapy, without Home Monitoring): Cardiac resynchronization therapy and atrial fibrillation therapy according to medical guidelines, without daily data transmission from the implant via Home Monitoring (except for the safety data on device integrity)
Cardiac disorders
Device related SAEs
13.6%
12/88 • Number of events 12 • From date of randomization until the date of death from any cause, study withdrawal, or study termination, which ever came first, assessed up to 1 year
The definition of Adverse Event (AE) and/or serious AE (SAE), used to collect AE information, differs not from the clinicaltrials.gov definitions. There is no source vocabulary for adverse event terms for this study. It is not possible to provide specific AE Terms (e.g. arrhythmia) to indicate whether or not events were related to the device. We used a standard AE Form to document the relationship to the medical device and the investigator ticked "device related, maybe or not related".
12.0%
9/75 • Number of events 11 • From date of randomization until the date of death from any cause, study withdrawal, or study termination, which ever came first, assessed up to 1 year
The definition of Adverse Event (AE) and/or serious AE (SAE), used to collect AE information, differs not from the clinicaltrials.gov definitions. There is no source vocabulary for adverse event terms for this study. It is not possible to provide specific AE Terms (e.g. arrhythmia) to indicate whether or not events were related to the device. We used a standard AE Form to document the relationship to the medical device and the investigator ticked "device related, maybe or not related".
Cardiac disorders
maybe device-related SAEs
3.4%
3/88 • Number of events 3 • From date of randomization until the date of death from any cause, study withdrawal, or study termination, which ever came first, assessed up to 1 year
The definition of Adverse Event (AE) and/or serious AE (SAE), used to collect AE information, differs not from the clinicaltrials.gov definitions. There is no source vocabulary for adverse event terms for this study. It is not possible to provide specific AE Terms (e.g. arrhythmia) to indicate whether or not events were related to the device. We used a standard AE Form to document the relationship to the medical device and the investigator ticked "device related, maybe or not related".
0.00%
0/75 • From date of randomization until the date of death from any cause, study withdrawal, or study termination, which ever came first, assessed up to 1 year
The definition of Adverse Event (AE) and/or serious AE (SAE), used to collect AE information, differs not from the clinicaltrials.gov definitions. There is no source vocabulary for adverse event terms for this study. It is not possible to provide specific AE Terms (e.g. arrhythmia) to indicate whether or not events were related to the device. We used a standard AE Form to document the relationship to the medical device and the investigator ticked "device related, maybe or not related".
Cardiac disorders
not device-related SAEs
44.3%
39/88 • Number of events 73 • From date of randomization until the date of death from any cause, study withdrawal, or study termination, which ever came first, assessed up to 1 year
The definition of Adverse Event (AE) and/or serious AE (SAE), used to collect AE information, differs not from the clinicaltrials.gov definitions. There is no source vocabulary for adverse event terms for this study. It is not possible to provide specific AE Terms (e.g. arrhythmia) to indicate whether or not events were related to the device. We used a standard AE Form to document the relationship to the medical device and the investigator ticked "device related, maybe or not related".
48.0%
36/75 • Number of events 65 • From date of randomization until the date of death from any cause, study withdrawal, or study termination, which ever came first, assessed up to 1 year
The definition of Adverse Event (AE) and/or serious AE (SAE), used to collect AE information, differs not from the clinicaltrials.gov definitions. There is no source vocabulary for adverse event terms for this study. It is not possible to provide specific AE Terms (e.g. arrhythmia) to indicate whether or not events were related to the device. We used a standard AE Form to document the relationship to the medical device and the investigator ticked "device related, maybe or not related".

Other adverse events

Other adverse events
Measure
1: Access to HMSC
n=88 participants at risk
Full functionality of the Home Monitoring System for an early optimization of cardiac resynchronization therapy and management of atrial fibrillation with a full access for the treating physician to the Home Monitoring Service Center Home Monitoring (Cardiac resynchronization therapy and atrial fibrillation therapy with Home Monitoring feature): Cardiac resynchronization therapy and atrial fibrillation therapy according to medical guidelines, where the physician receives relevant daily data from the implant via Home Monitoring
2: No Access to HMSC
n=75 participants at risk
Limited access of the treating physician to the HMSC where only events regarding implant and lead status will be generated and sent to the physician. Home Monitoring (Cardiac resynchronization therapy and atrial fibrillation therapy, without Home Monitoring): Cardiac resynchronization therapy and atrial fibrillation therapy according to medical guidelines, without daily data transmission from the implant via Home Monitoring (except for the safety data on device integrity)
Cardiac disorders
device-related AEs
5.7%
5/88 • Number of events 19 • From date of randomization until the date of death from any cause, study withdrawal, or study termination, which ever came first, assessed up to 1 year
The definition of Adverse Event (AE) and/or serious AE (SAE), used to collect AE information, differs not from the clinicaltrials.gov definitions. There is no source vocabulary for adverse event terms for this study. It is not possible to provide specific AE Terms (e.g. arrhythmia) to indicate whether or not events were related to the device. We used a standard AE Form to document the relationship to the medical device and the investigator ticked "device related, maybe or not related".
8.0%
6/75 • Number of events 19 • From date of randomization until the date of death from any cause, study withdrawal, or study termination, which ever came first, assessed up to 1 year
The definition of Adverse Event (AE) and/or serious AE (SAE), used to collect AE information, differs not from the clinicaltrials.gov definitions. There is no source vocabulary for adverse event terms for this study. It is not possible to provide specific AE Terms (e.g. arrhythmia) to indicate whether or not events were related to the device. We used a standard AE Form to document the relationship to the medical device and the investigator ticked "device related, maybe or not related".
Cardiac disorders
maybe device-related AEs
1.1%
1/88 • Number of events 4 • From date of randomization until the date of death from any cause, study withdrawal, or study termination, which ever came first, assessed up to 1 year
The definition of Adverse Event (AE) and/or serious AE (SAE), used to collect AE information, differs not from the clinicaltrials.gov definitions. There is no source vocabulary for adverse event terms for this study. It is not possible to provide specific AE Terms (e.g. arrhythmia) to indicate whether or not events were related to the device. We used a standard AE Form to document the relationship to the medical device and the investigator ticked "device related, maybe or not related".
2.7%
2/75 • Number of events 4 • From date of randomization until the date of death from any cause, study withdrawal, or study termination, which ever came first, assessed up to 1 year
The definition of Adverse Event (AE) and/or serious AE (SAE), used to collect AE information, differs not from the clinicaltrials.gov definitions. There is no source vocabulary for adverse event terms for this study. It is not possible to provide specific AE Terms (e.g. arrhythmia) to indicate whether or not events were related to the device. We used a standard AE Form to document the relationship to the medical device and the investigator ticked "device related, maybe or not related".

Additional Information

Mathias Freudigmann

BIOTRONIK

Phone: +49(0)30 68905 - 1248

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60