Evolution of Management Strategies of Heart Failure Patients With Implantable Defibrillators

NCT ID: NCT00873899

Last Updated: 2009-04-02

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

UNKNOWN

Total Enrollment

200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2008-05-31

Study Completion Date

2010-09-30

Brief Summary

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The EVOLVO study is designed to compare the remote defibrillator management to the current standard of care, to assess its ability to treat and triage patients more effectively.

Detailed Description

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Heart failure patients with implantable defibrillators (ICD) perform frequent clinic visits for routine device monitoring. Moreover, in case of clinical events, such as ICD shocks or alert notifications for changes in cardiac status or safety issues, they often visit the emergency department or the clinic for an unscheduled visit. These planned and unplanned visits create a great burden on healthcare providers. Internet-based remote device interrogation systems, allowing physician's remote access to patients' data, are being proposed for reducing routine and interim visits and for earlier detection and notification of alert conditions.

Conditions

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Heart Failure Sudden Cardiac Death Implantable Defibrillator

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Remote Arm

The patients in Remote arm will receive a Medtronic CareLink Monitor to perform remote interrogation and transmission of ICD data. The remote arm ICD will be programmed to transmit over the CareLink Network.

The Medtronic CareLink system (Minneapolis, MN, USA).

Intervention Type DEVICE

The Medtronic CareLink system(Minneapolis, MN, USA)includes a patient monitor plugged into a standard analog telephone connection, and a lightweight wand to communicate with the implanted device. Interrogation of the device and transmission of the data occur when the patient places the wand over the implanted device. The system uses radio frequency telemetry for wireless automatic communication. This allows for data transmission without patient intervention and enables automatic transmissions at pre-specified routine intervals as well as alert-based downloads.The system can transmit data in case of programmable conditions on diagnostic variables, arrhythmias, delivered ICD therapies, battery/lead issues, and alert the physician via phone or e-mail. The patient's information is sent to a secure Network server via the telephone connection and clinical staff can review device information.Available data are equivalent to that which can be retrieved at an in-office visit.

Implantable defibrillator patients

Heart failure patients implanted with a wireless-transmission-enabled ICD.

The Medtronic CareLink system (Minneapolis, MN, USA).

Intervention Type DEVICE

The Medtronic CareLink system(Minneapolis, MN, USA)includes a patient monitor plugged into a standard analog telephone connection, and a lightweight wand to communicate with the implanted device. Interrogation of the device and transmission of the data occur when the patient places the wand over the implanted device. The system uses radio frequency telemetry for wireless automatic communication. This allows for data transmission without patient intervention and enables automatic transmissions at pre-specified routine intervals as well as alert-based downloads.The system can transmit data in case of programmable conditions on diagnostic variables, arrhythmias, delivered ICD therapies, battery/lead issues, and alert the physician via phone or e-mail. The patient's information is sent to a secure Network server via the telephone connection and clinical staff can review device information.Available data are equivalent to that which can be retrieved at an in-office visit.

Interventions

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The Medtronic CareLink system (Minneapolis, MN, USA).

The Medtronic CareLink system(Minneapolis, MN, USA)includes a patient monitor plugged into a standard analog telephone connection, and a lightweight wand to communicate with the implanted device. Interrogation of the device and transmission of the data occur when the patient places the wand over the implanted device. The system uses radio frequency telemetry for wireless automatic communication. This allows for data transmission without patient intervention and enables automatic transmissions at pre-specified routine intervals as well as alert-based downloads.The system can transmit data in case of programmable conditions on diagnostic variables, arrhythmias, delivered ICD therapies, battery/lead issues, and alert the physician via phone or e-mail. The patient's information is sent to a secure Network server via the telephone connection and clinical staff can review device information.Available data are equivalent to that which can be retrieved at an in-office visit.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patient with left ventricular systolic dysfunction, left ventricular ejection fraction ≤35%, as documented at the moment of ICD implant;
* Patient implanted with a wireless-transmission-enabled Medtronic ICD or CRT-D;
* Patient must be able and willing to replace regularly-scheduled in-office routine follow-ups with remote follow-ups;
* Patient must be able to attend all required follow-up visits at the study center.

Exclusion Criteria

* Patient is less than 18 years of age;
* Patient is unwilling or unable to sign an informed consent;
* Patient life expectancy is less than 12 months;
* Patient is participating in another clinical study that may have an impact on the study endpoints.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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CEFRIEL, Milan Italy

UNKNOWN

Sponsor Role collaborator

Politecnico di Milano

OTHER

Sponsor Role collaborator

Medtronic Italia

INDUSTRY

Sponsor Role collaborator

Regione Lombardia

OTHER

Sponsor Role lead

Responsible Party

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Azienda Ospedaliera San Carlo Borromeo

Locations

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Azienda Ospedaliera Spedali Civili

Brescia, , Italy

Site Status RECRUITING

Azienda Ospedaliera Niguarda Ca' Granda

Milan, , Italy

Site Status ENROLLING_BY_INVITATION

Azienda Ospedaliera San Carlo Borromeo

Milan, , Italy

Site Status ENROLLING_BY_INVITATION

IRCCS Auxologico Italiano Ospedale S. Luca

Milan, , Italy

Site Status RECRUITING

IRCCS San Raffaele

Milan, , Italy

Site Status NOT_YET_RECRUITING

IRCCS Policlinico San Matteo

Pavia, , Italy

Site Status ENROLLING_BY_INVITATION

Countries

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Italy

Central Contacts

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Maurizio Marzegalli

Role: CONTACT

+390240222312

Facility Contacts

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Antonio Curnis

Role: primary

Giovanni B. Perego

Role: primary

Giancarlo Parati

Role: backup

Alessia Pappone

Role: primary

References

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Zanaboni P, Landolina M, Marzegalli M, Lunati M, Perego GB, Guenzati G, Curnis A, Valsecchi S, Borghetti F, Borghi G, Masella C. Cost-utility analysis of the EVOLVO study on remote monitoring for heart failure patients with implantable defibrillators: randomized controlled trial. J Med Internet Res. 2013 May 30;15(5):e106. doi: 10.2196/jmir.2587.

Reference Type DERIVED
PMID: 23722666 (View on PubMed)

Landolina M, Perego GB, Lunati M, Curnis A, Guenzati G, Vicentini A, Parati G, Borghi G, Zanaboni P, Valsecchi S, Marzegalli M. Remote monitoring reduces healthcare use and improves quality of care in heart failure patients with implantable defibrillators: the evolution of management strategies of heart failure patients with implantable defibrillators (EVOLVO) study. Circulation. 2012 Jun 19;125(24):2985-92. doi: 10.1161/CIRCULATIONAHA.111.088971. Epub 2012 May 24.

Reference Type DERIVED
PMID: 22626743 (View on PubMed)

Marzegalli M, Landolina M, Lunati M, Perego GB, Pappone A, Guenzati G, Campana C, Frigerio M, Parati G, Curnis A, Colangelo I, Valsecchi S. Design of the evolution of management strategies of heart failure patients with implantable defibrillators (EVOLVO) study to assess the ability of remote monitoring to treat and triage patients more effectively. Trials. 2009 Jun 18;10:42. doi: 10.1186/1745-6215-10-42.

Reference Type DERIVED
PMID: 19538734 (View on PubMed)

Other Identifiers

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RFPS-2006-2-335243-UO RL

Identifier Type: -

Identifier Source: org_study_id

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