Adaptive Cardiac Resynchronization Therapy Study

NCT ID: NCT00980057

Last Updated: 2018-10-16

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

522 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-10-01

Study Completion Date

2012-03-08

Brief Summary

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The purpose of this study is to demonstrate the AdaptivCRT algorithm is at least as good as manual echo based optimization in regard to patient outcomes and cardiac performance

Detailed Description

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The trial has 3 primary end points:

* to demonstrate that over 6-month follow-up, the proportion of the patients improved in the aCRT arm is at least as high as in the Echo arm
* to demonstrate that cardiac function is similar when using aCRT versus echo-optimized settings
* to demonstrate that aCRT does not result in inappropriate AV or VV delay settings

Conditions

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Heart Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Adaptive CRT (aCRT) arm

Intervention: Cardiac resynchronization therapy (CRT-D) with Adaptive CRT algorithm ON

Group Type EXPERIMENTAL

Adaptive CRT (aCRT)

Intervention Type DEVICE

Adaptive CRT (aCRT) is an algorithm, which provides ambulatory adjustment of pacing configuration (LV-only or BiV) and AV and VV delays based on periodic automatic evaluation of electrical conduction to optimize cardiac function

Echo-optimized arm

Intervention: Cardiac resynchronization therapy (CRT-D) with standard biventricular pacing (Adaptive CRT algorithm OFF)

Group Type ACTIVE_COMPARATOR

Echo

Intervention Type DEVICE

Standard BiV pacing with settings optimized using a standardized echocardiographic protocol

Interventions

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Adaptive CRT (aCRT)

Adaptive CRT (aCRT) is an algorithm, which provides ambulatory adjustment of pacing configuration (LV-only or BiV) and AV and VV delays based on periodic automatic evaluation of electrical conduction to optimize cardiac function

Intervention Type DEVICE

Echo

Standard BiV pacing with settings optimized using a standardized echocardiographic protocol

Intervention Type DEVICE

Other Intervention Names

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aCRT Control

Eligibility Criteria

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Inclusion Criteria

* Subject is willing to sign and date the study Informed Consent form
* Subject is at least 18 years of age (or older, if required by local law)
* Subject is expected to remain available for at least six months of follow-up visits
* Subject is indicated for a study device that will be implanted within 30 days after signing the Informed Consent form
* Subject has an intrinsic QRS duration greater than or equal to 120 milliseconds (documented within 30 days prior to enrollment)
* Subject has a left ventricular ejection fraction less than or equal to 35 percent (method per physician discretion) (documented within 180 days prior to enrollment)
* Subject is diagnosed with New York Heart Association (NYHA) class III or IV (within 30 days prior to enrollment) despite optimal medical therapy which is defined as: ACE-inhibitor (Angiotensin-Converting Enzyme) or Angiotensin II Receptor Blocker (ARB), if tolerated, for at least one month prior to implant, AND beta-blocker for at least three months preceding implant, if tolerated, and stable for one month, OR subject has an urgent medical need for an implantable cardioverter defibrillator (ICD) that precludes waiting the one or three months for the medication requirements for ACE inhibitor, ARB or beta-blocker

Exclusion Criteria

* Subject has chronic (permanent) atrial arrhythmias for which pharmacological therapy and/or cardioversion have been unsuccessful or have not been attempted
* Subject has existing CRT system
* Subject has non-intact or unstable leads
* Subject has medical conditions that would limit study participation (per physician discretion)
* Subject is enrolled in one or more concurrent studies that would confound the study results of this study as determined by Medtronic
* Subject has unstable angina, or experienced an acute myocardial infarction (MI) or received coronary artery revascularization (CABG) or coronary angioplasty (PTCA) (documented within 30 days prior to enrollment)
* Subject has a mechanical right heart valve or is scheduled to undergo valve repair or valve replacement during the course of the study
* Subject is post-heart transplant (subjects on the heart transplant list for the first time are not excluded)
* Subject has a limited life expectancy that would not allow completion of the 6 month visit
* Subject is pregnant (In the United States, all women of child-bearing potential must undergo a pregnancy test within seven days prior to aCRT download into device)
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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Adaptive CRT Trial Leader

Role: STUDY_CHAIR

Medtronic

Locations

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Huntsville, Alabama, United States

Site Status

Anchorage, Alaska, United States

Site Status

Phoenix, Arizona, United States

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Little Rock, Arkansas, United States

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Glendale, California, United States

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San Bernardino, California, United States

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San Diego, California, United States

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Colorado Springs, Colorado, United States

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Denver, Colorado, United States

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Clearwater, Florida, United States

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Jacksonville, Florida, United States

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Orlando, Florida, United States

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Pensacola, Florida, United States

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Augusta, Georgia, United States

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Barrington, Illinois, United States

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Fort Wayne, Indiana, United States

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Davenport, Iowa, United States

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Des Moines, Iowa, United States

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Kansas City, Kansas, United States

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Louisville, Kentucky, United States

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Takoma Park, Maryland, United States

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Burlington, Massachusetts, United States

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Detroit, Michigan, United States

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Grand Rapids, Michigan, United States

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Saginaw, Michigan, United States

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Saint Cloud, Minnesota, United States

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Saint Louis Park, Minnesota, United States

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Saint Paul, Minnesota, United States

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Tupelo, Mississippi, United States

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Kansas City, Missouri, United States

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St Louis, Missouri, United States

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Lincoln, Nebraska, United States

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Morristown, New Jersey, United States

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Brooklyn, New York, United States

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Buffalo, New York, United States

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New York, New York, United States

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Charlotte, North Carolina, United States

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Greensboro, North Carolina, United States

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Cleveland, Ohio, United States

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Columbus, Ohio, United States

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Oklahoma City, Oklahoma, United States

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Portland, Oregon, United States

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Charleston, South Carolina, United States

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Spartanburg, South Carolina, United States

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Chattanooga, Tennessee, United States

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Austin, Texas, United States

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Dallas, Texas, United States

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Tyler, Texas, United States

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Burlington, Vermont, United States

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Norfolk, Virginia, United States

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Richmond, Virginia, United States

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Bellingham, Washington, United States

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Spokane, Washington, United States

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Morgantown, West Virginia, United States

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Milwaukee, Wisconsin, United States

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Adelaide, , Australia

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Camperdown, , Australia

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Chermside, , Australia

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Darlinghurst, , Australia

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Perth, , Australia

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Spring Hill, , Australia

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Linz, , Austria

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Genk, , Belgium

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Leuven, , Belgium

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Yvoir, , Belgium

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Calgary, , Canada

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London, , Canada

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Montreal, , Canada

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Newmarket, , Canada

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Ottawa, , Canada

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Victoria, , Canada

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Aalborg, , Denmark

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Aarhus, , Denmark

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Copenhagen, , Denmark

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Odense, , Denmark

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Bochum, , Germany

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Hamburg, , Germany

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Lüdenscheid, , Germany

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Reinbek, , Germany

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Trier, , Germany

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Athens, , Greece

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Hong Kong, , Hong Kong

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Budapest, , Hungary

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Milan, , Italy

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Pavia, , Italy

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Pedara, , Italy

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Rozzano, , Italy

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Osaka, , Japan

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Tokyo, , Japan

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Tsukuba, , Japan

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Nijmegen, , Netherlands

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Rotterdam, , Netherlands

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Bergen, , Norway

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Oslo, , Norway

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Tyumen, , Russia

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Riyadh, , Saudi Arabia

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Belgrade, , Serbia

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Kamenitz, , Serbia

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Niš, , Serbia

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Albacete, , Spain

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Madrid, , Spain

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Majadahonda, , Spain

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Vitoria-Gasteiz, , Spain

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Lund, , Sweden

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Stockholm, , Sweden

Site Status

Countries

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United States Australia Austria Belgium Canada Denmark Germany Greece Hong Kong Hungary Italy Japan Netherlands Norway Russia Saudi Arabia Serbia Spain Sweden

References

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Gasparini M, Birnie D, Lemke B, Aonuma K, Lee KL, Gorcsan J 3rd, Landolina M, Klepfer R, Meloni S, Cicconelli M, Grammatico A, Martin DO. Adaptive Cardiac Resynchronization Therapy Reduces Atrial Fibrillation Incidence in Heart Failure Patients With Prolonged AV Conduction: The Adaptive CRT Randomized Trial. Circ Arrhythm Electrophysiol. 2019 May;12(5):e007260. doi: 10.1161/CIRCEP.119.007260. No abstract available.

Reference Type DERIVED
PMID: 30991823 (View on PubMed)

Birnie D, Hudnall H, Lemke B, Aonuma K, Lee KL, Gasparini M, Gorcsan J 3rd, Cerkvenik J, Martin DO. Continuous optimization of cardiac resynchronization therapy reduces atrial fibrillation in heart failure patients: Results of the Adaptive Cardiac Resynchronization Therapy Trial. Heart Rhythm. 2017 Dec;14(12):1820-1825. doi: 10.1016/j.hrthm.2017.08.017. Epub 2017 Sep 9.

Reference Type DERIVED
PMID: 28893549 (View on PubMed)

Yamasaki H, Lustgarten D, Cerkvenik J, Birnie D, Gasparini M, Lee KL, Sekiguchi Y, Varma N, Lemke B, Starling RC, Aonuma K. Adaptive CRT in patients with normal AV conduction and left bundle branch block: Does QRS duration matter? Int J Cardiol. 2017 Aug 1;240:297-301. doi: 10.1016/j.ijcard.2017.04.036. Epub 2017 Apr 12.

Reference Type DERIVED
PMID: 28416247 (View on PubMed)

Starling RC, Krum H, Bril S, Tsintzos SI, Rogers T, Hudnall JH, Martin DO. Impact of a Novel Adaptive Optimization Algorithm on 30-Day Readmissions: Evidence From the Adaptive CRT Trial. JACC Heart Fail. 2015 Jul;3(7):565-572. doi: 10.1016/j.jchf.2015.03.001. Epub 2015 Jun 10.

Reference Type DERIVED
PMID: 26071616 (View on PubMed)

Birnie D, Lemke B, Aonuma K, Krum H, Lee KL, Gasparini M, Starling RC, Milasinovic G, Gorcsan J 3rd, Houmsse M, Abeyratne A, Sambelashvili A, Martin DO. Clinical outcomes with synchronized left ventricular pacing: analysis of the adaptive CRT trial. Heart Rhythm. 2013 Sep;10(9):1368-74. doi: 10.1016/j.hrthm.2013.07.007. Epub 2013 Jul 11.

Reference Type DERIVED
PMID: 23851059 (View on PubMed)

Krum H, Lemke B, Birnie D, Lee KL, Aonuma K, Starling RC, Gasparini M, Gorcsan J, Rogers T, Sambelashvili A, Kalmes A, Martin D. A novel algorithm for individualized cardiac resynchronization therapy: rationale and design of the adaptive cardiac resynchronization therapy trial. Am Heart J. 2012 May;163(5):747-752.e1. doi: 10.1016/j.ahj.2012.02.007.

Reference Type DERIVED
PMID: 22607850 (View on PubMed)

Other Identifiers

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Adaptive CRT

Identifier Type: -

Identifier Source: org_study_id

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