Neural Cardiac Therapy for Heart Failure Study (NECTAR-HF)

NCT ID: NCT01385176

Last Updated: 2025-12-04

Study Results

Results available

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Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

118 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-09-21

Study Completion Date

2026-06-30

Brief Summary

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The NECTAR-HF feasibility trial is designed to evaluate the application of right vagal nerve stimulation in heart failure patients with a New York Heart Association Class III, an ejection fraction equal to or less than 35 %, and a narrow QRS duration equal to or less than 130 ms.

Detailed Description

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The objectives of this study are to assess the impact of right vagal nerve stimulation on left ventricular remodeling, functional capacity, quality of life, and other measures in heart failure patients over a 6-month period. In addition, the study will assess the safety of the NECTAR-HF study system over an 18-month period.

Conditions

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Heart Failure Congestive Heart Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Patients were randomized in a 2:1 ratio to receive therapy (VNS ON) or control (VNS OFF) for a 6-month period. The primary endpoint was the change in LVend systolic diameter (LVESD) at 6 months for control vs. therapy, with secondary endpoints of other echocardiography measurements, exercise capacity, quality-of-life assessments, 24-h Holter, and circulating biomarkers.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Therapy

Implant of investigational device system for vagus nerve stimulation. Patients were randomized in a 2 : 1 ratio to receive therapy (VNS ON) or control (VNS OFF) for a 6-month period.

The experimental arm was receiving vagus nerve stimulation during the first 6 months after implant.

Titration during the randomization phase with delivery of highest tolerable by patient stimulation current.

Blood Draw before implant and 6 months after implant. Titration after the randomization phase with adjustments of the chronically highest tolearble by patient current.

Group Type EXPERIMENTAL

Implant of investigational device system

Intervention Type DEVICE

Vagus nerve stimulation lead was wrapped around the right cervical vagus nerve and then connected to a stimulator permanently implanted in the right pectoral region.

Titration during the randomization phase

Intervention Type PROCEDURE

Amplitude of the chronically delivered vagus nerve stimulation in the experimental arm was adjusted to the highest tolerable by patient value. No chronically delivered vagus nerve stimulation in the control arm during the randomization phase.

Titration after the randomization phase

Intervention Type PROCEDURE

Amplitude of the chronically delivered vagus nerve stimulation was adjusted to the highest tolerable by patient value in all patients in both arms of the study.

Blood Draw

Intervention Type DIAGNOSTIC_TEST

Blood draw before implant and 6 months after implant at the end of the randomization phase.

Control

Implant of investigational device system for vagus nerve stimulation. Control group was implanted with study system like the experimental arm, but was not receiving experimental vagus nerve stimulation therapy during the first 6 months after implant. 6-month after implant a cross-over took place and the control arm also started to receive experimental vagus nerve stimulation.

Blood Draw before implant and 6 months after implant. Titration after the randomization phase with adjustments of the chronically highest tolearble by patient current.

Group Type SHAM_COMPARATOR

Implant of investigational device system

Intervention Type DEVICE

Vagus nerve stimulation lead was wrapped around the right cervical vagus nerve and then connected to a stimulator permanently implanted in the right pectoral region.

Titration after the randomization phase

Intervention Type PROCEDURE

Amplitude of the chronically delivered vagus nerve stimulation was adjusted to the highest tolerable by patient value in all patients in both arms of the study.

Blood Draw

Intervention Type DIAGNOSTIC_TEST

Blood draw before implant and 6 months after implant at the end of the randomization phase.

Interventions

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Implant of investigational device system

Vagus nerve stimulation lead was wrapped around the right cervical vagus nerve and then connected to a stimulator permanently implanted in the right pectoral region.

Intervention Type DEVICE

Titration during the randomization phase

Amplitude of the chronically delivered vagus nerve stimulation in the experimental arm was adjusted to the highest tolerable by patient value. No chronically delivered vagus nerve stimulation in the control arm during the randomization phase.

Intervention Type PROCEDURE

Titration after the randomization phase

Amplitude of the chronically delivered vagus nerve stimulation was adjusted to the highest tolerable by patient value in all patients in both arms of the study.

Intervention Type PROCEDURE

Blood Draw

Blood draw before implant and 6 months after implant at the end of the randomization phase.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Age 18 or above, and of legal age to give informed consent specific to national laws
* Willing and capable of providing informed consent
* Capable of participating in all testing associated with this clinical investigation
* Stable symptomatic heart failure NYHA class II-III
* Left ventricular (LV) ejection fraction equal or smaller than 35 %
* Left ventricular end diastolic diameter (LVEDD) of 5.5 cm or greater
* Prescribed to optimal pharmacologic therapy

Exclusion Criteria

* QRS larger than 130 ms
* Patients who have been hospitalized for heart failure and who required the use of HF IV therapy within 30 days before enrollment
* Patients unable to tolerate anesthesia required for implant
* Patients with unstable angina, myocardial infarction, PTCA, coronary artery bypass graft, cerebral vascular accident, or transient ischemic attack within previous 90 days before enrollment
* Patients whose primary cause of heart failure is mitral or aortic valve disease, with a severe classification
* Patients with persistent or permanent atrial fibrillation within 90 days prior to enrollment
* Pacemaker indicated patients
* Patients whose heart failure is due to congenital heart disease
* Patients who have started treatment for sleep apnea or sleep disordered breathing with therapies to maintain airway patency (e.g., CPAP, Bi-PAP,APAP) with or without oxygen supplementation within the previous 6 months prior to enrollment
* Patients with hypertrophic obstructive cardiomyopathy or infiltrative cardiomyopathy (e.g. amyloidosis, sarcoidosis)
* Patients with documented chronic obstructive lung disease
* Patients on or indicated for renal dialysis
* Type 1 diabetic patients
* Type 2 diabetic patients that have been treated with insulin for more than 5 years prior to enrollment
* Patients with a life expectancy of less than 12 months per physician judgment
* Patients involved in any concurrent clinical investigation
* Women of childbearing potential who are or might be pregnant at the time of the study or breastfeeding
* Patients with a prior cardiac transplant or expecting a heart transplant operation within the next 12 months
* Patients with a prior vagotomy
* Patients with prior or existing vagal nerve stimulation treatment
* Patients implanted with any active implantable medical device other than a left sided single or dual chamber implantable cardioverter defibrillator (ICD) with bipolar sensing, or a left sided CRT device with each sensing channel programmed to either bipolar sensing or no sensing. All CRT patients must have had CRT for at least 1 year prior to enrollment. The total number of CRT patients will not exceed 30
* Patients with locally implanted semi-/permanent devices such as vascular catheters, etc. that would interfere with the NECTAR-HF study system
* Patients with previously implanted devices on the right side that became infected before removal
* Patients with previous neck surgery and resultant scar formation that interferes with the ability to implant the study system on the right side of the neck (Thyroid/parathyroid, carotid artery etc)
* Patients with known recurrent nerve paralysis
* Patients who have undergone radiotherapy for thyroid disease/cancer
* Patients who have existing or prior tracheotomy
* Patients with severe vertebral cervical disease and limited mobility in the neck; includes those that frequently wear a brace
* Patients with carotid murmur/vascular bruit/carotid artery lesion
* Patients with known/suspected vascular malformation in carotid/vertebral circulatory bed
* Patients who are likely to need an MRI of the neck area because of previous medical conditions
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Boston Scientific Corporation

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Faiez Zannad, M.D.

Role: PRINCIPAL_INVESTIGATOR

Centre d'Investigation Clinique (CIC), Batiment Louis Mathieu, CHU de Nancy

Locations

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UMC Utrecht

Utrecht, , Netherlands

Site Status

UCL Bruxelles

Brussels, , Belgium

Site Status

Nemocnice Na Homolce

Prague, , Czechia

Site Status

Centre d'Investigation Clinique Pierre Drouin, CHU de Nancy

Vandœuvre-lès-Nancy, Nancy, France

Site Status

CHRU de Lille - Hôpital Cardiologique

Lille, , France

Site Status

Immanuel Klinikum Bernau Herzzentrum Brandenburg

Bernau bei Berlin, Brandenburg, Germany

Site Status

Universitätsmedizin Göttingen

Göttingen, , Germany

Site Status

Universitäres Herzzentrum GmbH, Universitätsklinikum Hamburg-Eppendorf

Hamburg, , Germany

Site Status

Universitätsklinikum Leipzig

Leipzig, , Germany

Site Status

Azienda Ospedaliera Niguarda Cà Granda

Milan, , Italy

Site Status

A. O. Dei Colli - Monaldi

Napoli, , Italy

Site Status

Policlinico San Matteo

Pavia, , Italy

Site Status

Catharina Ziekenhuis Eindhoven

Eindhoven, , Netherlands

Site Status

Clínica Universitaria de Navarra, Avenida Pio XII s/n

Pamplona, Navarre, Spain

Site Status

Hospital Clinic de Barcelona

Barcelona, , Spain

Site Status

Hospital Doce de Octubre

Madrid, , Spain

Site Status

University Hospitals Bristol, NHS Foundation Trust

Bristol, England, United Kingdom

Site Status

Liverpool Heart and Chest Hospital, NHS Foundation Trust

Liverpool, England, United Kingdom

Site Status

The Heart Hospital, University College London Hospitals, NHS Foundation Trust

London, England, United Kingdom

Site Status

Imperial College Healthcare NHS Trust, St. Mary's Hospital

London, England, United Kingdom

Site Status

King's College Hospital NHS Foundation Trust

London, , United Kingdom

Site Status

Countries

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Belgium Czechia France Germany Italy Netherlands Spain United Kingdom

References

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De Ferrari GM, Tuinenburg AE, Ruble S, Brugada J, Klein H, Butter C, Wright DJ, Schubert B, Solomon S, Meyer S, Stein K, Ramuzat A, Zannad F. Rationale and study design of the NEuroCardiac TherApy foR Heart Failure Study: NECTAR-HF. Eur J Heart Fail. 2014 Jun;16(6):692-9. doi: 10.1002/ejhf.80. Epub 2014 May 20.

Reference Type BACKGROUND
PMID: 24846173 (View on PubMed)

Zannad F, De Ferrari GM, Tuinenburg AE, Wright D, Brugada J, Butter C, Klein H, Stolen C, Meyer S, Stein KM, Ramuzat A, Schubert B, Daum D, Neuzil P, Botman C, Castel MA, D'Onofrio A, Solomon SD, Wold N, Ruble SB. Chronic vagal stimulation for the treatment of low ejection fraction heart failure: results of the NEural Cardiac TherApy foR Heart Failure (NECTAR-HF) randomized controlled trial. Eur Heart J. 2015 Feb 14;36(7):425-33. doi: 10.1093/eurheartj/ehu345. Epub 2014 Aug 31.

Reference Type RESULT
PMID: 25176942 (View on PubMed)

De Ferrari GM, Stolen C, Tuinenburg AE, Wright DJ, Brugada J, Butter C, Klein H, Neuzil P, Botman C, Castel MA, D'Onofrio A, de Borst GJ, Solomon S, Stein KM, Schubert B, Stalsberg K, Wold N, Ruble S, Zannad F. Long-term vagal stimulation for heart failure: Eighteen month results from the NEural Cardiac TherApy foR Heart Failure (NECTAR-HF) trial. Int J Cardiol. 2017 Oct 1;244:229-234. doi: 10.1016/j.ijcard.2017.06.036. Epub 2017 Jun 10.

Reference Type RESULT
PMID: 28663046 (View on PubMed)

Other Identifiers

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NECTAR-1109

Identifier Type: -

Identifier Source: org_study_id

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