MIRACLE EF Clinical Study

NCT ID: NCT01735916

Last Updated: 2017-11-06

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

44 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-12-31

Study Completion Date

2014-03-31

Brief Summary

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This study is looking at whether the electrical treatment provided by a special type of pacemaker called a Cardiac Resynchronization Therapy (CRT) pacemaker may keep a patient's heart failure from getting worse. When the lower heart chambers (i.e. ventricles) are electrically paced to beat together by the CRT pacemaker, blood may be pumped to the body more efficiently.

The CRT pacemaker being studied in this clinical trial is approved by the US Food and Drug Administration (FDA) for patients with moderate to severe heart failure, whose hearts pump blood inefficiently. In the MIRACLE EF study, patients who have heart failure with slightly less inefficient hearts will be observed to see if the electrical pacing treatment is better than not getting the treatment. This study is being conducted to support FDA approval of this type of pacemaker for people whose heart failure is less inefficient.

Detailed Description

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Medtronic, Inc. is sponsoring the MIRACLE EF study, a prospective, randomized, controlled, double-blinded, global multi-center, Cardiac Resynchronization Therapy (CRT) in Heart Failure (HF) clinical study. The purpose of this study is to evaluate market released CRT pacemaker (CRT-P) devices in symptomatic HF patients with less severe left ventricular systolic dysfunction, specifically patients with reduced left ventricular ejection fraction (LVEF) in the range of 36% to 50%. This study will support expansion of indications for CRT worldwide. The outcome of this study is expected to support modification of existing U.S. and Japanese labeling for Medtronic's implantable CRT-P devices and to provide further evidence to support changes to cardiology practice guidelines (ACC/AHA, ESC guidelines) regarding the use of CRT in patients with mild to moderate HF.

Following enrollment and the baseline assessment, eligible subjects will be implanted with a CRT-P system and randomized in a 2:1 fashion to either treatment (CRT-P ON) or control (CRT-P OFF) groups. Study subjects will be followed for a minimum of 24 months or until study closure, and will remain in their randomized groups until their 60 month visit or until the study is stopped, whichever comes first. The effectiveness of CRT-P in this population will be assessed using a composite endpoint of time to first event, with event defined as All-cause mortality or HF Event. To assess the safety of CRT-P in this population, the primary safety endpoint will measure freedom from system-related complications at 6 months post-implant.

Conditions

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Congestive Heart Failure Left Bundle Branch Block Systolic Heart Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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CRT-P ON

CRT-P Implant CRT-P ON

Group Type ACTIVE_COMPARATOR

CRT-P Implant

Intervention Type DEVICE

The Medtronic Consulta CRT-P (models C3TR01, C4TR011) dual chamber implantable pacemaker with cardiac resynchronization therapy (CRT-P) is a multi-programmable cardiac device that monitors and regulates the patient's heart rate by providing single or dual chamber rate-responsive bradycardia pacing, and sequential biventricular pacing.

The device senses the electrical activity of the patient's heart using the electrodes of the implanted atrial and right ventricular leads. It then analyzes the heart rhythm based on selectable detection parameters. The device responds to bradyarrhythmias by providing bradycardia pacing therapy.

Simultaneous or sequential biventricular pacing is used to provide patients with cardiac resynchronization therapy. The device also provides diagnostic and monitoring information that assists with system evaluation and patient care.

CRT-P OFF

CRT-P Implant CRT-P OFF

Group Type PLACEBO_COMPARATOR

CRT-P Implant

Intervention Type DEVICE

The Medtronic Consulta CRT-P (models C3TR01, C4TR011) dual chamber implantable pacemaker with cardiac resynchronization therapy (CRT-P) is a multi-programmable cardiac device that monitors and regulates the patient's heart rate by providing single or dual chamber rate-responsive bradycardia pacing, and sequential biventricular pacing.

The device senses the electrical activity of the patient's heart using the electrodes of the implanted atrial and right ventricular leads. It then analyzes the heart rhythm based on selectable detection parameters. The device responds to bradyarrhythmias by providing bradycardia pacing therapy.

Simultaneous or sequential biventricular pacing is used to provide patients with cardiac resynchronization therapy. The device also provides diagnostic and monitoring information that assists with system evaluation and patient care.

CRT-P OFF

Intervention Type DEVICE

Device programmed to minimal pacing at 40 beats/minute. Device and arrhythmia diagnostics may remain enabled.

Interventions

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CRT-P Implant

The Medtronic Consulta CRT-P (models C3TR01, C4TR011) dual chamber implantable pacemaker with cardiac resynchronization therapy (CRT-P) is a multi-programmable cardiac device that monitors and regulates the patient's heart rate by providing single or dual chamber rate-responsive bradycardia pacing, and sequential biventricular pacing.

The device senses the electrical activity of the patient's heart using the electrodes of the implanted atrial and right ventricular leads. It then analyzes the heart rhythm based on selectable detection parameters. The device responds to bradyarrhythmias by providing bradycardia pacing therapy.

Simultaneous or sequential biventricular pacing is used to provide patients with cardiac resynchronization therapy. The device also provides diagnostic and monitoring information that assists with system evaluation and patient care.

Intervention Type DEVICE

CRT-P OFF

Device programmed to minimal pacing at 40 beats/minute. Device and arrhythmia diagnostics may remain enabled.

Intervention Type DEVICE

Other Intervention Names

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Cardiac Resynchronization Therapy Pacemaker (CRT-P) Consulta CRT-P C4TR01

Eligibility Criteria

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Inclusion Criteria

* Patient has diagnosis of chronic heart failure \> 90 days in duration
* Has left ventricular ejection fraction (LVEF) between 36% and 50%, inclusive, as documented at baseline or within 30 days prior to enrollment
* Is either: (a) NYHA Class III at enrollment or at baseline OR (b) NYHA Class II at enrollment or at baseline, with a documented hospitalization for HF in the 12 months prior to enrollment OR (c) NYHA Class II at enrollment or at baseline, without a documented hospitalization for HF in the prior 12 months, but with BNP ≥250 pg/ml or NT-proBNP ≥1000 pg/ml
* Has documented left bundle branch block (LBBB) with QRS ≥130ms at baseline or within 30 days prior to enrollment.
* Is in sinus rhythm at time of enrollment or at the baseline visit.
* Has had no additions to or subtractions from non-diuretic heart failure medical therapy within 30 days prior to enrollment
* Is on maximum tolerated (guideline) dosages of medications in ACC/AHA guidelines for HF, Ischemic Heart Disease, Hypertension and AF as appropriate.
* Has signed and dated the study informed consent.
* Is able to receive a pectoral CRT-P implant.
* Is expected to remain available for follow-up visits.
* Is willing and able to comply with the Clinical Investigation Plan.

Exclusion Criteria

* Requires permanent cardiac pacing.
* Indicated for implantable cardioverter defibrillator (ICD), such as for secondary prevention of prior sudden cardiac arrest, related to prior history of ventricular tachycardia and/or ventricular fibrillation.
* Less than 18 years of age, or under a higher minimum age requirement as defined by local law.
* Unstable angina or an acute MI within 40 days prior to enrollment.
* Coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) within the 90 days prior to enrollment.
* Chronic (permanent) atrial arrhythmias. Chronic (permanent) atrial arrhythmias are defined as cases of long-standing atrial fibrillation (e.g., greater than 1 year) in which cardioversion has not been indicated or attempted.
* Cardioversion for atrial fibrillation within 30 days prior to enrollment.
* Treatable pericardial constraint within 30 days prior to enrollment.
* Restrictive (infiltrative) cardiomyopathies, such as amyloidosis, sarcoidosis, or hemochromatosis.
* Enrolled in a concurrent study, with the exception of a study-manager approved study that is strictly observational in nature and does not confound the results of this study (e.g. registries).
* Life expectancy of less than 24 months due to non-cardiac conditions.
* Pregnant, or of childbearing potential and not on a reliable form of birth control.
* CRT-P, pacemaker, ICD or CRT-D device implanted previously, or currently.
* Restrictive, hypertrophic, or reversible cardiomyopathy.
* Mechanical right heart valve.
* Primary valvular disease and is indicated for valve repair or replacement.
* Heart transplant, or is currently on a heart transplant list.
* Significant renal dysfunction, as manifested by serum creatinine level \>2.5 mg/dl or ≥275 μmol/L or estimated glomerular filtration rate (GFR) ≤30 mL/min/1.73 m2, which is documented within the 30 days prior to enrollment or at baseline.
* Significant hepatic dysfunction, as evidenced by a hepatic function panel (serum) \> 3 times upper limit of normal, which is documented within the 30 days prior to enrollment or at baseline.
* Chronic or treatment-resistant severe anemia (hemoglobin \<10.0 g/dL), which is documented within the 30 days prior to enrollment or at baseline.
* On intravenous inotropic drug therapy.
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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Cecilia Linde, MD PhD

Role: STUDY_CHAIR

Karolinska University Hospital

Locations

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John Muir Medical Center, Cor Cardiovascular Specialists, John Muir Medical Center (Concord), John Muir Cardiovascular Institute, Contra Costa Cardiology

Concord, California, United States

Site Status

Scripps Clinic Torrey Pines, Scripps Green Hospital

La Jolla, California, United States

Site Status

VA Greater Los Angeles Healthcare System

Los Angeles, California, United States

Site Status

Eisenhower Desert Cardiology Center, Eisenhower Medical Center Hospital

Rancho Mirage, California, United States

Site Status

Los Robles Medical Center

Thousand Oaks, California, United States

Site Status

Colorado Health Medical Group, Memorial Hospital Colorado Springs

Colorado Springs, Colorado, United States

Site Status

Hartford Hospital

Hartford, Connecticut, United States

Site Status

Bradenton Cardiology, Manatee Memorial Hospital

Bradenton, Florida, United States

Site Status

Melbourne Internal Medicine Associates / Century Research Associates, Holmes Regional Medical Center Hospital

Melbourne, Florida, United States

Site Status

Aventura Hospital and Medical Center, Hospital Corporation of America (Aventura), Hospital Corporation of America (Miami)

Miami, Florida, United States

Site Status

Emory University Hospital Midtown

Atlanta, Georgia, United States

Site Status

WellStar Cobb Hospital, WellStar Kennestone Hospital

Marietta, Georgia, United States

Site Status

Advocate Medical Group, Midwest Heart Specialists (Elmhurst), Elmhurst Memorial Hospital

Elmhurst, Illinois, United States

Site Status

Advocate Christ Medical Center

Oak Lawn, Illinois, United States

Site Status

Prairie Education and Research Cooperative (Springfield IL), Prairie Education Research Consultants, St. John's Hospital (Springfield IL)

Springfield, Illinois, United States

Site Status

McFarland Clinic PC

Ames, Iowa, United States

Site Status

Cardiovascular Medicine PC (Davenport IA), Trinity (Rock Island), Midwest Cardiovascular Research Foundation, Trinity Bettendorf Hospital

Davenport, Iowa, United States

Site Status

Midwest Cardiology Associates PA, Menorah Medical Center, Centerpoint Medical Center, Overland Park Regional Medical Center Hospital

Overland Park, Kansas, United States

Site Status

Lahey Hospital & Medical Center

Burlington, Massachusetts, United States

Site Status

Sparrow Clinical Research Institute, McLaren Hospital

Lansing, Michigan, United States

Site Status

William Beaumont Hospital

Royal Oak, Michigan, United States

Site Status

HealthEast HeartCare Clinic at Saint John's

Maplewood, Minnesota, United States

Site Status

Minneapolis Heart Institute Foundation

Minneapolis, Minnesota, United States

Site Status

The Cardiovascular Center, University of Minnesota Medical Center Fairview

Minneapolis, Minnesota, United States

Site Status

North Memorial Heart and Vascular Institute, North Memorial Medical Center

Robbinsdale, Minnesota, United States

Site Status

CentraCare Heart & Vascular Center

Saint Cloud, Minnesota, United States

Site Status

Minneapolis Heart Institute Foundation, Mercy Hospital (Coon Rapids MN), Unity Hospital, United Hospital, Abbott Northwestern Hospital

Saint Paul, Minnesota, United States

Site Status

Missouri Cardiovascular Specialists, Boone Hospital Center

Columbia, Missouri, United States

Site Status

Cardiovascular Consultants, P.C., Saint Luke's Hospital, Mid America Heart Institute (MAHI)

Kansas City, Missouri, United States

Site Status

Mercy Heart and Vascular Clinic, Mercy Hospital St. Louis

St Louis, Missouri, United States

Site Status

Glacier View Research Institute Cardiology, Duplicate Glacier View Research Institute Hospital

Kalispell, Montana, United States

Site Status

Hackensack University Medical Center

Hackensack, New Jersey, United States

Site Status

New Mexico Heart Institute PA

Albuquerque, New Mexico, United States

Site Status

Buffalo Heart Group LLP, Buffalo Heart Group LLC-Cheektowaga, Mercy Hospital of Buffalo

Buffalo, New York, United States

Site Status

Stony Brook Islandia Clinic, Stony Brook Hauppauge, Stony Brook University Medical Center

Stony Brook, New York, United States

Site Status

Duke University Medical Center (DUMC)

Durham, North Carolina, United States

Site Status

Durham VA Medical Center, Duke University Medical Center

Durham, North Carolina, United States

Site Status

FirstHealth Cardiology Services, FirstHealth Moore Regional Hospital

Pinehurst, North Carolina, United States

Site Status

Forsyth Medical Center, Novant Clinical Research Institute

Winston-Salem, North Carolina, United States

Site Status

Sanford Medical Center

Fargo, North Dakota, United States

Site Status

Lindner Research Center, The Christ Hospital

Cincinnati, Ohio, United States

Site Status

Ohio State University, Ohio State University Medical Center The Richard M Ross Heart Hospital

Columbus, Ohio, United States

Site Status

Mercy Hospital Fairfield, Mercy Hospital Anderson, The Jewish Hospital

Fairfield, Ohio, United States

Site Status

Integris Baptist Medical Center

Oklahoma City, Oklahoma, United States

Site Status

Samaritan Health Services

Corvallis, Oregon, United States

Site Status

Oregon Health & Science University

Portland, Oregon, United States

Site Status

Lehigh Valley Hospital

Allentown, Pennsylvania, United States

Site Status

Mercer Bucks Cardiology, Saint Mary Medical Center, Arrhythmia Institute Hospital

Newtown, Pennsylvania, United States

Site Status

University of Pittsburgh Medical Center UPMC Presbyterian

Pittsburgh, Pennsylvania, United States

Site Status

Cardiac Diagnostic Associates, York Hospital

York, Pennsylvania, United States

Site Status

Pee Dee Cardiology, McLeod Regional Medical Center

Florence, South Carolina, United States

Site Status

Arrhythmia Consultants (Greenville SC), Greenville Memorial Hospital

Greenville, South Carolina, United States

Site Status

Cardiology Consultants PA, Spartanburg Regional Hospital

Spartanburg, South Carolina, United States

Site Status

Wellmont CVA Heart Institute, Wellmont Holston Valley Medical Center

Kingsport, Tennessee, United States

Site Status

Centennial Heart Cardiovascular Consultants LLC

Nashville, Tennessee, United States

Site Status

Saint Thomas Research Institute LLC, Baptist Hospital

Nashville, Tennessee, United States

Site Status

Amarillo Heart Group, Northwest Texas Hospital

Amarillo, Texas, United States

Site Status

Cardiology Center of Amarillo, Northwest Texas Hospital

Amarillo, Texas, United States

Site Status

HeartPlace Cardiology Research, Baylor Heart & Vascular Hospital

Dallas, Texas, United States

Site Status

Methodist DeBakey Cardiology Associates, The Methodist Hospital

Houston, Texas, United States

Site Status

Baylor Research Institute (Plano TX), Legacy Heart Center

Plano, Texas, United States

Site Status

Scott & White Hospital

Temple, Texas, United States

Site Status

Fletcher Allen Medical Center

Burlington, Vermont, United States

Site Status

University of Virginia (UVA) Medical Center

Charlottesville, Virginia, United States

Site Status

Centra Medical Group Stroobants Cardiovascular Center, Centra Lynchburg General Hospital

Lynchburg, Virginia, United States

Site Status

Richmond Cardiology Associates, Bon Secours Memorial Regional Medical Center

Mechanicsville, Virginia, United States

Site Status

Sentara Cardiovascular Specialist, Sentara Williamsburg Regional Medical Center, Sentara Norfolk General Hospital, Sentara Virginia Beach General Hospital

Norfolk, Virginia, United States

Site Status

Harborview Medical Center, University of Washington (UW) Medical Center

Seattle, Washington, United States

Site Status

Aurora Cardiovascular Services, Aurora Sinai Medical Center, Aurora Saint Luke's Medical Center

Milwaukee, Wisconsin, United States

Site Status

Medanta-The Medicity

Haryāna, , India

Site Status

Tyumen Cardiology Center

Tyumen, , Russia

Site Status

Karolinska University Hospital

Stockholm, , Sweden

Site Status

University Hospitals of Birmingham NHS Foundation Trust - Queen Elizabeth Hospital

Birmingham, , United Kingdom

Site Status

Countries

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United States India Russia Sweden United Kingdom

Other Identifiers

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MIRACLE EF

Identifier Type: -

Identifier Source: org_study_id