Evaluation of ACUITY™ X4 Quadripolar Coronary Venous Leads and RELIANCE™ 4-FRONT Defibrillation Leads

NCT ID: NCT02071173

Last Updated: 2021-01-07

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

COMPLETED

Clinical Phase

NA

Total Enrollment

2244 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-04-14

Study Completion Date

2020-10-06

Brief Summary

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The objective of the NAVIGATE X4 Clinical Study is to gather data to establish the safety, performance and effectiveness of the ACUITY™ X4 quadripolar coronary venous leads and the RELIANCE 4-FRONT™ ventricular defibrillation leads to satisfy FDA requirements for pre-market submission. Additionally, data from this study will be used to support post-market approval requirements for the ACUITY X4 and RELIANCE 4-FRONT leads.

Detailed Description

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Conditions

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Cardiac Resynchronization Therapy

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Every subject had access to two study devices and were followed as a single group.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Enrolled Patients

Subjects undergo an implant procedure to receive at least one investigational lead -- ACUITY X4 left ventricular (LV) CRT lead, RELIANCE 4-FRONT right ventricular (RV) ICD lead

Group Type EXPERIMENTAL

ACUITY X4 quadripolar coronary venous lead and RELIANCE 4-FRONT defibrillation lead

Intervention Type DEVICE

The ACUITY X4 leads are intended for chronic left ventricular pacing and sensing. The leads have 3 tip configuration designs (straight tip, short tip spiral, and long tip spiral), which is intended to provide choices for patients with different anatomies.

The RELIANCE 4-FRONT leads are designed for right-side heart applications within the ventricle, atrium, and superior vena cava. It is intended for permanent sensing, pacing, and defibrillation when used with a compatible implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D).

Subjects were allowed to receive both the ACUITY X4 and RELIANCE 4-FRONT lead.

Interventions

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ACUITY X4 quadripolar coronary venous lead and RELIANCE 4-FRONT defibrillation lead

The ACUITY X4 leads are intended for chronic left ventricular pacing and sensing. The leads have 3 tip configuration designs (straight tip, short tip spiral, and long tip spiral), which is intended to provide choices for patients with different anatomies.

The RELIANCE 4-FRONT leads are designed for right-side heart applications within the ventricle, atrium, and superior vena cava. It is intended for permanent sensing, pacing, and defibrillation when used with a compatible implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D).

Subjects were allowed to receive both the ACUITY X4 and RELIANCE 4-FRONT lead.

Intervention Type DEVICE

Other Intervention Names

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LV Quadripolar coronary venous lead RV defibrillation Lead

Eligibility Criteria

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Inclusion Criteria

Subjects indicated for a CRT-D that fulfill one of the following 5 criteria\[1\]:

1. Subject with left ventricular ejection fraction (LVEF) less than or equal to 35%, sinus rhythm, left bundle branch block (LBBB) with a QRS duration greater than or equal to 150 ms, and a NYHA class II, III or ambulatory IV symptoms on Guideline-Directed Medical Therapy (GDMT)\*
2. Subject with LVEF less than or equal to 35%, sinus rhythm, LBBB with a QRS duration 120 to 149 ms, and NYHA class II, III, or ambulatory IV symptoms on GDMT\*
3. Subject with LVEF less than or equal to 35%, sinus rhythm, a non-LBBB pattern with a QRS duration greater than or equal to 150 ms, and NYHA class III/ ambulatory class IV symptoms on GDMT\*
4. Subject with atrial fibrillation and LVEF less than or equal to 35% on GDMT\* if a) the subject requires ventricular pacing or otherwise meets CRT criteria \[listed here\] and b) AV nodal ablation or pharmacologic rate control will allow near 100% ventricular pacing with CRT
5. Subject on GDMT\* who have LVEF less than or equal to 35% and are undergoing new device placement with anticipated requirement for significant (\>40%) ventricular pacing \*GDMT = Guideline-directed medical therapy (formerly known as optimal pharmaceutical therapy (OPT)), represents optimal medical therapy as defined by ACCF/ AHA guideline-recommended therapies (primarily Class I)

* Subject is intended to receive the ACUITY X4 LV lead and RELIANCE 4-FRONT RV lead (optional in Study Phase 1) and BSC CRT-D with quadripolar header as their initial (de novo) cardiac implants
* Subject is willing and capable of providing informed consent (which can include the use of a legally authorized representative \[LAR\] for documentation of informed consent) and participating in all testing associated with this investigation at an approved center and at the intervals defined by this protocol
* Subject is age 18 or above, or of legal age to give informed consent specific to state and national law

Exclusion Criteria

Subjects who meet any one of the following criteria will be excluded from this clinical study.

* Subject has a known or suspected sensitivity to dexamethasone acetate (DXA)
* Subject has a mechanical tricuspid heart valve
* Subject is enrolled in any other concurrent study, with the exception of local mandatory governmental registries and observational studies/registries\* that are not in conflict and do not affect the following:
* Schedule of procedures for the Study (i.e. should not cause additional or missed visits);
* Study outcome (i.e. involve medications that could affect the heart rate of the subject);
* Conduct of the Study per good clinical practice (GCP) / International Organization for Standardization (ISO) 14155:2011/ 21 Code of Federal Regulations (CFR) 812, local regulations
* Subject is currently on the active heart transplant list
* Subject has a documented life expectancy of less than twelve months
* Women of childbearing potential who are or might be pregnant at the time of study enrollment or CRT-D System implant (method of assessment upon physician's discretion)
* Subjects currently requiring chronic dialysis \*Sponsors of such studies/registries should be informed and Boston Scientific must be informed by the investigator about the parallel conduct of these projects in the subject and of the project's basic nature. The decision if a desired mandatory governmental registry or observational study/ registry is in conflict with this exclusion criterion is up to the enrolling investigator.
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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Suneet Mittal, MD

Role: PRINCIPAL_INVESTIGATOR

The Valley Hospital

Martin Burke, DO

Role: PRINCIPAL_INVESTIGATOR

University of Chicago

Locations

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University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

Huntsville Hospital

Huntsville, Alabama, United States

Site Status

Providence Alaska Medical Center

Anchorage, Alaska, United States

Site Status

Banner Baywood Heart Hospital

Mesa, Arizona, United States

Site Status

Scottsdale Healthcare - Osborn

Scottsdale, Arizona, United States

Site Status

Cardiology Associates of Northeast Arkansas, P.A.

Jonesboro, Arkansas, United States

Site Status

Kaiser Permanente

Los Angeles, California, United States

Site Status

USC Medical Center

Los Angeles, California, United States

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Alta Bates Medical Center

Oakland, California, United States

Site Status

Mercy General Hospital

Sacramento, California, United States

Site Status

Sharp Memorial Hospital

San Diego, California, United States

Site Status

Hartford Hospital

Hartford, Connecticut, United States

Site Status

Yale University School of Medicine

New Haven, Connecticut, United States

Site Status

Delray Medical Center

Fort Lauderdale, Florida, United States

Site Status

Lakeland Regional Medical Center

Lakeland, Florida, United States

Site Status

West Florida Cardiology Network, LLC

Largo, Florida, United States

Site Status

Tallahassee Memorial Hospital

Tallahassee, Florida, United States

Site Status

Tampa General Hospital

Tampa, Florida, United States

Site Status

Emory University Hospital

Atlanta, Georgia, United States

Site Status

Gwinnett Hospital System Inc.

Lawrenceville, Georgia, United States

Site Status

University of Chicago

Chicago, Illinois, United States

Site Status

Alexian Brothers Medical Center

Elk Grove Village, Illinois, United States

Site Status

St. John's Hospital

Springfield, Illinois, United States

Site Status

Porter Memorial Hospital

Dyer, Indiana, United States

Site Status

Lutheran Medical Group

Fort Wayne, Indiana, United States

Site Status

St. Vincent's Hospital

Indianapolis, Indiana, United States

Site Status

Ball Memorial Hospital

Muncie, Indiana, United States

Site Status

University of Iowa Hospitals and Clinics

Iowa City, Iowa, United States

Site Status

University of Kansas Hospital

Kansas City, Kansas, United States

Site Status

Baptist Health Lexington

Lexington, Kentucky, United States

Site Status

University of Louisville Hospital

Louisville, Kentucky, United States

Site Status

Eastern Maine Medical Center

Bangor, Maine, United States

Site Status

Union Memorial Hospital

Baltimore, Maryland, United States

Site Status

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status

Spectrum Health Hospitals

Grand Rapids, Michigan, United States

Site Status

St. Joseph Mercy Hospital

Ypsilanti, Michigan, United States

Site Status

St. Mary's Duluth Clinic Regional Heart Center

Duluth, Minnesota, United States

Site Status

St. Cloud Hospital

Saint Cloud, Minnesota, United States

Site Status

HealthEast St. Joseph's Hospital

Saint Paul, Minnesota, United States

Site Status

United Heart and Vascular Clinic

Saint Paul, Minnesota, United States

Site Status

Boone Hospital Center

Columbia, Missouri, United States

Site Status

St. Luke's Hospital of Kansas City

Kansas City, Missouri, United States

Site Status

Cox Health

Springfield, Missouri, United States

Site Status

Barnes Jewish Hospital

St Louis, Missouri, United States

Site Status

Nebraska Heart Institute

Lincoln, Nebraska, United States

Site Status

Deborah Heart and Lung Center

Browns Mills, New Jersey, United States

Site Status

Cooper Hospital - University Medical Center

Haddon Heights, New Jersey, United States

Site Status

Jersey Shore University Medical Center

Neptune City, New Jersey, United States

Site Status

Valley Hospital

Ridgewood, New Jersey, United States

Site Status

Maimonides Medical Center

Brooklyn, New York, United States

Site Status

Long Island Jewish Medical Center

New Hyde Park, New York, United States

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Columbia University Medical Center

New York, New York, United States

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Stony Brook University Hospital

Stony Brook, New York, United States

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Montefiore Medical Center

The Bronx, New York, United States

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Buffalo General Hospital

Williamsville, New York, United States

Site Status

Mercy Hospital of Buffalo, Catholic Health System

Williamsville, New York, United States

Site Status

University of North Carolina Hospital

Chapel Hill, North Carolina, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

Aultman Hospital

Canton, Ohio, United States

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Good Samaritan Hospital

Cincinnati, Ohio, United States

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Cleveland Clinic Foundation

Cleveland, Ohio, United States

Site Status

Ohio State University Medical Center

Columbus, Ohio, United States

Site Status

OhioHealth Research and Innovation Institute - Riverside Methodist Hospital

Columbus, Ohio, United States

Site Status

Wheeling Hospital Inc.

Steubenville, Ohio, United States

Site Status

The Toledo Hospital

Toledo, Ohio, United States

Site Status

Asante Rogue Regional Medical Center

Medford, Oregon, United States

Site Status

Providence St. Vincent Medical Center

Portland, Oregon, United States

Site Status

Abington Memorial Hospital

Abington, Pennsylvania, United States

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Lehigh Valley Hospital

Allentown, Pennsylvania, United States

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York Hospital

York, Pennsylvania, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

PeeDee Cardiology Associates PA

Florence, South Carolina, United States

Site Status

Spartanburg Regional Medical Center

Spartanburg, South Carolina, United States

Site Status

Rapid City Regional Hospital

Rapid City, South Dakota, United States

Site Status

Avera Heart Hospital of South Dakota

Sioux Falls, South Dakota, United States

Site Status

Stern Cardiovascular Foundation, Inc.

Germantown, Tennessee, United States

Site Status

St. Thomas Research Institute, LLC

Nashville, Tennessee, United States

Site Status

Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

Texas Cardiac Arrhythmia Research

Austin, Texas, United States

Site Status

Heart Hospital of Austin

Austin, Texas, United States

Site Status

SouthEast Texas Clinical Research Center

Beaumont, Texas, United States

Site Status

Medical City Dallas Hospital

Dallas, Texas, United States

Site Status

Walnut Hill Medical Center

Dallas, Texas, United States

Site Status

Plaza Medical Center of Fort Worth

Fort Worth, Texas, United States

Site Status

University of Texas Houston Health Science Center

The Woodlands, Texas, United States

Site Status

Trinity Mother Frances Health System

Tyler, Texas, United States

Site Status

Intermountain Medical Center

Murray, Utah, United States

Site Status

Bon Secours Heart & Vascular Institute

Mechanicsville, Virginia, United States

Site Status

Sentara Norfolk General Hospital

Norfolk, Virginia, United States

Site Status

Virginia Cardiovascular Specialist

Richmond, Virginia, United States

Site Status

PeaceHealth St. Joseph Medical Center

Bellingham, Washington, United States

Site Status

Providence Regional Medical Center Everett

Everett, Washington, United States

Site Status

Kootenai Heart Clinics

Spokane, Washington, United States

Site Status

Providence Health & Services - Washington

Spokane, Washington, United States

Site Status

Charleston Area Medical Center

Charleston, West Virginia, United States

Site Status

Monongalia General Hospital

Morgantown, West Virginia, United States

Site Status

Countries

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United States

References

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Mittal S, Nair D, Padanilam BJ, Ciuffo A, Gupta N, Gallagher P, Goldner B, Hammill EF, Wold N, Stein K, Burke M. Performance of Anatomically Designed Quadripolar Left Ventricular Leads: Results from the NAVIGATE X4 Clinical Trial. J Cardiovasc Electrophysiol. 2016 Oct;27(10):1199-1205. doi: 10.1111/jce.13044. Epub 2016 Aug 19.

Reference Type DERIVED
PMID: 27434039 (View on PubMed)

Provided Documents

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Document Type: Statistical Analysis Plan

View Document

Document Type: Study Protocol

View Document

Other Identifiers

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C1481

Identifier Type: -

Identifier Source: org_study_id

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