Cardiac Resynchronization Therapy Efficacy Enhancements

NCT ID: NCT02222818

Last Updated: 2017-01-06

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

COMPLETED

Clinical Phase

NA

Total Enrollment

71 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-10-31

Study Completion Date

2016-01-31

Brief Summary

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The purpose of this study is to demonstrate that the amount of effective CRT (Cardiac Resynchronization Therapy) pacing during AF (atrial fibrillation) when CAFRPlus (Conducted AF Response Plus) is applied is not inferior to the amount of effective CRT pacing during AF when CAFR (Conducted AF Response) is applied.

Detailed Description

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The CRTee study is an IDE, prospective, multi-center, randomized, controlled, crossover clinical study, conducted worldwide and designed to demonstrate that the amount of effective CRT pacing during AF (atrial fibrillation) when CAFRPlus (Conducted AF Response Plus) is applied is not inferior to the amount of effective CRT pacing during AF when CAFR (Conducted AF Response) is applied.

The study will be conducted at up to 30 centers located in the United States, Europe and Middle East and Africa (MEA).

Conditions

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Atrial Fibrillation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Group A: CAFR first

Subjects randomized to Group A will receive CAFR first, then cross over to CAFRPlus.

Group Type OTHER

Conducted AF Response (CAFR)

Intervention Type DEVICE

The CAFR algorithm is currently available in the Medtronic market-released devices and intended to promote delivery of CRT pacing during conducted AT/AF episodes.

Conducted AF Response Plus (CAFRPlus)

Intervention Type DEVICE

The CAFRPlus algorithm is part of the CRTee feature set. This feature set has a diagnostic element that tracks the loss of effective CRT pacing that is occurring over time, both during normal sinus rhythm (NSR) and during AF. It also has an interventional element (i.e. CAFRPlus) that uses this evaluation of effective CRT pacing to adjust the pacing rate during AF to decrease loss of effective CRT pacing.

Group B: CAFRPlus first

Subjects randomized to Group B will receive CAFRPlus first, then cross over to CAFR.

Group Type OTHER

Conducted AF Response (CAFR)

Intervention Type DEVICE

The CAFR algorithm is currently available in the Medtronic market-released devices and intended to promote delivery of CRT pacing during conducted AT/AF episodes.

Conducted AF Response Plus (CAFRPlus)

Intervention Type DEVICE

The CAFRPlus algorithm is part of the CRTee feature set. This feature set has a diagnostic element that tracks the loss of effective CRT pacing that is occurring over time, both during normal sinus rhythm (NSR) and during AF. It also has an interventional element (i.e. CAFRPlus) that uses this evaluation of effective CRT pacing to adjust the pacing rate during AF to decrease loss of effective CRT pacing.

Interventions

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Conducted AF Response (CAFR)

The CAFR algorithm is currently available in the Medtronic market-released devices and intended to promote delivery of CRT pacing during conducted AT/AF episodes.

Intervention Type DEVICE

Conducted AF Response Plus (CAFRPlus)

The CAFRPlus algorithm is part of the CRTee feature set. This feature set has a diagnostic element that tracks the loss of effective CRT pacing that is occurring over time, both during normal sinus rhythm (NSR) and during AF. It also has an interventional element (i.e. CAFRPlus) that uses this evaluation of effective CRT pacing to adjust the pacing rate during AF to decrease loss of effective CRT pacing.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Subject is willing to sign and date the study patient Informed Consent form.
* Subject is at least 18 years of age (or older, if required by local law).
* Subject is expected to remain available after enrollment to complete follow-up visits in both arms of the study
* Subject has had a Medtronic Viva or Brava CRT-D device implanted at least 30 days prior to enrollment.
* Subject has history of AF burden, of at least 6 days of at least 4 hours of AF over any 4 week period within the last 90 days as documented in device diagnostic data OR if subject has no atrial lead (therefore no device diagnostic data) but clinical evidence of high AF burden.
* Subject has demonstrated history of being able to complete Left Ventricular Capture Management (LVCM) documented in device data.
* Subject has a documented % V pacing during AF of less than or equal to 97% within 90 days prior to enrollment or within 10 days after enrollment.

Exclusion Criteria

* Subject has undergone AV node ablation for treatment of AF.
* Subject has complete or 3rd degree AV block.
* Subject has had an MI within 30 days.
* Subject has medical conditions that limit study participation (per physician discretion).
* Subject is enrolled in one or more concurrent studies that could confound the study results as determined by Medtronic.
* Subject has a limited life expectancy for non-cardiac causes that would not allow completion of the study.
* Subject is pregnant (in the US, all women of child-bearing potential must undergo a pregnancy test within seven days prior to CRTee download).
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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Suneet Mittal, MD

Role: PRINCIPAL_INVESTIGATOR

Valley Health System

Locations

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Cardiac Arrythmia Services

Boca Raton, Florida, United States

Site Status

Iowa Heart Center

West Des Moines, Iowa, United States

Site Status

North Memorial Heart and Vascular

Minneapolis, Minnesota, United States

Site Status

CentraCare

Saint Cloud, Minnesota, United States

Site Status

North Carolina Heart and Vascular

Raleigh, North Carolina, United States

Site Status

Mount Carmel

Columbus, Ohio, United States

Site Status

Oklahoma Heart

Oklahoma City, Oklahoma, United States

Site Status

Berks Cardiology

Reading, Pennsylvania, United States

Site Status

Texas Cardiac Arrhythmia Services

Austin, Texas, United States

Site Status

Kootenai Heart Clinics

Spokane, Washington, United States

Site Status

Magyar Honvédség Honvédkorház

Budapest, , Hungary

Site Status

Policlinico Universitario Agostino Gemelli

Roma, , Italy

Site Status

Azienda Ospedaliera Bolognini Seriate - Ospedale Bolognini

Seriate, , Italy

Site Status

Azienda Ospedaliera Cardinale Panico

Tricase, , Italy

Site Status

Prince Sultan Cardiac Center

Riyadh, , Saudi Arabia

Site Status

Vychodoslovensky ustav srdcovych a cievnych chorob, a.s.

Košice, , Slovakia

Site Status

Mediclinic Panorama

Cape Town, , South Africa

Site Status

Liverpool Heart and Chest Hospital NHS Foundation Trust

Liverpool, , United Kingdom

Site Status

he Newcastle upon Tyne Hospitals NHS Foundation Trust - Freeman Hospital

Newcastle upon Tyne, , United Kingdom

Site Status

Countries

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United States Hungary Italy Saudi Arabia Slovakia South Africa United Kingdom

References

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Plummer CJ, Frank CM, Bari Z, Al Hebaishi YS, Klepfer RN, Stadler RW, Ghosh S, Liu S, Mittal S. A novel algorithm increases the delivery of effective cardiac resynchronization therapy during atrial fibrillation: The CRTee randomized crossover trial. Heart Rhythm. 2018 Mar;15(3):369-375. doi: 10.1016/j.hrthm.2017.10.026. Epub 2017 Nov 11.

Reference Type DERIVED
PMID: 29132930 (View on PubMed)

Other Identifiers

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CRTee

Identifier Type: -

Identifier Source: org_study_id

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