Sensible Medical Innovations Lung fLuid Status Monitor Allows rEducing Readmission Rate of Heart Failure Patients

NCT ID: NCT02448342

Last Updated: 2017-12-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

380 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-09-30

Study Completion Date

2017-11-30

Brief Summary

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Multi center, randomized controlled study, to determine if a significant decrease in the rate of heart failure re-hospitalizations occurs during a follow-up period when - ReDS guided treatment is used as an adjunct to standard of care.

Detailed Description

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The study is designed as a prospective, randomized, controlled, multi-center trial. Patients will be enrolled during an index hospitalization for Acutely decompensated Heart Failure (ADHF) and will be followed for a minimum of 3 months or a maximum of 9 months (until the last patient has completed the 3- month follow-up). Patients will be blinded to ReDS readings values.

Recruitment will take place either during a heart failure hospitalization (see acceptance criteria below) or within 10 days after discharge from a qualifying heart failure hospitalization.

The Remote Dielectric Sensing (ReDS) device provides noninvasive measurement of lung fluid content. It comprises a wearable vest with embedded sensors and a bedside console. A measurement reading is provided within 90sec. Results are shared with the treating physician via a secured web portal.

Study objective is to determine if a significant decrease in the rate of heart failure re-hospitalizations occurs during the entire follow-up period when ReDS guided treatment is used as an adjunct to standard of care (SOC).

Patients will be randomized between two groups before hospital discharge to: ReDS with SOC vs. SOC.

Patient that are randomized to the treatment arm will perform daily ReDS measurement at home. Treating physician will follow up on patients' measurements through a secured dedicated web site. Notification messages will be automatically sent by the system to the physician if certain thresholds are crossed (thresholds are physician adjustable). Medications will be adjusted according to defined guidelines.

Patients that are randomized to the control arm will be followed up and medically managed according to standard of care guidelines.

Both arms scheduled clinical visits and phone follow up:

* A follow up phone call, per current treatment guidelines, will be attempted within 2 days of hospital discharge to obtain information regarding medication reconciliation, Heart Failure (HF) symptoms and other HF management issues (e.g., dietary restrictions).
* An outpatient clinic visit will be scheduled after a week of hospital discharge.
* Study follow-up visits at 1 and 3 months. Follow-up will be continued for enrolled subjects at 6 and 9 months until the last subject has pass through the 3-month follow-up window.

* At each study follow-up visit, patients will undergo complete physical exam, vital signs, collection of readmission and standard blood tests and QOL questionnaire.

Conditions

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Heart Failure

Keywords

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Heart Failure Remote Patient Monitoring Non Invasive Lung Fluid Status Monitor

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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ReDS Guided Treatment

After discharge from hospital, patient will perform daily ReDS measurement. Data is automatically transmitted to the secured web portal. Treating physician will follow up on patients' measurements through a secured dedicated web site. Notification messages will be automatically sent by the system to the physician if certain thresholds are crossed (thresholds are physician adjustable). Medications will be adjusted according to defined guidelines. During the study a service center will monitor and support patient adherence and investigators attending to patients' notifications.

Group Type EXPERIMENTAL

Remote Dielectric Sensing (ReDS) Wearable System

Intervention Type DEVICE

The ReDS device provides noninvasive measurement of lung fluid content. It comprises a wearable vest with embedded sensors and a bedside console, with touch-screen display. A measurement reading is provided within 90sec. Results are shared with the treating physician via a secured web portal.

Standard of Care- Control arm

After discharge from hospital, patient will be followed up and medically managed according to standard of care guidelines.

Group Type ACTIVE_COMPARATOR

Remote Dielectric Sensing (ReDS) Wearable System

Intervention Type DEVICE

The ReDS device provides noninvasive measurement of lung fluid content. It comprises a wearable vest with embedded sensors and a bedside console, with touch-screen display. A measurement reading is provided within 90sec. Results are shared with the treating physician via a secured web portal.

Interventions

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Remote Dielectric Sensing (ReDS) Wearable System

The ReDS device provides noninvasive measurement of lung fluid content. It comprises a wearable vest with embedded sensors and a bedside console, with touch-screen display. A measurement reading is provided within 90sec. Results are shared with the treating physician via a secured web portal.

Intervention Type DEVICE

Other Intervention Names

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ReDS Wearable Vest

Eligibility Criteria

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Inclusion Criteria

1. Patient has signed informed consent and authorization to use and disclose health information.
2. Patient's physical condition enables him to sit up and lay down with minimal assistance.
3. Diagnosis of HF, with preserved or reduced LVEF, was made at least 30 days prior to enrollment.
4. Patients with LVEF \<40% must have been treated at least 30 days prior to enrollment with diuretics and beta-blocker (unless intolerant or contra-indicated) and an ACE-inhibitor or ARB (unless intolerant or contra-indicated).
5. Patient is hospitalized for ADHF requiring significant alteration in heart failure treatment (i.e. diuretics or vasoactive drugs) or up to 10 days post-discharge from an ADHF admission.
6. BNP ≥ 350 pg/ml (NT pro BNP \> 1400 pg/ml) at enrollment (within 24h) and/or ≥750 pg/ml any time during the hospital stay (NT-pro BNP \>3000 pg/ml).

Note that if a patient is enrolled during a clinic visit rather than during a hospitalization, then the BNP from the index admission is referenced.

Exclusion Criteria

1. Patient has had a cardiac transplantation or VAD implantation.
2. CRT implantation within 90 days prior to screening or planned implantation during study duration.
4. Diagnosis of Severe Pulmonary Hypertension.
5. STEMI and or CABG within 30 days of screening visit. Note: Type 2 MI due to ADHF is not an exclusion.
6. Chronic renal failure with CrCl\<25mL/min, as calculated by the Cockcroft-Gault formula.
7. Chronic home IV therapy or cardiac inotropes or diuretics
8. Physical deformity in the thorax area or lesion that may prevent proper vest application or adjustment (Severe scoliosis/ sensitive sternotomy lesion etc.).
9. Illness/ Condition which may be aggravated or cause significant discomfort by the application of the vest (Rib fractures, with or without flail chest, Severe Osteoporosis).
10. Impaired cognitive ability or any other state that may prevent full compliance with the study protocol, according to investigator's assessment.
11. Patient's habitus out of range due to one or more of the following:

* Height less than 155cm or higher than 195cm (5.1; 6.4 feet respectively).
12. Congenital heart malformations or intra-thoracic mass that would affect the right lung anatomy (Dextrocardia, Lung Carcinoma etc.) including pacemaker box on the right side of the chest.
13. Severe COPD, defined as chronic and continuous home use of O2 (O2 dependancy) and/ or oral steroids. Continuous is defined as 24hours a day, every day.
14. Severe disease / conditions with life expectancy \<6 months according to investigator's assessment.
15. Patient is enrolled in another interventional study with permission of study manager (observational or registries are not excluded).
16. Patient HF is managed remotely with another monitoring device or program (for example: Pulmonary/ Lt Atrial pressure monitoring, Weight scale, BNP or bioimpedance).
17. Prisoners and ward of the state
Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sensible Medical Innovations Ltd.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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William Abraham, MD

Role: PRINCIPAL_INVESTIGATOR

Ohio State University

Aharon (Ronnie) Abbo, MD

Role: STUDY_DIRECTOR

Sensible Medical Innovations Ltd.

Locations

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University of Alabama

Birmingham, Alabama, United States

Site Status

Cedars Sinai

Hollywood, California, United States

Site Status

Scripps Memorial Hospital La Jolla

La Jolla, California, United States

Site Status

Scripps Mercy Hospital San Diego

San Diego, California, United States

Site Status

UCSF Medical Center, Parnassus

San Francisco, California, United States

Site Status

Pacific Heart Institute

Santa Monica, California, United States

Site Status

Yale University Medical Center

New Haven, Connecticut, United States

Site Status

MedStar Heart and Vascular Institute

Washington D.C., District of Columbia, United States

Site Status

Washington DC VA Medical Center

Washington D.C., District of Columbia, United States

Site Status

Memorial Regional Hospital

Hollywood, Florida, United States

Site Status

Encore Research Group

Jacksonville, Florida, United States

Site Status

Piedmont Heart Institute

Atlanta, Georgia, United States

Site Status

University of Chicago

Chicago, Illinois, United States

Site Status

Elmhurst Memorial Hospital

Elmhurst, Illinois, United States

Site Status

Northshore University HealthSystem

Evanston, Illinois, United States

Site Status

Advanced Heart Care Group

Fairview Heights, Illinois, United States

Site Status

Edward Heart Hospital

Naperville, Illinois, United States

Site Status

Prairie Heart Institute / St. John's Hospital

Springfield, Illinois, United States

Site Status

St Elizabeth Healthcare

Edgewood, Kentucky, United States

Site Status

Minneapolis Heart Institute Foundation

Minneapolis, Minnesota, United States

Site Status

Saint Luke's Hospital of Kansas City

Kansas City, Missouri, United States

Site Status

St. Louis Heart and Vascular

St Louis, Missouri, United States

Site Status

Bryan Heart

Lincoln, Nebraska, United States

Site Status

North Shore University Hospital

Manhasset, New York, United States

Site Status

Long Island Jewish Hospital

New Hyde Park, New York, United States

Site Status

Mount Sinai Medical Center

New York, New York, United States

Site Status

Weil Cornell Medical Center

New York, New York, United States

Site Status

Lenox Hill Hospital

New York, New York, United States

Site Status

Suma Health Services

Akron, Ohio, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

Dorothy M. Davis Heart & Lung Research Institute at The Ohio State University Wexner Medical Center

Columbus, Ohio, United States

Site Status

The Ohio State University Wexner Medical Center

Columbus, Ohio, United States

Site Status

Geisinger Medical Center

Danville, Pennsylvania, United States

Site Status

Lancaster General Health Hospital

Lancaster, Pennsylvania, United States

Site Status

Drexel University Medical Center

Philadelphia, Pennsylvania, United States

Site Status

VA Pittsburgh Health System

Pittsburgh, Pennsylvania, United States

Site Status

Geisinger Wyoming Valley Medical Center

Wilkes-Barre, Pennsylvania, United States

Site Status

Pinnacle Health Cardiovascular Institute

Wormleysburg, Pennsylvania, United States

Site Status

Centennial Medical Center - Sarah Cannon Research Institute

Nashville, Tennessee, United States

Site Status

Virginia Cardiovascular Specialties

Midlothian, Virginia, United States

Site Status

Henrico Doctors' Hospital

Richmond, Virginia, United States

Site Status

Countries

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United States

References

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Amir O, Rappaport D, Zafrir B, Abraham WT. A novel approach to monitoring pulmonary congestion in heart failure: initial animal and clinical experiences using remote dielectric sensing technology. Congest Heart Fail. 2013 May-Jun;19(3):149-55. doi: 10.1111/chf.12021. Epub 2013 Jan 25.

Reference Type BACKGROUND
PMID: 23350643 (View on PubMed)

Amir O, Azzam ZS, Gaspar T, Faranesh-Abboud S, Andria N, Burkhoff D, Abbo A, Abraham WT. Validation of remote dielectric sensing (ReDS) technology for quantification of lung fluid status: Comparison to high resolution chest computed tomography in patients with and without acute heart failure. Int J Cardiol. 2016 Oct 15;221:841-6. doi: 10.1016/j.ijcard.2016.06.323. Epub 2016 Jul 1.

Reference Type BACKGROUND
PMID: 27434357 (View on PubMed)

Amir O, Ben-Gal T, Weinstein JM, Schliamser J, Burkhoff D, Abbo A, Abraham WT. Evaluation of remote dielectric sensing (ReDS) technology-guided therapy for decreasing heart failure re-hospitalizations. Int J Cardiol. 2017 Aug 1;240:279-284. doi: 10.1016/j.ijcard.2017.02.120. Epub 2017 Mar 3.

Reference Type BACKGROUND
PMID: 28341372 (View on PubMed)

Related Links

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Other Identifiers

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CL-00100-P

Identifier Type: -

Identifier Source: org_study_id