Cardiac Resynchronization Therapy in Previously Untreatable and High Risk Upgrade Patients

NCT ID: NCT02922036

Last Updated: 2025-07-09

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-01-17

Study Completion Date

2026-06-30

Brief Summary

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This study is a prospective, multi-center, pivotal trial to study the safety and efficacy of the WiSE-CRT System for Cardiac Re-synchronization Therapy.

Detailed Description

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The WiSE-CRT System is an implantable cardiac pacing system capable of delivering pacing energy to the left ventricle of the heart without using a pacing lead.

Conditions

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Heart Failure

Study Design

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Allocation Method

NA

Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

One part of the study was randomized. The final part of the study was single-arm, open label.

Study Groups

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Treatment

WiSE System therapy ON with Guideline Directed Medical Therapy

Group Type EXPERIMENTAL

WiSE System

Intervention Type DEVICE

The WiSE System is an implantable cardiac system to provide LV pacing stimulation in conjunction with a co-implanted system that provides right ventricular stimulation.

Interventions

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WiSE System

The WiSE System is an implantable cardiac system to provide LV pacing stimulation in conjunction with a co-implanted system that provides right ventricular stimulation.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Patient with a class I or IIa (1) or (2) indication for implantation of a CRT-D device according to current available guidelines (with additional QRS criteria on Class IIa (1)):

1. Class I: NYHA II, III, IV, EF ≤ 35%, LBBB, QRS ≥ 150ms
2. Class IIa (1): NYHA II, III, IV, EF≤ 35%, LBBB, QRS ≥ 130 to \< 150ms
3. Class IIa (2): NYHA II, III, IV, EF≤ 35%, non-LBBB, QRS ≥ 150ms
2. Patient is a:

1. 'Non-responder' \[Not Enrolling\]: Patients who have a CRT system that is functional and despite an adequate trial of Guideline Directed Medical Therapy (GDMT) and attempts at optimal device programming the patient has not responded to therapy for a minimum of 6 months. Non-response is defined as:

* EF has remained unchanged or worsened (defined as \< 5% increase since implant), and
* The patient's clinical status based in the totality of available clinical evidence (such as NYHA Class, exercise tolerance, QOL, or global assessment) has remained unchanged or worsened, as determined by the local Site Enrollment Committee

OR

i. Patients in whom CS lead implantation for CRT has failed
* CS lead implant was attempted but abandoned due any of the following: difficult CS access or anatomy, inadequate lead location, inadequate pacing thresholds, persistent phrenic nerve pacing, or other procedural challenges

ii. CS lead implanted but has been programmed OFF
* LV lead that was implanted but not operational includes patients in whom the LV lead is inoperative or programmed off due to improper function such as high threshold, non-capture, phrenic nerve pacing, lead failure, lead dislodgement, or sub-optimal LV lead location

OR

c. 'High Risk Upgrade:

Patients who have a relative contraindication to CS lead implant, due to:
* venous occlusion or lesion precluding implant
* pocket infection risk (at co-implanted device site)
* considered high risk for CS implant due to co-morbidities
3. Patients on a stable Guideline Directed Medical Therapy (GDMT)
4. Patient must be 18 years old or over
5. Patient has signed and dated informed consent
6. Patient has suitable anatomy for implant of the WiSE CRT System (e.g. adequate acoustic window, LV wall thickness in target implant area ≥ 5 mm, absence of LV wall structural abnormalities which may preclude implant)

Exclusion Criteria

Patients who meet any one of these criteria will be excluded from the investigation:

1. Pure RBBB
2. LVEDD ≥ 8cm
3. Non-ambulatory or unstable NYHA class IV
4. Contraindication to heparin, chronic anticoagulants or antiplatelet agents
5. Triple anticoagulant patients who cannot tolerate peri-procedural stopping of anticoagulation therapy
6. Attempted device implant (pacemaker, ICD, CRT, LV lead) or successful co-implant within prior 30 days.
7. Patients with planned or expected lithotripsy treatment post implant
8. Life expectancy of \< 12 months
9. Chronic hemodialysis
10. Stage 4 or 5 renal dysfunction defined as eGFR \< 30
11. Grade 4 mitral valve regurgitation
12. Noncardiac implanted electrical stimulation therapy devices
13. Patients with a prosthetic aortic valve in which the electrode cannot be implanted via a transseptal approach
14. Patients with a prosthetic mitral valve in which the electrode cannot be implanted via a retrograde aortic approach
15. Unstable angina, acute MI, CABG, or PTCA within the past 1 month
16. Correctable valvular disease that is the primary cause of heart failure
17. Recent CVA or TIA (within the previous 3 months)
18. Patients with a history of paroxysmal or persistent atrial fibrillation/flutter are excluded if they have had a documented AF episode \> 30 min or a cardioversion in the past 1 month.
19. Patients with permanent AF are excluded if they have intact AV node conduction (RV pacing \<95%)
20. Already included in another clinical study that could confound the results of this study
21. Pregnancy
22. Known drug or alcohol addiction or abuse
23. Moderate or severe aortic stenosis
24. Subject unable to attend follow-up at the investigative center or unable, for physical or mental reasons, or to comply with the trial's procedures
25. For Part II Randomized patients only, those who will not tolerate being randomized to the Control Group for 6 months
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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EBR Systems, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jagmeet Singh, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Massachusetts General Hospital

Mary N Walsh, MD, MACC

Role: PRINCIPAL_INVESTIGATOR

St. Vincent Heart Center

Locations

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Heart Center Research

Huntsville, Alabama, United States

Site Status

University of California, San Diego

La Jolla, California, United States

Site Status

Broward Health Medical Center

Fort Lauderdale, Florida, United States

Site Status

St. Vincent's Healthcare

Jacksonville, Florida, United States

Site Status

Watson Clinic

Lakeland, Florida, United States

Site Status

Naples Community Hospital

Naples, Florida, United States

Site Status

Northside Hospital and Heart Institute

St. Petersburg, Florida, United States

Site Status

Piedmont Heart Institute

Atlanta, Georgia, United States

Site Status

Emory Healthcare

Atlanta, Georgia, United States

Site Status

Prairie Heart

Springfield, Illinois, United States

Site Status

St. Vincent's Hospital and Healthcare Center

Indianapolis, Indiana, United States

Site Status

University of Iowa

Iowa City, Iowa, United States

Site Status

Saint Luke's Health System Kansas City

Kansas City, Kansas, United States

Site Status

The University of Kansas Medical Center

Kansas City, Kansas, United States

Site Status

Baptist Health Lexington

Lexington, Kentucky, United States

Site Status

Ochsner Medical Center - Baton Rouge

Baton Rouge, Louisiana, United States

Site Status

University of Michigan

Ann Arbor, Michigan, United States

Site Status

Michigan Heart

Canton, Michigan, United States

Site Status

Henry Ford Hospital

Detroit, Michigan, United States

Site Status

William Beaumont Hospital

Hazel Park, Michigan, United States

Site Status

Sparrow Hospital

Lansing, Michigan, United States

Site Status

Minneapolis Heart Institute

Minneapolis, Minnesota, United States

Site Status

Mayo Clinic

Rochester, Minnesota, United States

Site Status

United Heart and Vascular Clinic

Saint Paul, Minnesota, United States

Site Status

Methodist Physicians Clinic Heart Consultants

Omaha, Nebraska, United States

Site Status

Rutgers University

New Brunswick, New Jersey, United States

Site Status

AtlantiCare Regional Medical Center

Pomona, New Jersey, United States

Site Status

Weill Cornell Medical Center

New York, New York, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

The Ohio State University

Columbus, Ohio, United States

Site Status

PeaceHealth

Springfield, Oregon, United States

Site Status

Penn State Health, Hershey Medical Center

Hershey, Pennsylvania, United States

Site Status

UPMC Heart and Vascular Institute

Pittsburgh, Pennsylvania, United States

Site Status

MUSC Gazes Research Institute

Charleston, South Carolina, United States

Site Status

Stern Cardiovascular Center

Germantown, Tennessee, United States

Site Status

Texas Heart Institute

Houston, Texas, United States

Site Status

The University of Texas Health Science Center at Houston

Houston, Texas, United States

Site Status

The Heart Hospital Baylor Plano

Plano, Texas, United States

Site Status

Houston Methodist

Sugar Land, Texas, United States

Site Status

Intermountain Medical Center

Murray, Utah, United States

Site Status

University of Virginia

Charlottesville, Virginia, United States

Site Status

Sentara Healthcare

Norfolk, Virginia, United States

Site Status

Aurora St. Luke's Medical Center

Milwaukee, Wisconsin, United States

Site Status

Canberra Hospital

Garran, Australian Capital Territory, Australia

Site Status

John Hunter Hospital

New Lambton Heights, New South Wales, Australia

Site Status

Prince of Wales Hospital

Randwick, New South Wales, Australia

Site Status

Sydney Adventist Hospital

Wahroonga, New South Wales, Australia

Site Status

The Prince Charles Hospital

Chermside, Queensland, Australia

Site Status

Royal Adelaide Hospital

Adelaide, South Australia, Australia

Site Status

Monash Heart

Clayton, Victoria, Australia

Site Status

Royal Melbourne Hospital / Royal Hobart Hospital

Parkville, Victoria, Australia

Site Status

Fiona Stanley Hospital

Perth, Western Australia, Australia

Site Status

Royal Prince Alfred Hospital

Camperdown, , Australia

Site Status

CHU Grenoble - Hopital Michallon Service de Cardiologie

Grenoble, , France

Site Status

Centre Cardiologique du Nord

Paris, , France

Site Status

CHU-Hopital Pontchaillou

Rennes, , France

Site Status

Immanuel Klinikum Bernau - Herzzentrum Brandenburg

Bernau, , Germany

Site Status

Universitätsklinikum Erlangen

Erlangen, , Germany

Site Status

Universitäres Herzzentrum Hamburg (UKE Hamburg) GmbH (UHZ)

Hamburg, , Germany

Site Status

Policlinico S. Orsola

Bologna, , Italy

Site Status

Ospedale San Gerardo

Monza, , Italy

Site Status

Isala Hartcentrum

Zwolle, , Netherlands

Site Status

Liverpool Heart and Chest Hospital

Liverpool, , United Kingdom

Site Status

Barts Heart Centre

London, , United Kingdom

Site Status

St. Thomas Hospital

London, , United Kingdom

Site Status

Manchester Heart Centre

Manchester, , United Kingdom

Site Status

James Cook University Hospital

Middlesbrough, , United Kingdom

Site Status

John Radcliffe Hospital

Oxford, , United Kingdom

Site Status

Countries

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United States Australia France Germany Italy Netherlands United Kingdom

References

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Singh JP, Abraham WT, Auricchio A, Delnoy PP, Gold M, Reddy VY, Sanders P, Lindenfeld J, Rinaldi CA. Design and rationale for the Stimulation Of the Left Ventricular Endocardium for Cardiac Resynchronization Therapy in non-responders and previously untreatable patients (SOLVE-CRT) trial. Am Heart J. 2019 Nov;217:13-22. doi: 10.1016/j.ahj.2019.04.002. Epub 2019 Apr 9.

Reference Type DERIVED
PMID: 31472360 (View on PubMed)

Related Links

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https://pmc.ncbi.nlm.nih.gov/articles/pmid/39083254/

Leadless Ultrasound-Based Cardiac Resynchronization System in Heart Failure

Other Identifiers

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CSP-03035

Identifier Type: -

Identifier Source: org_study_id

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