LINQ for impEdance meAsuremeNt While Off From HF Medication Study

NCT ID: NCT03245281

Last Updated: 2018-06-21

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-10-30

Study Completion Date

2019-04-30

Brief Summary

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The purpose of this non-randomized, cross-over, unblinded, single-center feasibility study is to assess the sensitivity of the LINQ ICM to measure derived-subcutaneous impedance in patients with heart failure during periods when diuretics and/or HF-medication consumption is increased or suspended for 48 hours (up to 72 hours at physician discretion) and to collect safety information related to HF status and to medication consumption changes.

Detailed Description

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Up to 30 subjects with a clinical diagnosis of Heart Failure will be enrolled in the study. It is expected that the subjects will be enrolled over a period of approximately 6 months.

3 follow up visits are planned at 2, 4 and 6 months (+/- one week) following the LINQ ICM implant.

The total expected duration of the study is of about 1 year. According to the enrolment chronological order, each subject will be allocated to Diuretic Suspension group (DS), Diuretic Increase (DI) or Diuretic+MRA medication Suspension (DMS), which will define the medication regimen before the follow-up visit.

Primary objective of the study is detecting the variation of impedance magnitude and the time of occurrence after medication regimen changes will be evaluated at each follow-up.

Conditions

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Heart Failure

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

CROSSOVER

According to the enrolment chronological order, each subject will be allocated to Diuretic Suspension group (DS), Diuretic Increase (DI) or Diuretic+MRA medication Suspension (DMS), which will define the medication regimen before the follow-up visit.
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Diuretic Suspension (DS)

Group Type EXPERIMENTAL

Diuretic Suspension (DS)

Intervention Type DRUG

Stop diuretic consumption in the 48h before the follow-up visit

Diuretic Increase (DI)

Group Type EXPERIMENTAL

Diuretic Increase (DI)

Intervention Type DRUG

Double diuretics dosage in the 48h before the follow-up visit

Diuretic and Medication Suspension (DMS)

Group Type EXPERIMENTAL

Diuretic and Medication Suspension (DMS)

Intervention Type DRUG

Stop diuretic and MRA medication consumption in the 48h before the follow-up visit

Interventions

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Diuretic Suspension (DS)

Stop diuretic consumption in the 48h before the follow-up visit

Intervention Type DRUG

Diuretic Increase (DI)

Double diuretics dosage in the 48h before the follow-up visit

Intervention Type DRUG

Diuretic and Medication Suspension (DMS)

Stop diuretic and MRA medication consumption in the 48h before the follow-up visit

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Clinical Diagnosis of Heart Failure
* Plasma NT-proBNP (\>250ng/L in SR and \>1,000ng/L in AF)
* LVEF \<50% measured in the year before enrolment
* Treated routinely with a daily dose of loop diuretic
* Receiving other guideline-indicated therapy for heart failure
* Willing to sign the informed consent form.
* Greater than 18 years of age.

Exclusion Criteria

* Pregnant patients (all females of child-bearing potential must have a negative pregnancy test before LINQ ICM implant)
* eGFR \<30 ml/minute.
* Any concomitant condition which in the opinion of the investigator would not allow a safe participation in the study.
* Patients with implanted pacemakers or defibrillators
* Severe aortic or mitral valve disease
* Breathlessness at rest or on minor exertion.
* Chest pain at rest or on mild or moderate exertion.
* Patients deemed too unstable to miss 48 hours of heart failure treatment
* Enrolled in another study that could confound the results of this study, without documented pre-approval from Medtronic study manager
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medtronic BRC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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John Cleland, Prof

Role: STUDY_CHAIR

NHS Greater Glasgow & Clyde

Locations

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Nhs Greater Glasgow & Clyde

Glasgow, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Teodora Bellone

Role: CONTACT

433566566 ext. 0031

Mirko De Melis

Role: CONTACT

Facility Contacts

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Clare Murphy, Dr

Role: primary

References

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Rosamond W, Flegal K, Furie K, Go A, Greenlund K, Haase N, Hailpern SM, Ho M, Howard V, Kissela B, Kittner S, Lloyd-Jones D, McDermott M, Meigs J, Moy C, Nichol G, O'Donnell C, Roger V, Sorlie P, Steinberger J, Thom T, Wilson M, Hong Y; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics--2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2008 Jan 29;117(4):e25-146. doi: 10.1161/CIRCULATIONAHA.107.187998. Epub 2007 Dec 17. No abstract available.

Reference Type BACKGROUND
PMID: 18086926 (View on PubMed)

Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005 Aug 4;353(5):487-97. doi: 10.1056/NEJMra050100. No abstract available.

Reference Type BACKGROUND
PMID: 16079372 (View on PubMed)

Butler J, Arbogast PG, Daugherty J, Jain MK, Ray WA, Griffin MR. Outpatient utilization of angiotensin-converting enzyme inhibitors among heart failure patients after hospital discharge. J Am Coll Cardiol. 2004 Jun 2;43(11):2036-43. doi: 10.1016/j.jacc.2004.01.041.

Reference Type BACKGROUND
PMID: 15172409 (View on PubMed)

Monane M, Bohn RL, Gurwitz JH, Glynn RJ, Avorn J. Noncompliance with congestive heart failure therapy in the elderly. Arch Intern Med. 1994 Feb 28;154(4):433-7.

Reference Type BACKGROUND
PMID: 8117176 (View on PubMed)

Mittal S, Sanders P, Pokushalov E, Dekker L, Kereiakes D, Schloss EJ, Pouliot E, Franco N, Zhong Y, DI Bacco M, Purerfellner H. Safety Profile of a Miniaturized Insertable Cardiac Monitor: Results from Two Prospective Trials. Pacing Clin Electrophysiol. 2015 Dec;38(12):1464-9. doi: 10.1111/pace.12752. Epub 2015 Oct 20.

Reference Type BACKGROUND
PMID: 26412309 (View on PubMed)

Purerfellner H, Sanders P, Pokushalov E, Di Bacco M, Bergemann T, Dekker LR; Reveal LINQ Usability Study Investigators. Miniaturized Reveal LINQ insertable cardiac monitoring system: First-in-human experience. Heart Rhythm. 2015 Jun;12(6):1113-9. doi: 10.1016/j.hrthm.2015.02.030. Epub 2015 Feb 26.

Reference Type BACKGROUND
PMID: 25728756 (View on PubMed)

van der Wal MH, Jaarsma T, van Veldhuisen DJ. Non-compliance in patients with heart failure; how can we manage it? Eur J Heart Fail. 2005 Jan;7(1):5-17. doi: 10.1016/j.ejheart.2004.04.007.

Reference Type BACKGROUND
PMID: 15642526 (View on PubMed)

Other Identifiers

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MDT16014

Identifier Type: -

Identifier Source: org_study_id

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