Withdrawal of Pharmacological Treatment in Patients Responding to Cardiac Resynchronization Therapy:

NCT ID: NCT05151861

Last Updated: 2021-12-30

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

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-12-03

Study Completion Date

2023-05-15

Brief Summary

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The purpose of this randomized trial is to investigate the effect of the complete removal of pharmacological treatment in patients responding to cardiac resynchronization therapy with recuperated LVEF in terms of imaging parameters (changes in LVEF and LV volume), as well as, clinical parameters that translate into worsening of heart failure.

Detailed Description

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Conditions

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Heart Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Experimental

Complete removal of pharmacological treatment

Group Type EXPERIMENTAL

Complete removal of pharmacological treatment

Intervention Type OTHER

Removal of treatment

Control

Maintenance of pharmacological treatment

Group Type ACTIVE_COMPARATOR

Control

Intervention Type DRUG

Maintenance of pharmacological treatment

Interventions

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Complete removal of pharmacological treatment

Removal of treatment

Intervention Type OTHER

Control

Maintenance of pharmacological treatment

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Patient with a CRT device for at least one year due to the presence of LBBB and LVEF \<40% of non-ischemic origin
2. Current LVEF ≥50% and normal volumes in two consecutive echocardiographic studies, separated at least 3 months, and the last one performed in the previous 6 months.
3. Normally functioning CRT device with stimulation\> 95%.
4. NYHA functional class I-II.
5. Absence of admissions for HF in the last year.
6. NT-proBNP \<450pg/ml in sinus rhythm and \<900pg/ml in patients with atrial fibrillation, in the previous 6 months.
7. Pharmacological treatment with beta-blockers, ACEIs/AIIRA/RNAI with or without MRA.
8. Older than 18 years.
9. Patients who have given their informed consent in writing.

Exclusion Criteria

1. Previous episode of sustained ventricular tachycardia/recovered sudden death/appropriate shock (in the case of a patient with an implantable cardioverter-defibrillator associated with CRT).
2. Uncontrolled arterial hypertension (figures\> 140/90 mmHg).
3. Need to use beta-blockers at the medical discretion for other indications such as heart rate (HR) control in atrial fibrillation (in the absence of ablation of the atrioventricular node) or to control other supra or ventricular arrhythmias.
4. Severe valve disease.
5. Diabetic or hypertensive with microalbuminuria or proteinuria.
6. Renal failure with creatinine clearance \<30ml/min/1.73m2.
7. Fertile women who are neither using contraceptives nor surgically sterilized; pregnant or lactating women.
8. Patients are currently participating in a clinical trial or have participated in the past 30 days.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fundacion para la Formacion e Investigacion Sanitarias de la Region de Murcia

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Francisco José Pastor Pérez, MD

Role: PRINCIPAL_INVESTIGATOR

HCUVA

Locations

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Hospital Clínico Universitario Virgen de la Arrixaca

Murcia, , Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Francisco José Pastor Pérez, MD

Role: CONTACT

Phone: 968369500

Email: [email protected]

Lola Serna Guirao

Role: CONTACT

Email: [email protected]

References

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Pastor-Perez FJ, Garrido-Bravo IP, Penafiel-Verdu P, Fernandez-Villa N, Manzano-Fernandez S, Oliva-Sandoval MJ, Perez-Martinez MT, Caro-Martinez C, Hernandez-Vicente A, Pascual-Figal DA; clinical trial REMOVE researches. Withdrawal of drug therapy in responders to cardiac resynchronization therapy: rationale and design of the REMOVE trial. Rev Esp Cardiol (Engl Ed). 2024 Oct;77(10):851-858. doi: 10.1016/j.rec.2024.02.021. Epub 2024 May 1. English, Spanish.

Reference Type DERIVED
PMID: 38701881 (View on PubMed)

Other Identifiers

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IMIB-RMV-2021-02

Identifier Type: -

Identifier Source: org_study_id