Comparative Effectiveness of Prophylactic ICD Versus Non-ICD Therapy

NCT ID: NCT06543446

Last Updated: 2026-01-09

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

RECRUITING

Clinical Phase

NA

Total Enrollment

3290 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-04

Study Completion Date

2031-02-28

Brief Summary

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The investigators aim to compare the risk of mortality of Non-implantable carioverter defibrillator (ICD) vs. ICD management in patients with heart failure with reduced ejection fraction (HFrEF).

Detailed Description

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The proposed CONTEMP-ICD trial is a prospective, multicenter, open-label, randomized controlled trial; enrolling 3290 participants with HFrEF, on stable and optimal guideline-directed medical therapy (GDMT), who are eligible for a primary prevention ICD, but have a low predicted arrhythmic risk. Enrolled participants will be randomized in a 1:1 ratio to non-ICD vs. ICD treatment arms. The investigators hypothesize that, in participants with HFrEF who have a low predicted arrhythmic risk, non-ICD vs. ICD is non-inferior with respect to the primary endpoint of all-cause mortality and superior survival free of major cardiovascular (CV) events.

This study will recruit adults 18 years of age and older with heart failure. Participants will be asked to complete questionnaires. Information from medical records will be gathered including medical history, physical exam, medications, blood work results, and imaging. Visits will be at initial, three, six months, and every six months beyond six months. For those who get an ICD device an interrogation will be collected at the visits.

Conditions

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Heart Failure With Reduced Ejection Fraction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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No-ICD implantation

No-ICD implantation despite current recommendation

Group Type NO_INTERVENTION

No interventions assigned to this group

ICD implantation

ICD implantation based on current guidelines

Group Type ACTIVE_COMPARATOR

ICD implantation

Intervention Type PROCEDURE

Surgical implant of ICD device

Interventions

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ICD implantation

Surgical implant of ICD device

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years (no upper limit)
* Class I or IIa indication for a primary prevention ICD15: Ischemic or non-ischemic cardiomyopathy and NYHA Class ≥ II if most recent LVEF is ≤ 35% OR ischemic cardiomyopathy with NYHA Class I if most recent LVEF is ≤ 30%
* Most recent LVEF (%) obtained per cardiac imaging obtained at any time prior to enrollment after being stable on optimal GDMT\*\* for at least one month
* Stable optimal GDMT at least one calendar month prior to last cardiac imaging test, prespecified as one of the following for at least 1 calendar month prior to study randomization:

receiving all 4 therapy classes (beta-blockers, ARNI/ARB/ACE, MRA and SGLT2i) OR GDMT Score ≥ 6 (per Figure 7)

• MADIT-ICD Benefit Score \< 50 (per Figure 4)

Exclusion Criteria

* Existing ICD/CRT-D
* • Planned CRT-P or CRT-D implant for any indications including Class I or IIa indication for CRT: Presence of left bundle branch block (LBBB) with QRS ≥ 120 msec OR QRS duration ≥ 150 msec regardless of QRS morphology OR decision for CRT implant by EP provider for other indications
* Acute MI within the past 3 calendar months
* Chronic renal failure requiring hemodialysis
* Coronary revascularization within the past 3 calendar months
* History of sustained VT or VF
* Known genetic cause of cardiomyopathy
* Life expectancy \< 1 year
* Unable or unwilling to follow study protocol
* Inability to consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role collaborator

University of Rochester

OTHER

Sponsor Role lead

Responsible Party

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Ilan Goldenberg

Professor of Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ilan Goldenberg, MD

Role: PRINCIPAL_INVESTIGATOR

Univ of Rochester Medical Center, Clinical Cardiovascular Research Center

Locations

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MaineHealth

Portland, Maine, United States

Site Status RECRUITING

Johns Hopkins University

Baltimore, Maryland, United States

Site Status RECRUITING

Tufts Medical Center

Boston, Massachusetts, United States

Site Status RECRUITING

Corewell Health

Grand Rapids, Michigan, United States

Site Status RECRUITING

Minneapolis Heart Institute Foundation

Minneapolis, Minnesota, United States

Site Status RECRUITING

Rutgers

New Brunswick, New Jersey, United States

Site Status RECRUITING

The Valley Hospital

Paramus, New Jersey, United States

Site Status RECRUITING

Northwell Health

New York, New York, United States

Site Status RECRUITING

Nuvance Health Hudson Valley Cardiovascular Practice, PC

Poughkeepsie, New York, United States

Site Status RECRUITING

University of Rochester

Rochester, New York, United States

Site Status RECRUITING

Intermountain Health Care, Inc.

Salt Lake City, Utah, United States

Site Status RECRUITING

University of Virginia Health System

Charlottesville, Virginia, United States

Site Status RECRUITING

West Virginia University

Morgantown, West Virginia, United States

Site Status RECRUITING

University of Calgary

Calgary, Alberta, Canada

Site Status RECRUITING

University of Alberta

Edmonton, Alberta, Canada

Site Status RECRUITING

Countries

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United States Canada

Central Contacts

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Ilan Goldenberg

Role: CONTACT

585-275-5391

Ann Colasurdo

Role: CONTACT

585-275-1054

Facility Contacts

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Joanne Burgess

Role: primary

207-662-6317

Yavette Goldsborough

Role: primary

410-614-4449

Juan Carlos Collado Falcon

Role: primary

617-636-7433

Lisa Van Loo

Role: primary

616-391-3327

Molly Fuller

Role: primary

612-863-7493

Anupama Ubriani

Role: primary

732-418-8189

Lauren Tedeschi

Role: primary

201-447-8453

Shanice Brown

Role: primary

212-434-6918

Rishitha Thanikonda

Role: primary

845-790-5846

Jennifer Henchen

Role: primary

585-273-1300

Paden Hansen

Role: primary

801-507-4701

Cathy Roy

Role: primary

434-982-1058

Tanja Aucremanne

Role: primary

304-285-1947

Karen Cowan

Role: primary

403-210-6414

Quentin Kushnerik

Role: primary

780-407-3535

References

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Fiuzat M, Hamo CE, Butler J, Abraham WT, DeFilippis EM, Fonarow GC, Lindenfeld J, Mentz RJ, Psotka MA, Solomon SD, Teerlink JR, Vaduganathan M, Vardeny O, McMurray JJV, O'Connor CM. Optimal Background Pharmacological Therapy for Heart Failure Patients in Clinical Trials: JACC Review Topic of the Week. J Am Coll Cardiol. 2022 Feb 8;79(5):504-510. doi: 10.1016/j.jacc.2021.11.033.

Reference Type BACKGROUND
PMID: 35115106 (View on PubMed)

Goldenberg I, Zareba W, Ezekowitz JA, Albert C, Alexis JD, Anderson L, Behr ER, Daubert J, Di Palo KE, Ellenbogen KA, Dzikowicz DJ, Harrington JM, Hsich E, Huang DT, Januzzi JL, Jawaid A, Kutyifa V, Lala-Trindade A, Nakonechnyi A, Onwuanyi A, Pina IL, Sandhu RK, Sears S, Sroubek J, Baykaner T, Strawderman R, Beck C, Butler J. Rationale and design of the comparative effectiveness of ICD vs non-ICD therapy in contemporary heart failure patients at a low risk for arrhythmic death (CONTEMP-ICD) trial. Am Heart J. 2026 Jan;291:162-174. doi: 10.1016/j.ahj.2025.08.020. Epub 2025 Sep 4.

Reference Type DERIVED
PMID: 40914445 (View on PubMed)

Other Identifiers

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ADVARRA

Identifier Type: -

Identifier Source: org_study_id

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