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CardioFit™ for the Treatment of Heart Failure

Primary Purpose

Heart Failure

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Implantation and activation of the vagus nerve stimulator
Sponsored by
BioControl Medical
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Heart Failure

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. The patient is in chronic heart failure, NYHA II-III. The patient may have been previously in class IV but must be in class II or III for three or more months prior to study entry;
  2. Age between 18 and 75 years;
  3. The patient is a male or postmenopausal female. Females of childbearing age may be included if pregnancy is excluded and acceptable contraception measures are used;
  4. Patient must sign an approved informed consent form. Patient agrees to attend all follow-up evaluations;
  5. Patient should be in sinus rhythm. Average 24-hour heart rate is between 60 and 110 b/min in a recorded 24-h Holter measurement;
  6. Patient should be in optimal medical treatment with no change in treatment in the previous 3 months with the exception of diuretics;
  7. Left ventricular ejection fraction estimated by echocardiography, cardiac angiography, radionuclide study, or other accepted mode of evaluation, is no more than 35%;
  8. Patient is physically capable and willing to perform repeated physically demanding tests associated with the study.

Exclusion Criteria:

  1. Presence of an immediately life threatening condition or disease other than heart failure, such as cancer, terminal renal failure etc.
  2. Acute myocardial Infarction (MI), variant angina pectoris, unstable angina or acute coronary syndrome in the previous three months;
  3. Previous stroke;
  4. Coronary Artery Bypass Surgery (CABG) or Percutaneous Coronary Intervention in the past 3 months;
  5. Episode of NYHA class IV heart failure, including acute pulmonary oedema in the previous three months;
  6. Heart failure due to acute myocarditis. Restrictive or constrictive pericarditis, haemodynamically significant aortic valve insufficiency aortic stenosis, or mitral valve stenosis;
  7. Severe renal or hepatic failure (Creatinine level>3 mg% (265 micromole/liter) or transaminase level four times ULN);
  8. Diabetes Mellitus treated with insulin for more than two years prior to study entry;
  9. Diabetic neuropathy;
  10. Previous neck surgery, including for Peripheral Vascular Disease (PVD), malignancy, and previous irradiation therapy of the neck;
  11. Current hypotension (systolic blood pressure below 80 mmHg);
  12. Active peptic disease or history of upper GI bleeding;
  13. Asthma, severe COPD (e.g. FEV1<1.5 liter), or severe restrictive lung disease;
  14. 1st degree AV block with PR interval > 240msec, 2nd or 3rd degree AV block;
  15. Atrial fibrillation or flutter in the in the previous 3 months;
  16. Sustained ventricular tachyarrhythmia with hemodynamic compromise, in the absence of implanted ICD;
  17. Long QT syndrome, congenital or acquired;
  18. Recorded or suspected symptomatic vaso-vagal response;
  19. Treatment by investigational drug or device within the past 3 months;
  20. Glaucoma, or history of glaucoma;
  21. Major psychiatric disorder in the present or in the past; Dementia;
  22. Patients transplanted with tissues or organs;
  23. Immunosuppressed patients; patients under systemic steroid treatment;
  24. Anemia with Hb<10gr/L, unless treated with Epo;
  25. Patients who are at risk for carotid arteries plaques and have unstable carotid plaques, as assessed by Echo Doppler; and/or patients with >70% carotid artery stenosis;
  26. Patient is candidate for cardiac resynchronization device implantation.

Sites / Locations

  • Georg-August-Universität Göttingen
  • Otto von-Guericke University Clinik
  • I. Medizinische Klinik, Klinikum Mannheim GmbH Universitätsklinikum Fakultät für klinische Medizin Mannheim der Universität Heidelberg
  • Fondazione IRCCS Policlinico "San Matteo"
  • Academic Hospital Maastricht
  • Pacemaker center, Cardiovascular institute Clinical Center of Serbia

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Implantation of the CardioFit system

Arm Description

Outcomes

Primary Outcome Measures

The occurrence of all system and/or procedure related adverse events.

Secondary Outcome Measures

Change in NYHA class
Quality of Life
Exercise capacity (by 6-min walk)
LV Ejection fraction
LV end-systolic and end-diastolic volumes
Blood tests.

Full Information

First Posted
April 16, 2007
Last Updated
March 4, 2011
Sponsor
BioControl Medical
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1. Study Identification

Unique Protocol Identification Number
NCT00461019
Brief Title
CardioFit™ for the Treatment of Heart Failure
Official Title
CardioFiT™ for Heart Failure - Safety and Efficacy Study Protocol
Study Type
Interventional

2. Study Status

Record Verification Date
March 2011
Overall Recruitment Status
Completed
Study Start Date
February 2007 (undefined)
Primary Completion Date
February 2010 (Actual)
Study Completion Date
February 2010 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
BioControl Medical

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Congestive Heart Failure is the result of a number of diseases affecting the heart, causing the heart's failure to properly meet the body demands for blood circulation. In spite of advances in drug therapy, it remains a significant public health problem. Pharmacologic antagonism of the beta-adrenergic receptors shifting the autonomic balance in the direction of greater vagal influence is a well-proven treatment for heart failure patients, although there are patients who cannot tolerate, or only partially benefit from such a treatment. It has been proven in the past and well established that parasympathetic nerve stimulation can slow the rate of the heart and reduce the workload of the heart. Therefore, the potential benefit of vagus nerve stimulation, hence parasympathetic activation, for treatment of heart failure is substantial. In this study, the safety and efficacy of a new vagus nerve stimulating system will be evaluated. This study will compare whether the new device improves Heart Failure parameters in Class II - III Heart Failure patients.
Detailed Description
Purpose of the study: To determine the safety and efficacy of the CardioFit™ system for treatment of Class II-III Heart Failure patients. Study hypothesis: CardioFit system treatment will improve patients Heart Failure parameters. Tested hypothesis: Thirty patients are required to provide 80% power at 95% confidence level in order to detect 12 points difference on a quality of life questionnaire between pre- and post activation. Design: Prospective, self-controlled interventional study composed of 5 periods: Pre-implantation, Implantation, Device activation, Follow-up (with active device) and post-study extension period. Study duration is 7.5-months per patient. At the end of the study, patients enter an extension period (with active devices) during which they will be monitored for quality of life and survival, for up to 3 years post-implantation in 6-months intervals. Study Endpoints: Primary endpoints: The occurrence of all system and/or procedure related adverse events. Secondary endpoints: changes in the following individual variables as well as in a composite score of individual variables change: NYHA class; Quality of Life; Exercise capacity (by 6-min walk); LV Ejection fraction; LV end-systolic and end-diastolic volumes; blood tests. Up to 10 participating centers in Europe, Israel and Australia

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Heart Failure

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
32 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Implantation of the CardioFit system
Arm Type
Experimental
Intervention Type
Procedure
Intervention Name(s)
Implantation and activation of the vagus nerve stimulator
Intervention Description
Implantation of the nerve stimulator, cuff nerve electrode and RV sensing lead
Primary Outcome Measure Information:
Title
The occurrence of all system and/or procedure related adverse events.
Time Frame
along the study
Secondary Outcome Measure Information:
Title
Change in NYHA class
Time Frame
At 6-months
Title
Quality of Life
Time Frame
At 6-months
Title
Exercise capacity (by 6-min walk)
Time Frame
At 6-months
Title
LV Ejection fraction
Time Frame
At 6-months
Title
LV end-systolic and end-diastolic volumes
Time Frame
At 6-months
Title
Blood tests.
Time Frame
At 6-months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The patient is in chronic heart failure, NYHA II-III. The patient may have been previously in class IV but must be in class II or III for three or more months prior to study entry; Age between 18 and 75 years; The patient is a male or postmenopausal female. Females of childbearing age may be included if pregnancy is excluded and acceptable contraception measures are used; Patient must sign an approved informed consent form. Patient agrees to attend all follow-up evaluations; Patient should be in sinus rhythm. Average 24-hour heart rate is between 60 and 110 b/min in a recorded 24-h Holter measurement; Patient should be in optimal medical treatment with no change in treatment in the previous 3 months with the exception of diuretics; Left ventricular ejection fraction estimated by echocardiography, cardiac angiography, radionuclide study, or other accepted mode of evaluation, is no more than 35%; Patient is physically capable and willing to perform repeated physically demanding tests associated with the study. Exclusion Criteria: Presence of an immediately life threatening condition or disease other than heart failure, such as cancer, terminal renal failure etc. Acute myocardial Infarction (MI), variant angina pectoris, unstable angina or acute coronary syndrome in the previous three months; Previous stroke; Coronary Artery Bypass Surgery (CABG) or Percutaneous Coronary Intervention in the past 3 months; Episode of NYHA class IV heart failure, including acute pulmonary oedema in the previous three months; Heart failure due to acute myocarditis. Restrictive or constrictive pericarditis, haemodynamically significant aortic valve insufficiency aortic stenosis, or mitral valve stenosis; Severe renal or hepatic failure (Creatinine level>3 mg% (265 micromole/liter) or transaminase level four times ULN); Diabetes Mellitus treated with insulin for more than two years prior to study entry; Diabetic neuropathy; Previous neck surgery, including for Peripheral Vascular Disease (PVD), malignancy, and previous irradiation therapy of the neck; Current hypotension (systolic blood pressure below 80 mmHg); Active peptic disease or history of upper GI bleeding; Asthma, severe COPD (e.g. FEV1<1.5 liter), or severe restrictive lung disease; 1st degree AV block with PR interval > 240msec, 2nd or 3rd degree AV block; Atrial fibrillation or flutter in the in the previous 3 months; Sustained ventricular tachyarrhythmia with hemodynamic compromise, in the absence of implanted ICD; Long QT syndrome, congenital or acquired; Recorded or suspected symptomatic vaso-vagal response; Treatment by investigational drug or device within the past 3 months; Glaucoma, or history of glaucoma; Major psychiatric disorder in the present or in the past; Dementia; Patients transplanted with tissues or organs; Immunosuppressed patients; patients under systemic steroid treatment; Anemia with Hb<10gr/L, unless treated with Epo; Patients who are at risk for carotid arteries plaques and have unstable carotid plaques, as assessed by Echo Doppler; and/or patients with >70% carotid artery stenosis; Patient is candidate for cardiac resynchronization device implantation.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peter J Schwartz, Professor
Organizational Affiliation
Fondazione IRCCS Policlinico San-Matteo
Official's Role
Principal Investigator
Facility Information:
Facility Name
Georg-August-Universität Göttingen
City
Göttingen
ZIP/Postal Code
37075
Country
Germany
Facility Name
Otto von-Guericke University Clinik
City
Magdeburg
ZIP/Postal Code
39120
Country
Germany
Facility Name
I. Medizinische Klinik, Klinikum Mannheim GmbH Universitätsklinikum Fakultät für klinische Medizin Mannheim der Universität Heidelberg
City
Mannheim
ZIP/Postal Code
68167
Country
Germany
Facility Name
Fondazione IRCCS Policlinico "San Matteo"
City
Pavia
ZIP/Postal Code
27100
Country
Italy
Facility Name
Academic Hospital Maastricht
City
Maastricht
ZIP/Postal Code
6202 AZ
Country
Netherlands
Facility Name
Pacemaker center, Cardiovascular institute Clinical Center of Serbia
City
Belgrade
ZIP/Postal Code
11000
Country
Serbia

12. IPD Sharing Statement

Citations:
PubMed Identifier
21030409
Citation
De Ferrari GM, Crijns HJ, Borggrefe M, Milasinovic G, Smid J, Zabel M, Gavazzi A, Sanzo A, Dennert R, Kuschyk J, Raspopovic S, Klein H, Swedberg K, Schwartz PJ; CardioFit Multicenter Trial Investigators. Chronic vagus nerve stimulation: a new and promising therapeutic approach for chronic heart failure. Eur Heart J. 2011 Apr;32(7):847-55. doi: 10.1093/eurheartj/ehq391. Epub 2010 Oct 28.
Results Reference
result
PubMed Identifier
18760668
Citation
Schwartz PJ, De Ferrari GM, Sanzo A, Landolina M, Rordorf R, Raineri C, Campana C, Revera M, Ajmone-Marsan N, Tavazzi L, Odero A. Long term vagal stimulation in patients with advanced heart failure: first experience in man. Eur J Heart Fail. 2008 Sep;10(9):884-91. doi: 10.1016/j.ejheart.2008.07.016. Epub 2008 Aug 28.
Results Reference
result
Links:
URL
http://www.clinicaltrials.gov/ct2/show/NCT01303718?term=BioControl+Medical&rank=1
Description
INOVATE-HF INcrease Of VAgal TonE in Heart Failure

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CardioFit™ for the Treatment of Heart Failure

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