APPROPRIATE - Rate Adaptive Pacing Sensor (APPROPRIATE)
Primary Purpose
Heart Diseases
Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Rate adaptive pacemaker
Rate adaptive pacemaker
Sponsored by

About this trial
This is an interventional treatment trial for Heart Diseases focused on measuring Pacemaker
Eligibility Criteria
Inclusion Criteria:
- Meets or met current pacemaker implantation indications
- Willing and capable of providing informed consent for participation
- Receiving a dual-chamber pacemaker or previously received a dual-chamber pacemaker with active atrial and ventricular leads
- Plans to remain in the long-term care of his/her enrolling physician and is available for study follow-up for three months post-enrollment
Exclusion Criteria:
- Mobitz II second degree heart block
- Third degree heart block
- Chronic atrial fibrillation or uncontrolled atrial arrhythmias within the past 90 days prior to consent
- Neuromuscular, orthopedic, or vascular disability that prevents normal walking or weight carrying (e.g., intermittent claudication, arthritis, residual stroke weakness, need for a wheelchair or walker)
- A symptom-limited exercise protocol is thought to be dangerous or contra-indicated, including but not limited to changing pattern of chest discomfort or uncontrolled arrhythmias
Pulmonary disease as defined by any one of the following:
- Forced Vital Capacity (FVC) or Forced Expiratory Volume in one second (FEV1) < 60% of predicted values
- Use of two or more pulmonary inhalers
- Use of supplemental oxygen
- Chronic use of oral steroids for pulmonary disease treatment
- Life expectancy is less than 12 months due to other medical conditions, per physician discretion
- Has or indicated for an implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy-defibrillator (CRT-D)
- Currently enrolled in another investigational study that would directly impact the treatment or outcome of the current study.
- Younger than 18 years of age
- Pregnant or planning to become pregnant during the study (method of assessment upon physician's discretion)
- Unable or unwilling to comply with the protocol requirements
Sites / Locations
- Cardiology Association of NE Arkansas
- Genesis Heart Institute
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
Accelerometer
Minute Ventilation
Arm Description
Patients implanted with a Boston Scientific ALTRUA 60 pacemaker with accelerometer (motion-based) sensor.
Patients implanted with a Boston Scientific ALTRUA 60 pacemaker with minute ventilation sensor.
Outcomes
Primary Outcome Measures
Mean Change in Functional Capacity (Peak VO2).
The APPROPRIATE Study compared differences in functional capacity (peak VO2) between CI patients randomized to receive rate responsive pacing driven by either the minute ventilation (respiration-based) sensor or by an accelerometer (motion-based) sensor.
The mean change in functional capactity will be compared against baseline; changes from baseline will be measured.
Secondary Outcome Measures
Changes in Heart Rate During Activities of Daily Living (ADL) Using a Lift and Carry Test
This outcome measure will be compared against baseline.
Metabolic Chronotropic Relationship (MCR) Slope
Exercise Time
VO2 at Ventilatory Threshold
Full Information
NCT ID
NCT00757666
First Posted
September 19, 2008
Last Updated
May 17, 2017
Sponsor
Boston Scientific Corporation
1. Study Identification
Unique Protocol Identification Number
NCT00757666
Brief Title
APPROPRIATE - Rate Adaptive Pacing Sensor
Acronym
APPROPRIATE
Official Title
Assessment of Proper Physiologic Response With Rate Adaptive Pacing Driven by Minute Ventilation or Accelerometer
Study Type
Interventional
2. Study Status
Record Verification Date
May 2017
Overall Recruitment Status
Terminated
Why Stopped
Difficulty enrollment; higher than planned patient attrition and data attrition
Study Start Date
December 2008 (Actual)
Primary Completion Date
January 2011 (Actual)
Study Completion Date
January 2011 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Boston Scientific Corporation
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The APPROPRIATE study will compare differences in functional capacity (peak VO2) between chronotropically incompetent patients randomized to receive rate responsive pacing driven by either the minute ventilation (respiration-based) sensor or an accelerometer (motion-based).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Heart Diseases
Keywords
Pacemaker
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
566 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Accelerometer
Arm Type
Active Comparator
Arm Description
Patients implanted with a Boston Scientific ALTRUA 60 pacemaker with accelerometer (motion-based) sensor.
Arm Title
Minute Ventilation
Arm Type
Active Comparator
Arm Description
Patients implanted with a Boston Scientific ALTRUA 60 pacemaker with minute ventilation sensor.
Intervention Type
Device
Intervention Name(s)
Rate adaptive pacemaker
Intervention Description
Accelerometer sensor
Intervention Type
Device
Intervention Name(s)
Rate adaptive pacemaker
Intervention Description
Minute ventilation sensor
Primary Outcome Measure Information:
Title
Mean Change in Functional Capacity (Peak VO2).
Description
The APPROPRIATE Study compared differences in functional capacity (peak VO2) between CI patients randomized to receive rate responsive pacing driven by either the minute ventilation (respiration-based) sensor or by an accelerometer (motion-based) sensor.
The mean change in functional capactity will be compared against baseline; changes from baseline will be measured.
Time Frame
1 month and 2 months post-implant
Secondary Outcome Measure Information:
Title
Changes in Heart Rate During Activities of Daily Living (ADL) Using a Lift and Carry Test
Description
This outcome measure will be compared against baseline.
Time Frame
2 months post-implant
Title
Metabolic Chronotropic Relationship (MCR) Slope
Time Frame
1 month and 2 months post-implant
Title
Exercise Time
Time Frame
1 month and 2 months post-implant
Title
VO2 at Ventilatory Threshold
Time Frame
1 month and 2 months post-implant
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Meets or met current pacemaker implantation indications
Willing and capable of providing informed consent for participation
Receiving a dual-chamber pacemaker or previously received a dual-chamber pacemaker with active atrial and ventricular leads
Plans to remain in the long-term care of his/her enrolling physician and is available for study follow-up for three months post-enrollment
Exclusion Criteria:
Mobitz II second degree heart block
Third degree heart block
Chronic atrial fibrillation or uncontrolled atrial arrhythmias within the past 90 days prior to consent
Neuromuscular, orthopedic, or vascular disability that prevents normal walking or weight carrying (e.g., intermittent claudication, arthritis, residual stroke weakness, need for a wheelchair or walker)
A symptom-limited exercise protocol is thought to be dangerous or contra-indicated, including but not limited to changing pattern of chest discomfort or uncontrolled arrhythmias
Pulmonary disease as defined by any one of the following:
Forced Vital Capacity (FVC) or Forced Expiratory Volume in one second (FEV1) < 60% of predicted values
Use of two or more pulmonary inhalers
Use of supplemental oxygen
Chronic use of oral steroids for pulmonary disease treatment
Life expectancy is less than 12 months due to other medical conditions, per physician discretion
Has or indicated for an implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy-defibrillator (CRT-D)
Currently enrolled in another investigational study that would directly impact the treatment or outcome of the current study.
Younger than 18 years of age
Pregnant or planning to become pregnant during the study (method of assessment upon physician's discretion)
Unable or unwilling to comply with the protocol requirements
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Giudici, MD
Organizational Affiliation
Genesis Heart Institute
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
F. Roosevelt Gilliam, MD
Organizational Affiliation
Cardiology Associates of NE Arkansas
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cardiology Association of NE Arkansas
City
Jonesboro
State/Province
Arkansas
Country
United States
Facility Name
Genesis Heart Institute
City
Davenport
State/Province
Iowa
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
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