Novel Setup Algorithm for Cardiac Neuromodulation Therapy (CS-10)
Hypertension, Bradycardia
About this trial
This is an interventional treatment trial for Hypertension
Eligibility Criteria
Inclusion Criteria: Subject is ≥ 18 years of age Subject requires implantation or replacement of a dual chamber pacemaker or requires an upgrade from a single chamber to a dual chamber pacemaker. Subject has stable (for prior 1 month) hypertension treatment with 1, 2 or 3 antihypertensive drugs, which is planned to be maintained without changes for a period of at least 2 months post implant. Subject has an office systolic blood pressure (oSBP) ≥140 and <180 mmHg At 4 weeks from device implant, subject has an average 24-Hour ambulatory systolic blood pressure (aSBP) ≥130 mmHg and <170 mmHg and an office blood pressure (oSBP) ≥140 and <180 mmHg. Subject is willing and able to comply with study visits and procedures Subject is willing to adhere to the prescribed baseline antihypertension medical regimen for the duration of the study. Exclusion Criteria: 1. Subject has a known secondary cause of HTN (e.g. renal vascular disease, hyperthyroidism, hyperaldosterone and pheochromocytoma) Subject has permanent atrial fibrillation Subject has intermittent paroxysmal atrial fibrillation/flutter with significant burden (i.e., >10% atrial fibrillation/flutter beats if available. Subject has an ejection fraction <50% Subject has a drop of > 15% (absolute) in ejection fraction from baseline to week 4 Subject has symptoms of heart failure, NYHA Class II or greater Subject has mitral regurgitation ≥2+, aortic stenosis with valve area <1.0 cm2 , or is expected to need a valve repair or replacement. Subject has a history of stroke or TIA within 12 months or any prior stroke with a residual neurological deficit (modified Rankin Score >2+) Subject experienced myocardial infarction (MI) within 3 months prior to enrolment Subject had a cardiovascular interventional procedure or cardiovascular surgery within 6 months prior to enrolment Subject has hypertrophic cardiomyopathy, restrictive cardiomyopathy or interventricular septal thickness ≥15 mm Subject is on dialysis Subject has estimated glomerular filtration rate (GFR) <30 ml/min/1.73m² Subject has significant (>50% occlusion of left or right carotid artery) carotid artery stenosis Subject has a history of clinically significant untreated ventricular tachyarrhythmia or has experienced sudden cardiac arrest Subject has an active device-based treatment for hypertension Subject has an existing active cardiac device or neurostimulator (e.g., ICD, spinal cord stimulator) Subject has Type I Diabetes Subject is a member of a vulnerable population (e.g., prisoners, pregnant or lactating women, mentally disabled) Subject has the possibility of becoming pregnant during the conduct of the study and is not willing to use a means of contraception during the study Subject cannot or is unwilling to provide informed consent
Sites / Locations
- Nemocnice Na Homolce (Na Homolce Hospital)
- Semmelweis University Heart and Vascular CenterRecruiting
- Jagiellonian University Hospital
- Uniwersytecki Szpital Kliniczny w Poznaniu
- Samodzielny Pub. Szpital Kliniczny nr 2 PUM
- Publiczny Centralny Szpital
- Silesian Center for Heart Diseases
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Other
CNT Setup Algorithm Version 1
CNT Setup Algorithm Version 2
CNT therapy optimization without use of the Setup Algorithm
When performing the Setup Algorithm Version 1, each subject's blood pressure is measured with a standard cuff system while the BackBeat-CNT is activated, and system parameters are varied successively according to a specified sequence or based on the blood pressure measurements obtained during previous activations of BackBeat CNT, until the Setup Algorithm is complete. The parameter values as determined by the Setup Algorithm will constitute the programming of the Moderato IPG for the 24 hour activation following setup.
When performing the Setup Algorithm Version 1, each subject's blood pressure is measured with a standard cuff system while the BackBeat-CNT is activated, and system parameters are varied successively according to a specified sequence or based on the blood pressure measurements obtained during previous activations of BackBeat CNT, until the Setup Algorithm is complete. The parameter values as determined by the Setup Algorithm will constitute the programming of the Moderato IPG for the 24 hour activation following setup.
For this optimization procedure, each subject's blood pressure is measured with a continuous blood pressure measurement system while the BackBeat-CNT is activated, and system parameters are varied according to a specified sequence until the desired blood pressure reduction is achieved. The parameter values that provide the desired blood pressure reduction will be recorded, for possible use by the investigator following trial completion