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Multicenter Automatic Defibrillator Implantation Trial - Reduce Inappropriate Therapy (MADIT-RIT)

Primary Purpose

Primary Prevention of Sudden Cardiac Arrest

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Standard ICD programming
High rate cutoff
Long delay
Sponsored by
Boston Scientific Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary Prevention of Sudden Cardiac Arrest focused on measuring Inappropriate therapy, ICD therapy, Primary prevention

Eligibility Criteria

21 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Primary prevention patient with ischemic or non-ischemic heart disease who meets current guidelines for dual-chamber ICD or CRT-D device therapy
  • Patient in sinus rhythm
  • Patient on stable optimal pharmacologic therapy for the cardiac condition or who has developed a recent ICD indication that necessitates ICD therapy concurrent with the optimization of pharmacologic therapy
  • Patient ≥ 21 years of age, or legal representative, willing and capable of giving informed consent

Exclusion Criteria:

  • Patient with an implanted pacemaker or CRT-P
  • Patient with existing ICD or CRT-D device components
  • Patient with a history of VT or VF
  • Patient with permanent or chronic AF, or cardioversion for AF, within the past three calendar months before enrollment
  • Patient with coronary artery bypass graft surgery or percutaneous coronary intervention within the past three calendar months prior to enrollment
  • Patient with enzyme-positive myocardial infarction within the past three calendar months prior to enrollment
  • Patient with angiographic evidence of coronary disease who are candidates for coronary revascularization and are likely to undergo coronary artery bypass graft surgery or percutaneous coronary intervention in the foreseeable future
  • Patient with second or third degree heart block
  • Patient in NYHA Class IV
  • Patient who is pregnant or plans to become pregnant during the course of the trial
  • Patient with irreversible brain damage from preexisting cerebral disease
  • Patient with presence of any disease, other than the patient's cardiac disease, associated with a reduced likelihood of survival for the duration of the trial, e.g., cancer, uremia, liver failure, etc.
  • Patient with chronic renal disease with BUN ≥ 50mg/dl or creatinine ≥ 2.5 mg/dl
  • Patient participating in any other clinical trial
  • Patient unwilling or unable to cooperate with the protocol
  • Patient who lives at such a distance from the clinic that travel for follow-up visits would be unusually difficult
  • Patient who does not anticipate being a resident of the area for the scheduled duration of the trial
  • Patient unwilling to sign the consent for participation
  • Patient whose physician does not allow participation

Sites / Locations

  • University of Rochester (Multiple Facilities Participating World Wide)

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

A

B

C

Arm Description

Standard ICD Programming

High rate cutoff

Long ICD duration delay

Outcomes

Primary Outcome Measures

Inappropriate ICD Therapy
First occurance of inappropriate therapy (either anti-tachycardia pacing or shock)

Secondary Outcome Measures

All-cause Mortality
Syncope
First episode of syncope

Full Information

First Posted
July 27, 2009
Last Updated
July 12, 2018
Sponsor
Boston Scientific Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT00947310
Brief Title
Multicenter Automatic Defibrillator Implantation Trial - Reduce Inappropriate Therapy
Acronym
MADIT-RIT
Official Title
IDE-Exempt: Multicenter Automatic Defibrillator Implantation Trial - Reduce Inappropriate Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
March 2013
Overall Recruitment Status
Completed
Study Start Date
September 2009 (undefined)
Primary Completion Date
August 2012 (Actual)
Study Completion Date
December 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Boston Scientific Corporation

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will assess the impact of higher rate cutoffs and longer delays than standard programming on inappropriate therapy in primary prevention ICD and CRT-D patients.
Detailed Description
The purpose of the MADIT-RIT trial is to compare the time to first inappropriate therapy using high rate cutoff and/or long delay in primary prevention patients receiving an ICD or CRT-D device compared to standard programming.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Prevention of Sudden Cardiac Arrest
Keywords
Inappropriate therapy, ICD therapy, Primary prevention

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
1500 (Actual)

8. Arms, Groups, and Interventions

Arm Title
A
Arm Type
Experimental
Arm Description
Standard ICD Programming
Arm Title
B
Arm Type
Experimental
Arm Description
High rate cutoff
Arm Title
C
Arm Type
Experimental
Arm Description
Long ICD duration delay
Intervention Type
Device
Intervention Name(s)
Standard ICD programming
Intervention Description
Standard ICD programming
Intervention Type
Device
Intervention Name(s)
High rate cutoff
Intervention Description
Programming of a high rate cutoff
Intervention Type
Device
Intervention Name(s)
Long delay
Intervention Description
Programming of a prolonged delay
Primary Outcome Measure Information:
Title
Inappropriate ICD Therapy
Description
First occurance of inappropriate therapy (either anti-tachycardia pacing or shock)
Time Frame
Average of 1.4 years follow-up
Secondary Outcome Measure Information:
Title
All-cause Mortality
Time Frame
Average 1.4 years of follow-up
Title
Syncope
Description
First episode of syncope
Time Frame
Average of 1.4 years follow-up

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Primary prevention patient with ischemic or non-ischemic heart disease who meets current guidelines for dual-chamber ICD or CRT-D device therapy Patient in sinus rhythm Patient on stable optimal pharmacologic therapy for the cardiac condition or who has developed a recent ICD indication that necessitates ICD therapy concurrent with the optimization of pharmacologic therapy Patient ≥ 21 years of age, or legal representative, willing and capable of giving informed consent Exclusion Criteria: Patient with an implanted pacemaker or CRT-P Patient with existing ICD or CRT-D device components Patient with a history of VT or VF Patient with permanent or chronic AF, or cardioversion for AF, within the past three calendar months before enrollment Patient with coronary artery bypass graft surgery or percutaneous coronary intervention within the past three calendar months prior to enrollment Patient with enzyme-positive myocardial infarction within the past three calendar months prior to enrollment Patient with angiographic evidence of coronary disease who are candidates for coronary revascularization and are likely to undergo coronary artery bypass graft surgery or percutaneous coronary intervention in the foreseeable future Patient with second or third degree heart block Patient in NYHA Class IV Patient who is pregnant or plans to become pregnant during the course of the trial Patient with irreversible brain damage from preexisting cerebral disease Patient with presence of any disease, other than the patient's cardiac disease, associated with a reduced likelihood of survival for the duration of the trial, e.g., cancer, uremia, liver failure, etc. Patient with chronic renal disease with BUN ≥ 50mg/dl or creatinine ≥ 2.5 mg/dl Patient participating in any other clinical trial Patient unwilling or unable to cooperate with the protocol Patient who lives at such a distance from the clinic that travel for follow-up visits would be unusually difficult Patient who does not anticipate being a resident of the area for the scheduled duration of the trial Patient unwilling to sign the consent for participation Patient whose physician does not allow participation
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Arthur J Moss, MD
Organizational Affiliation
University of Rochester
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Rochester (Multiple Facilities Participating World Wide)
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
22816536
Citation
Schuger C, Daubert JP, Brown MW, Cannom D, Estes NA 3rd, Hall WJ, Kayser T, Klein H, Olshansky B, Power KA, Wilber D, Zareba W, Moss AJ. Multicenter automatic defibrillator implantation trial: reduce inappropriate therapy (MADIT-RIT): background, rationale, and clinical protocol. Ann Noninvasive Electrocardiol. 2012 Jul;17(3):176-85. doi: 10.1111/j.1542-474X.2012.00531.x.
Results Reference
background
PubMed Identifier
31765809
Citation
Younis A, Heist EK, McNitt S, Aktas MK, Rosero S, Goldenberg I, Kutyifa V. Predictors and outcomes of atrial tachyarrhythmia among patients with implantable defibrillators. Heart Rhythm. 2020 Apr;17(4):553-559. doi: 10.1016/j.hrthm.2019.11.024. Epub 2019 Nov 22.
Results Reference
derived
PubMed Identifier
29978932
Citation
Jackson LR 2nd, Thomas KL, Polonsky B, Zareba W, Lahiri M, Saba S, McNitt S, Schuger C, Daubert JP, Moss AJ, Kutyifa V. Effectiveness of high rate and delayed detection ICD programming by race: A MADIT-RIT substudy. J Cardiovasc Electrophysiol. 2018 Oct;29(10):1418-1424. doi: 10.1111/jce.13693. Epub 2018 Jul 24.
Results Reference
derived
PubMed Identifier
26743237
Citation
Kutyifa V, Daubert JP, Schuger C, Goldenberg I, Klein H, Aktas MK, McNitt S, Stockburger M, Merkely B, Zareba W, Moss AJ. Novel ICD Programming and Inappropriate ICD Therapy in CRT-D Versus ICD Patients: A MADIT-RIT Sub-Study. Circ Arrhythm Electrophysiol. 2016 Jan;9(1):e001965. doi: 10.1161/CIRCEP.114.001965.
Results Reference
derived
PubMed Identifier
26001510
Citation
Kutyifa V, Daubert JP, Olshansky B, Huang DT, Zhang C, Ruwald AC, McNitt S, Zareba W, Moss AJ, Schuger C. Characterization and predictors of first and subsequent inappropriate ICD therapy by heart rate ranges: Result of the MADIT-RIT efficacy analysis. Heart Rhythm. 2015 Sep;12(9):2030-7. doi: 10.1016/j.hrthm.2015.05.021. Epub 2015 May 19.
Results Reference
derived
PubMed Identifier
25917337
Citation
Kutyifa V, Moss AJ, Schuger C, McNitt S, Polonsky B, Ruwald AH, Ruwald MH, Daubert JP, Zareba W. Reduction in Inappropriate ICD Therapy in MADIT-RIT Patients Without History of Atrial Tachyarrhythmia. J Cardiovasc Electrophysiol. 2015 Aug;26(8):879-884. doi: 10.1111/jce.12692. Epub 2015 Jun 15.
Results Reference
derived
PubMed Identifier
25745075
Citation
Stockburger M, Moss AJ, Olshansky B, Klein H, McNitt S, Schuger C, Daubert JP, Goldenberg I, Ruwald AC, Merkely B, Zareba W, Kutyifa V. Time-dependent risk reduction of ventricular tachyarrhythmias in cardiac resynchronization therapy patients: a MADIT-RIT sub-study. Europace. 2015 Jul;17(7):1085-91. doi: 10.1093/europace/euv008. Epub 2015 Mar 4.
Results Reference
derived
PubMed Identifier
25546486
Citation
Sedlacek K, Ruwald AC, Kutyifa V, McNitt S, Thomsen PEB, Klein H, Stockburger M, Wichterle D, Merkely B, DE LA Concha JF, Swissa M, Zareba W, Moss AJ, Kautzner J, Ruwald MH; MADIT-RIT Investigators. The effect of ICD programming on inappropriate and appropriate ICD Therapies in ischemic and nonischemic cardiomyopathy: the MADIT-RIT trial. J Cardiovasc Electrophysiol. 2015 Apr;26(4):424-433. doi: 10.1111/jce.12605. Epub 2015 Feb 11.
Results Reference
derived
PubMed Identifier
25136077
Citation
Ruwald AC, Schuger C, Moss AJ, Kutyifa V, Olshansky B, Greenberg H, Cannom DS, Estes NA, Ruwald MH, Huang DT, Klein H, McNitt S, Beck CA, Goldstein R, Brown MW, Kautzner J, Shoda M, Wilber D, Zareba W, Daubert JP. Mortality reduction in relation to implantable cardioverter defibrillator programming in the Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT). Circ Arrhythm Electrophysiol. 2014 Oct;7(5):785-92. doi: 10.1161/CIRCEP.114.001623. Epub 2014 Aug 18.
Results Reference
derived
PubMed Identifier
24201303
Citation
Ruwald MH, Okumura K, Kimura T, Aonuma K, Shoda M, Kutyifa V, Ruwald AC, McNitt S, Zareba W, Moss AJ. Syncope in high-risk cardiomyopathy patients with implantable defibrillators: frequency, risk factors, mechanisms, and association with mortality: results from the multicenter automatic defibrillator implantation trial-reduce inappropriate therapy (MADIT-RIT) study. Circulation. 2014 Feb 4;129(5):545-52. doi: 10.1161/CIRCULATIONAHA.113.004196. Epub 2013 Nov 7.
Results Reference
derived
PubMed Identifier
23881862
Citation
Ruwald MH, Zareba W, Jons C, Zhang C, Ruwald AC, Olshansky B, McNitt S, Bloch Thomsen PE, Shoda M, Merkely B, Moss AJ, Kutyifa V. Influence of diabetes mellitus on inappropriate and appropriate implantable cardioverter-defibrillator therapy and mortality in the Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT) Trial. Circulation. 2013 Aug 13;128(7):694-701. doi: 10.1161/CIRCULATIONAHA.113.002472. Epub 2013 Jul 23.
Results Reference
derived
PubMed Identifier
23131066
Citation
Moss AJ, Schuger C, Beck CA, Brown MW, Cannom DS, Daubert JP, Estes NA 3rd, Greenberg H, Hall WJ, Huang DT, Kautzner J, Klein H, McNitt S, Olshansky B, Shoda M, Wilber D, Zareba W; MADIT-RIT Trial Investigators. Reduction in inappropriate therapy and mortality through ICD programming. N Engl J Med. 2012 Dec 13;367(24):2275-83. doi: 10.1056/NEJMoa1211107. Epub 2012 Nov 6.
Results Reference
derived

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Multicenter Automatic Defibrillator Implantation Trial - Reduce Inappropriate Therapy

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