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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/study/NCT00980057




Registration number
NCT00980057
Ethics application status
Date submitted
16/09/2009
Date registered
18/09/2009
Date last updated
16/10/2018

Titles & IDs
Public title
Adaptive Cardiac Resynchronization Therapy Study
Scientific title
Adaptive Cardiac Resynchronization Therapy Study
Secondary ID [1] 0 0
Adaptive CRT
Universal Trial Number (UTN)
Trial acronym
aCRT
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Heart Failure 0 0
Condition category
Condition code
Cardiovascular 0 0 0 0
Coronary heart disease
Cardiovascular 0 0 0 0
Other cardiovascular diseases

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Devices - Adaptive CRT (aCRT)
Treatment: Devices - Echo

Experimental: Adaptive CRT (aCRT) arm - Intervention: Cardiac resynchronization therapy (CRT-D) with Adaptive CRT algorithm ON

Active comparator: Echo-optimized arm - Intervention: Cardiac resynchronization therapy (CRT-D) with standard biventricular pacing (Adaptive CRT algorithm OFF)


Treatment: Devices: Adaptive CRT (aCRT)
Adaptive CRT (aCRT) is an algorithm, which provides ambulatory adjustment of pacing configuration (LV-only or BiV) and AV and VV delays based on periodic automatic evaluation of electrical conduction to optimize cardiac function

Treatment: Devices: Echo
Standard BiV pacing with settings optimized using a standardized echocardiographic protocol
Intervention code [1] 0 0
Treatment: Devices
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Percentage of Patients With Improved Heart Failure Outcomes Clinical Composite Score
Timepoint [1] 0 0
randomization to six month visit
Primary outcome [2] 0 0
Correlation Between Aortic Velocity Time Integral (AoVTI) at Adaptive CRT and Echo-optimized Device Settings
Timepoint [2] 0 0
randomization visit and six month visit
Primary outcome [3] 0 0
Percentage of Patients With a Safety Event (Inappropriate AV or VV Delay Settings Related to the aCRT Feature)
Timepoint [3] 0 0
randomization to 6 months post randomization
Secondary outcome [1] 0 0
Right Ventricular Pacing Percentage
Timepoint [1] 0 0
implant to six months post randomization
Secondary outcome [2] 0 0
Change in Left Ventricular End Systolic Volume Index (LVESVi)
Timepoint [2] 0 0
baseline to six month visit
Secondary outcome [3] 0 0
Change in Left Ventricular Ejection Fraction (LVEF)
Timepoint [3] 0 0
baseline to six month visit
Secondary outcome [4] 0 0
Change in New York Heart Association (NYHA) Classification
Timepoint [4] 0 0
baseline to six month visit
Secondary outcome [5] 0 0
Change in Distance Walked During the Six Minute Hall Walk
Timepoint [5] 0 0
baseline to six month visit
Secondary outcome [6] 0 0
Change in Quality of Life Measured by the Minnesota Living With Heart Failure Questionnaire (MLWHF)
Timepoint [6] 0 0
baseline to six month visit

Eligibility
Key inclusion criteria
* Subject is willing to sign and date the study Informed Consent form
* Subject is at least 18 years of age (or older, if required by local law)
* Subject is expected to remain available for at least six months of follow-up visits
* Subject is indicated for a study device that will be implanted within 30 days after signing the Informed Consent form
* Subject has an intrinsic QRS duration greater than or equal to 120 milliseconds (documented within 30 days prior to enrollment)
* Subject has a left ventricular ejection fraction less than or equal to 35 percent (method per physician discretion) (documented within 180 days prior to enrollment)
* Subject is diagnosed with New York Heart Association (NYHA) class III or IV (within 30 days prior to enrollment) despite optimal medical therapy which is defined as: ACE-inhibitor (Angiotensin-Converting Enzyme) or Angiotensin II Receptor Blocker (ARB), if tolerated, for at least one month prior to implant, AND beta-blocker for at least three months preceding implant, if tolerated, and stable for one month, OR subject has an urgent medical need for an implantable cardioverter defibrillator (ICD) that precludes waiting the one or three months for the medication requirements for ACE inhibitor, ARB or beta-blocker
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
* Subject has chronic (permanent) atrial arrhythmias for which pharmacological therapy and/or cardioversion have been unsuccessful or have not been attempted
* Subject has existing CRT system
* Subject has non-intact or unstable leads
* Subject has medical conditions that would limit study participation (per physician discretion)
* Subject is enrolled in one or more concurrent studies that would confound the study results of this study as determined by Medtronic
* Subject has unstable angina, or experienced an acute myocardial infarction (MI) or received coronary artery revascularization (CABG) or coronary angioplasty (PTCA) (documented within 30 days prior to enrollment)
* Subject has a mechanical right heart valve or is scheduled to undergo valve repair or valve replacement during the course of the study
* Subject is post-heart transplant (subjects on the heart transplant list for the first time are not excluded)
* Subject has a limited life expectancy that would not allow completion of the 6 month visit
* Subject is pregnant (In the United States, all women of child-bearing potential must undergo a pregnancy test within seven days prior to aCRT download into device)
* Subject meets the exclusion criteria required by local law

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s


The people analysing the results/data
Intervention assignment
Parallel
Other design features
Phase
Not applicable
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
1/10/2009
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
8/03/2012
Sample size
Target
Accrual to date
Final
522
Recruitment in Australia
Recruitment state(s)
Recruitment hospital [1] 0 0
- Adelaide
Recruitment hospital [2] 0 0
- Camperdown
Recruitment hospital [3] 0 0
- Chermside
Recruitment hospital [4] 0 0
- Darlinghurst
Recruitment hospital [5] 0 0
- Perth
Recruitment hospital [6] 0 0
- Spring Hill
Recruitment postcode(s) [1] 0 0
- Adelaide
Recruitment postcode(s) [2] 0 0
- Camperdown
Recruitment postcode(s) [3] 0 0
- Chermside
Recruitment postcode(s) [4] 0 0
- Darlinghurst
Recruitment postcode(s) [5] 0 0
- Perth
Recruitment postcode(s) [6] 0 0
- Spring Hill
Recruitment outside Australia
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United States of America
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Alabama
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United States of America
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Alaska
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Arizona
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Arkansas
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California
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Colorado
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Florida
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Georgia
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Illinois
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Indiana
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Iowa
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Kentucky
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Maryland
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Massachusetts
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Michigan
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Missouri
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Nebraska
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New York
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North Carolina
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South Carolina
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Tennessee
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Texas
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Vermont
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Washington
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West Virginia
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Wisconsin
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Austria
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Linz
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Belgium
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Genk
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Leuven
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Yvoir
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Ottawa
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Victoria
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Denmark
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Aalborg
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København
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Odense
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Århus
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Germany
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Bochum
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Hamburg
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Ludenscheid
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Reinbek
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Trier
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Greece
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Athens
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Hong Kong
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Hong Kong
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Hungary
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Budapest
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Italy
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Milano
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Italy
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Pavia
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Italy
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Pedara
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Italy
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Rozzano
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Japan
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Osaka
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Japan
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Tokyo
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Japan
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Tsukuba city
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Netherlands
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Nijmegen
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Netherlands
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Rotterdam
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Norway
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Bergen
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Norway
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Oslo
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Russian Federation
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Tyumen
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Saudi Arabia
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Riyadh
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Serbia
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Belgrade
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Serbia
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Nis
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Serbia
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Sremska Kamenica
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Spain
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Albacete
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Madrid
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Spain
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Majadahonda
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Spain
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Vitoria-Gasteiz
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Sweden
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Lund
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Sweden
State/province [78] 0 0
Stockholm

Funding & Sponsors
Primary sponsor type
Commercial sector/industry
Name
Medtronic Cardiac Rhythm and Heart Failure
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
The purpose of this study is to demonstrate the AdaptivCRT algorithm is at least as good as manual echo based optimization in regard to patient outcomes and cardiac performance
Trial website
https://clinicaltrials.gov/study/NCT00980057
Trial related presentations / publications
Gasparini M, Birnie D, Lemke B, Aonuma K, Lee KL, Gorcsan J 3rd, Landolina M, Klepfer R, Meloni S, Cicconelli M, Grammatico A, Martin DO. Adaptive Cardiac Resynchronization Therapy Reduces Atrial Fibrillation Incidence in Heart Failure Patients With Prolonged AV Conduction: The Adaptive CRT Randomized Trial. Circ Arrhythm Electrophysiol. 2019 May;12(5):e007260. doi: 10.1161/CIRCEP.119.007260. No abstract available.
Birnie D, Hudnall H, Lemke B, Aonuma K, Lee KL, Gasparini M, Gorcsan J 3rd, Cerkvenik J, Martin DO. Continuous optimization of cardiac resynchronization therapy reduces atrial fibrillation in heart failure patients: Results of the Adaptive Cardiac Resynchronization Therapy Trial. Heart Rhythm. 2017 Dec;14(12):1820-1825. doi: 10.1016/j.hrthm.2017.08.017. Epub 2017 Sep 9.
Yamasaki H, Lustgarten D, Cerkvenik J, Birnie D, Gasparini M, Lee KL, Sekiguchi Y, Varma N, Lemke B, Starling RC, Aonuma K. Adaptive CRT in patients with normal AV conduction and left bundle branch block: Does QRS duration matter? Int J Cardiol. 2017 Aug 1;240:297-301. doi: 10.1016/j.ijcard.2017.04.036. Epub 2017 Apr 12.
Starling RC, Krum H, Bril S, Tsintzos SI, Rogers T, Hudnall JH, Martin DO. Impact of a Novel Adaptive Optimization Algorithm on 30-Day Readmissions: Evidence From the Adaptive CRT Trial. JACC Heart Fail. 2015 Jul;3(7):565-572. doi: 10.1016/j.jchf.2015.03.001. Epub 2015 Jun 10.
Birnie D, Lemke B, Aonuma K, Krum H, Lee KL, Gasparini M, Starling RC, Milasinovic G, Gorcsan J 3rd, Houmsse M, Abeyratne A, Sambelashvili A, Martin DO. Clinical outcomes with synchronized left ventricular pacing: analysis of the adaptive CRT trial. Heart Rhythm. 2013 Sep;10(9):1368-74. doi: 10.1016/j.hrthm.2013.07.007. Epub 2013 Jul 11.
Krum H, Lemke B, Birnie D, Lee KL, Aonuma K, Starling RC, Gasparini M, Gorcsan J, Rogers T, Sambelashvili A, Kalmes A, Martin D. A novel algorithm for individualized cardiac resynchronization therapy: rationale and design of the adaptive cardiac resynchronization therapy trial. Am Heart J. 2012 May;163(5):747-752.e1. doi: 10.1016/j.ahj.2012.02.007.
Public notes

Contacts
Principal investigator
Name 0 0
Adaptive CRT Trial Leader
Address 0 0
Medtronic
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/study/NCT00980057