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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00547729
Registration number
NCT00547729
Ethics application status
Date submitted
19/10/2007
Date registered
23/10/2007
Titles & IDs
Public title
Hemodynamically Guided Home Self-Therapy in Severe Heart Failure Patients (HOMEOSTASIS)
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Scientific title
Hemodynamically Guided Home Self-Therapy in Severe Heart Failure Patients: A Prospective, Multi-center, Non-randomized, Open Label Study.
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Secondary ID [1]
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HP-05-04/HP-12-04
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Universal Trial Number (UTN)
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Trial acronym
HOMEOSTASIS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Heart Failure
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Condition category
Condition code
Cardiovascular
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Coronary heart disease
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Cardiovascular
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Devices - HeartPOD™ System
Experimental: HeartPOD™ System - Implantation of HeartPOD™ Heart Failure Management System with DynamicRx®
Treatment: Devices: HeartPOD™ System
HeartPOD™ device with DynamicRx® automatically measures left heart pressures throughout the day.
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Intervention code [1]
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Treatment: Devices
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Number of Patients Free From Major Adverse Cardiac and Neurological Events (MACNE) at 6 Weeks.
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Assessment method [1]
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Out of 71 subjects enrolled, data from 55 subjects was adjudicated by a Clinical Events Committee and included in this primary endpoint analysis. MACNE was defined as a hierarchical composite of cardiovascular related death, myocardial infarction, systemic thromboembolism and stroke.
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Timepoint [1]
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6 Weeks
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Eligibility
Key inclusion criteria
* Age > 18 and < 85.
* Documented history of congestive heart failure resulting from ischemic or non-ischemic cardiomyopathy with systolic or diastolic dysfunction of at least 6 months duration.
* Patients with LVEF < 40% should receive maximally tolerated doses of ACE-I (or ARB if ACE-I is not tolerated), beta blockers, and anti-aldosterone therapy. The combination of hydralazine and nitrates should be considered in the persistently symptomatic African American patient.
* A history of NYHA Class II (OUS only), III or IV symptoms.
* Minimum of one (1) prior hospital admission within the last 12 months for exacerbation of CHF or one (1) presentation to the Emergency Department or Clinic requiring parenteral diuretic, vasodilator, inotrope, nesiritide, or equivalent treatment.
* Female subjects of childbearing potential must have a negative pregnancy test within seven (7) days before the procedure.
* Central venous vascular access.
* Capable of Valsalva maneuver with airway pressure > 40 mm Hg for 10 seconds.
* The subject and the treating physician agree that the subject will comply with all required post-procedure follow-up, and that the patient is capable of correct device use as outlined in the protocol.
* Written informed consent.
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Minimum age
18
Years
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Maximum age
85
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Intractable HF with resting symptoms despite maximal medical therapy or active listing for cardiac transplantation (< 6 months survival expected).
* Resting systolic blood pressure < 90 or > 180 mmHg.
* Acute MI, unstable ischemic syndrome within the last 6 weeks.
* Percutaneous coronary intervention (PCI) or cardiac surgery performed or planned within 6 weeks.
* Coexisting stenotic valve lesions, vegetations, hypertrophic cardiomyopathy, amyloidosis or other infiltrative heart disease, constrictive, restrictive disease, tamponade, or moderate or large pericardial effusion.
* Subject has a history of deep venous thrombosis or pulmonary embolism.
* Surgical correction of congenital heart disease involving atrial septum.
* CVA or TIA within 6 months. History of uncorrected cerebral vascular disease.
* Atrial or ventricular thrombus, tumor or systemic thromboembolism.
* Chronic atrial fibrillation.
* Symptomatic bradyarrhythmia or sustained VT/VF unless successfully treated with cardiac rhythm management device for 6 weeks.
* Atrial septal defect or patent foramen ovale > 2 mm in diameter.
* Life expectancy < 1 year from malignancy, primary pulmonary hypertension, renal, hepatic, or neurological condition, etc.
* Gastrointestinal bleeding during the last 6 months.
* Coagulopathy or uninterruptible anticoagulation therapy or unable to take antiplatelet medications.
* Creatinine > 2.5 gm/dl
* Temperature > 37.8C or white blood cell count (WBC) > 13,000/mm3.
* The subject is currently participating in an investigational drug or another device study that has not completed the primary endpoint or that clinically interferes with the current study endpoints.
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
NA
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/03/2005
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/06/2008
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Sample size
Target
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Accrual to date
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Final
71
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Alfred Hospital - Melbourne
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Recruitment postcode(s) [1]
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3004 - Melbourne
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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California
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Country [2]
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United States of America
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State/province [2]
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Ohio
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Country [3]
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United States of America
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State/province [3]
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Oklahoma
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Country [4]
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New Zealand
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State/province [4]
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Auckland
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Country [5]
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New Zealand
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State/province [5]
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Christchurch
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Abbott Medical Devices
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
This study is a feasibility study of the HeartPOD™ Heart Failure Management System with DynamicRx® (HeartPOD system) in patients with severe chronic congestive heart failure. The device being studied in this trial monitors heart function and alerts the patient and physician of necessary changes to medication. The study will assess the safety, reliability, and preliminary efficacy of the HeartPOD™ system.
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Trial website
https://clinicaltrials.gov/study/NCT00547729
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Trial related presentations / publications
Ritzema J, Melton IC, Richards AM, Crozier IG, Frampton C, Doughty RN, Whiting J, Kar S, Eigler N, Krum H, Abraham WT, Troughton RW. Direct left atrial pressure monitoring in ambulatory heart failure patients: initial experience with a new permanent implantable device. Circulation. 2007 Dec 18;116(25):2952-9. doi: 10.1161/CIRCULATIONAHA.107.702191. Epub 2007 Dec 3. Pretorius V, Birgersdotter-Green U, Heywood JT, Hafelfinger W, Gutfinger DE, Eigler NL, Love CJ, Abraham WT. An implantable left atrial pressure sensor lead designed for percutaneous extraction using standard techniques. Pacing Clin Electrophysiol. 2013 May;36(5):570-7. doi: 10.1111/pace.12111. Epub 2013 Feb 28. Ritzema JL, Richards AM, Crozier IG, Frampton CF, Melton IC, Doughty RN, Stewart JT, Eigler N, Whiting J, Abraham WT, Troughton RW. Serial Doppler echocardiography and tissue Doppler imaging in the detection of elevated directly measured left atrial pressure in ambulant subjects with chronic heart failure. JACC Cardiovasc Imaging. 2011 Sep;4(9):927-34. doi: 10.1016/j.jcmg.2011.07.004. Ritzema J, Troughton R, Melton I, Crozier I, Doughty R, Krum H, Walton A, Adamson P, Kar S, Shah PK, Richards M, Eigler NL, Whiting JS, Haas GJ, Heywood JT, Frampton CM, Abraham WT; Hemodynamically Guided Home Self-Therapy in Severe Heart Failure Patients (HOMEOSTASIS) Study Group. Physician-directed patient self-management of left atrial pressure in advanced chronic heart failure. Circulation. 2010 Mar 9;121(9):1086-95. doi: 10.1161/CIRCULATIONAHA.108.800490. Epub 2010 Feb 22.
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Public notes
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Contacts
Principal investigator
Name
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William T. Abraham, MD, FACC
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Address
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Ohio State University
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT00547729