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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03093961
Registration number
NCT03093961
Ethics application status
Date submitted
15/03/2017
Date registered
28/03/2017
Date last updated
6/02/2024
Titles & IDs
Public title
REDUCE LAP-HFREF TRIAL
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Scientific title
A Study to Evaluate the Corvia Medical, Inc. IASD® System II to REDUCE Elevated Left Atrial Pressure in Patients With Heart Failure With Reduced Ejection Fraction
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Secondary ID [1]
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1502
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Universal Trial Number (UTN)
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Trial acronym
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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 - IASD implant
Experimental: Intervention - IASD Implantation
Treatment: Devices: IASD implant
Single arm for implant
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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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The percent of subjects who experience major adverse cardiac and/or cerebrovascular events (MACCE)
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Assessment method [1]
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The primary endpoint will be peri-procedural, and 6 months Major Adverse Cardiac and Cerebrovascular Events (MACCE) and systemic embolic events in patients implanted with the IASD.
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Timepoint [1]
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6 months
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Primary outcome [2]
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The percent of subjects who have successful device implantation
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Assessment method [2]
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Deployment at the intended location during the index procedure
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Timepoint [2]
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Index Procedure
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Primary outcome [3]
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The percent of subjects left to right flow through the device
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Assessment method [3]
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Left to right flow through the device at 6 months as assessed by an echocardiographic core laboratory
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Timepoint [3]
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6 months
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Eligibility
Key inclusion criteria
1. Chronic symptomatic Heart Failure (HF) documented by the following:
1. New York Heart Association (NYHA) Class III/ambulatory class IV symptoms (Paroxysmal nocturnal dyspnea, Orthopnea, Dyspnea on mild or moderate exertion) at screening visit, and signs (e.g. any rales post cough, Chest x-ray demonstrating pulmonary congestion,) within past 12 months; AND
2. One hospital admission for which HF was a major component of the hospitalization within the 12 months prior to study entry (transient heart failure in the context of myocardial infarction does not qualify), or one emergency department visit with IV treatment for HF within the 12 months prior to study entry
2. Ongoing stable GDMT for HF (Class I, and IIa recommendations) according to the 2016 ACC/AHA Guidelines for the management of Heart Failure (with no significant changes [>100% increase or 50% decrease], excluding diuretic dose changes for a minimum of 3 months prior to screening), which is expected to be maintained without change for 6 months
3. Age = 18 years old
4. Reduced Left ventricular ejection fraction between 20% and 40% as documented by echocardiography, radio nuclide ventriculography, or MRI within the past 3 months
5. Elevated left atrial pressure with a gradient compared to right atrial pressure (RAP) documented by:
a. Resting end expiratory PCWP = 18 mmHg, and greater than RAP by = 5 mmHg
6. Subject has been informed of the nature of the study, agrees to its provisions and has provided written informed consent, as approved by the IRB
7. Subject is willing to comply with clinical investigation procedures and agrees to return for all required follow-up visits, tests, and exams
8. Trans-septal catheterization by femoral vein access is determined to be feasible
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Minimum age
18
Years
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Maximum age
No limit
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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
1. Patients who are not receiving GDMT for specified reasons
2. NT-Pro BNP < 100 pg/mL (if in sinus rhythm), or <300 pg/mL (if in atrial fibrillation); or BNP < 70 pg/mL (if in sinus rhythm), or < 200 pg/mL (if in atrial fibrillation)
3. Myocardial infarction (MI) and/or percutaneous cardiac intervention within past 3 months; CABG in past 3 months, or current indication for coronary revascularization
4. Cardiac Resynchronization Therapy initiated within the past 3 months
5. Automated Implantable Cardioverter Defibrillator (AICD) placed within past 3 months
6. Severe heart failure defined by all of the following:
1. ACC/AHA/ESC Stage D heart failure, Non-ambulatory NYHA Class IV HF;
2. Cardiac Index < 2.0 L/min/m2
3. Requiring inotropic infusion (continuous or intermittent) within the past 3 months.
4. Listed on transplant waiting list
7. Ability to perform the 6 minute walk Test >600m
8. Known clinically significant un-revascularized coronary artery disease, defined as: epi-cardial coronary artery stenosis associated with angina or other evidence of coronary ischemia.
9. History of stroke, transient ischemic attack (TIA), deep vein thrombosis (DVT), or pulmonary emboli within the past 6 months or recurrent DVT/pulmonary emboli
10. Presence of significant valve disease defined by echocardiography as:
1. Mitral valve regurgitation defined as grade > 2+ MR
2. Tricuspid valve regurgitation defined as grade > 2+ TR;
3. Aortic valve disease defined as = 2+ AR or moderate AS
11. Subject is contraindicated to receive either dual antiplatelet therapy or warfarin analogue; or has a documented coagulopathy
12. Atrial fibrillation with resting HR > 100 BPM
13. Arterial Oxygen saturation < 95% on room air
14. Significant hepatic impairment defined as 3X upper limit of normal of transaminases, total bilirubin, or alkaline phosphatase; Hepatic cirrhosis; Hypoalbuminemia
15. Resting RAP > 14 mmHg
16. Right ventricular dysfunction, defined as
1. More than mild RV dysfunction as determined by TTE: OR
2. TAPSE < 1.4 cm: OR
3. RV volume = LV volume on echo estimate; OR
4. Evidence of RV dysfunction defined by echo as an RV fractional area change < 35%
17. Evidence of pulmonary hypertension with PVR =4 Woods Units
18. Chronic pulmonary disease requiring continuous home oxygen, OR significant chronic pulmonary disease defined as FEV1 <1L.
19. Currently participating in an investigational drug or device study that may interfere with the conduct and outcome of this study.
20. Life expectancy less than 12 months for non-cardiovascular reasons
21. Echocardiographic evidence of intra-cardiac mass, thrombus or vegetation
22. Known or suspected allergy to nickel
23. Women of child bearing potential
24. Currently requiring dialysis; or e-GFR <25ml/min
25. Systolic blood pressure >170 mmHg despite appropriate medical management
26. Subjects with existing or surgically closed (with a patch) Atrial Septal Defects. Subjects with a Patent Foramen Ovale (PFO), who have elevated filling pressure despite the PFO are allowed
27. Subjects on immunosuppression or systemic steroid treatment
28. In the opinion of the investigator, the subject is not an appropriate candidate for the study
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Study design
Purpose of the study
Treatment
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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
Active, not recruiting
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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
10/03/2017
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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
1/12/2027
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Actual
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Sample size
Target
10
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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John Hunter Hospital - New Lambton Heights
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Recruitment hospital [2]
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St. Vincent Hospital - Sydney
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Recruitment postcode(s) [1]
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2305 - New Lambton Heights
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Recruitment postcode(s) [2]
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- Sydney
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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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New York
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Country [2]
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Czechia
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State/province [2]
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Prague
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Corvia Medical
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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
The objective of this pilot study is to evaluate the safety and performance of implanting the IASD® System II in Heart Failure patients with reduced ejection fraction and elevated left sided filling pressures, who remain symptomatic despite Guideline Directed Medical Therapy (GDMT).
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Trial website
https://clinicaltrials.gov/study/NCT03093961
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Jan Komtebedde, DVM
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Address
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Corvia Medical
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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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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
No information has been provided regarding IPD availability
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 not provided in
https://clinicaltrials.gov/study/NCT03093961
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