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Trial registered on ANZCTR
Registration number
ACTRN12612000805875
Ethics application status
Approved
Date submitted
30/07/2012
Date registered
1/08/2012
Date last updated
1/08/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
Echocardiography Guided Optimisation of Cardiac Resynchronization Therapy Late after Implantation
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Scientific title
Echocardiography Guided Optimisation of Cardiac Resynchronization Therapy Late after Implantation
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Secondary ID [1]
280935
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Nil
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Universal Trial Number (UTN)
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Trial acronym
CORE
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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
287356
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0
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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
Heart failure patients with cardiac resynchronization therapy (CRT) devices will be investigated in a 2 stage trial investigating whether no optimization or echocardiographic CRT optimization, either at rest or on exercise, is advantageous.
Optimization will occur by adjusting both the atrioventricular (AV) and ventriculo-ventricular (VV) delay of the CRT device.
Stage 1 - individuals will either be randomized to no optimization or resting optimization. For this we will use the iterative method for the AV delay and the Left Ventricular Outflow Tract Velocity Time Integral (LVOT VTI) method for the VV delay.
Stage 2 - individuals will either be randomized to resting optimization (as in stage 1) or optimization just on completion of a 6 minute walk test (exercise optimization). Resting optimization will be as in stage 1. On exercise (6 minute walk) we will only adjust the VV delay using the difference in time to systolic peak contraction between opposing LV segments at rest and then on exercise.
Individuals will thus be optimized twice in total.
At each visit they will undergo a resting echocardiogram, blood testing and measures of functional capacity such as treadmill walking and 6 minute walk test distance.
Once at the start of stage 1 (month 1) and then at the start of stage 2 (month 7). Each optimization takes roughly 90 mins once per 6 months.
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Intervention code [1]
285368
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Treatment: Devices
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Comparator / control treatment
No CRT optimization
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Control group
Active
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Outcomes
Primary outcome [1]
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Functional improvement assessed using standard heart failure mechanisms - 6 minute walk distance, treadmill time, peak oxygen consumption on exercise (VO2 max), brain natriuretic peptide (BNP).
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Assessment method [1]
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Timepoint [1]
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6 and 12 months
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Secondary outcome [1]
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Echocardiographic improvement in terms of ventricular function and ventricular synchrony. We will measure Simpsons biplane ejection fraction as a measure of left ventricular function and compare change from the start of each stage to the end. we will use the standard deviation fo the time to peak systolic contraction as a measure of left ventricular dyssychrony. Again we will compare change from the start of each stage to the end.
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Assessment method [1]
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Timepoint [1]
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6 and 12 months
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Eligibility
Key inclusion criteria
We studied individuals who had undergone CRT implantation and were able to perform moderate exercise to level of completion of 6 minute walk test.
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Minimum age
21
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
Unable or unwilling to consent
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Consent will be obtained and then randomization occur by sealed opaque envelopes by an independent observer. Neither investigator nor patient will know randomization.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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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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Date of first participant enrolment
Anticipated
1/10/2007
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Actual
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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
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Address [1]
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Country [1]
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Funding source category [2]
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University
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Name [2]
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Cardiac Imaging Group, University of Queensland
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Address [2]
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School of Medicine
Level 4 Princess Alexandra Hospital
Ipswich Road
Brisbane
Australia
QLD 4102
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Country [2]
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Australia
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Primary sponsor type
University
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Name
Cardiac Imaging Group, University of Queensland
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Address
School of Medicine
Level 4 Princess Alexandra Hospital
Ipswich Road
Brisbane
Australia
QLD 4102
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Princess Alexandra Hospital HREC
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Ethics committee address [1]
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Princess Alexandra Hospital Ipswich Road Woollongabba Brisbane QLD 4102
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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24/09/2007
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Ethics approval number [1]
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Ethics committee name [2]
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Uniting Care Health HREC
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Ethics committee address [2]
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First Floor Moorlands House The Wesley Hospital 451 Coronation Drive Auchenflower QLD 4066
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
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Approval date [2]
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19/07/2007
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Ethics approval number [2]
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Summary
Brief summary
Cardiac resynchronization therapy pacemaker devices are now an established therapy for heart failure patients. However the optimal method to set up these devices is as yet uncertain. We aim to use echocardiography to optimize these devices on a patient specific basis. We will examine no optimization vs. resting optimization vs exercise optimization in a systematic manor to determine the superior method in terms of functional and cardiac improvment.
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Trial website
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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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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 public queries
Name
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Assoc Prof Tony Stanton
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Address
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School of Medicine
Level 4 Princess Alexandra Hospital
Ipswich Road
Brisbane
Australia
QLD 4102
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Country
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Australia
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Phone
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+61 7 3176 5813
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Assoc Prof Tony Stanton
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Address
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School of Medicine
Level 4 Princess Alexandra Hospital
Ipswich Road
Brisbane
Australia
QLD 4102
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Country
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Australia
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Phone
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+61 7 3176 5813
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Fax
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Email
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[email protected]
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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
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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