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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02922036
Registration number
NCT02922036
Ethics application status
Date submitted
27/09/2016
Date registered
3/10/2016
Titles & IDs
Public title
Cardiac Resynchronization Therapy in Previously Untreatable and High Risk Upgrade Patients
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Scientific title
Stimulation Of the Left Ventricular Endocardium for Cardiac Resynchronization Therapy in Non-Responders, Previously Untreatable and High Risk Upgrade Patients (SOLVE CRT)
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Secondary ID [1]
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CSP-03035
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Universal Trial Number (UTN)
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Trial acronym
SOLVE-CRT
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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 - WiSE System
Experimental: Treatment - WiSE System therapy ON with Guideline Directed Medical Therapy
Treatment: Devices: WiSE System
The WiSE System is an implantable cardiac system to provide LV pacing stimulation in conjunction with a co-implanted system that provides right ventricular stimulation.
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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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Primary Safety
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Assessment method [1]
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Freedom from Procedure and Device System related Type 1 Complications
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Timepoint [1]
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6 Months
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Primary outcome [2]
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Primary Efficacy 1
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Assessment method [2]
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Mean relative % change in Left Ventricular End Systolic Volume (LVESV) baseline to 6 Months.
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Timepoint [2]
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6 Months
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Secondary outcome [1]
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Secondary Efficacy 1
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Assessment method [1]
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Electrode Acoustic Pacing Capture Threshold (APCT) measured at the 6-month follow-up post-implant visit
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Timepoint [1]
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6 Months
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Secondary outcome [2]
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Secondary Efficacy 2
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Assessment method [2]
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Electrode Acoustic Pacing Capture Threshold Stability (APCT Stability) measured from pre-discharge through the 6-month follow-up post-implant visit
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Timepoint [2]
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6 Months
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Secondary outcome [3]
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Secondary Efficacy 3
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Assessment method [3]
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% Bi-ventricular pacing at 6 months
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Timepoint [3]
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6 months
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Secondary outcome [4]
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Secondary Efficacy 4
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Assessment method [4]
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EF responder analysis for = 5% absolute increase from baseline to 6 months.
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Timepoint [4]
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6 months
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Secondary outcome [5]
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Secondary Efficacy 5
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Assessment method [5]
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KCCQ responder analysis for = 5 points absolute increase from baseline to 6 months
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Timepoint [5]
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6 months
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Eligibility
Key inclusion criteria
Inclusion/
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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?
Yes
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Key exclusion criteria
Exclusion:
Inclusion Criteria
1. Patient with a class I or IIa (1) or (2) indication for implantation of a CRT-D device according to current available guidelines (with additional QRS criteria on Class IIa (1)):
1. Class I: NYHA II, III, IV, EF = 35%, LBBB, QRS = 150ms
2. Class IIa (1): NYHA II, III, IV, EF= 35%, LBBB, QRS = 130 to < 150ms
3. Class IIa (2): NYHA II, III, IV, EF= 35%, non-LBBB, QRS = 150ms
2. Patient is a:
1. 'Non-responder' [Not Enrolling]: Patients who have a CRT system that is functional and despite an adequate trial of Guideline Directed Medical Therapy (GDMT) and attempts at optimal device programming the patient has not responded to therapy for a minimum of 6 months. Non-response is defined as:
* EF has remained unchanged or worsened (defined as < 5% increase since implant), and
* The patient's clinical status based in the totality of available clinical evidence (such as NYHA Class, exercise tolerance, QOL, or global assessment) has remained unchanged or worsened, as determined by the local Site Enrollment Committee
OR
2. 'Previously Untreatable': Patients who have a full or partial CRT system, who meet general inclusion criteria and are deemed as 'previously untreatable' for one of the following reasons:
i. Patients in whom CS lead implantation for CRT has failed
* CS lead implant was attempted but abandoned due any of the following: difficult CS access or anatomy, inadequate lead location, inadequate pacing thresholds, persistent phrenic nerve pacing, or other procedural challenges
ii. CS lead implanted but has been programmed OFF
* LV lead that was implanted but not operational includes patients in whom the LV lead is inoperative or programmed off due to improper function such as high threshold, non-capture, phrenic nerve pacing, lead failure, lead dislodgement, or sub-optimal LV lead location
OR
c. 'High Risk Upgrade:
Patients who have a relative contraindication to CS lead implant, due to:
* venous occlusion or lesion precluding implant
* pocket infection risk (at co-implanted device site)
* considered high risk for CS implant due to co-morbidities
3. Patients on a stable Guideline Directed Medical Therapy (GDMT)
4. Patient must be 18 years old or over
5. Patient has signed and dated informed consent
6. Patient has suitable anatomy for implant of the WiSE CRT System (e.g. adequate acoustic window, LV wall thickness in target implant area = 5 mm, absence of LV wall structural abnormalities which may preclude implant)
Exclusion Criteria
Patients who meet any one of these criteria will be excluded from the investigation:
1. Pure RBBB
2. LVEDD = 8cm
3. Non-ambulatory or unstable NYHA class IV
4. Contraindication to heparin, chronic anticoagulants or antiplatelet agents
5. Triple anticoagulant patients who cannot tolerate peri-procedural stopping of anticoagulation therapy
6. Attempted device implant (pacemaker, ICD, CRT, LV lead) or successful co-implant within prior 30 days.
7. Patients with planned or expected lithotripsy treatment post implant
8. Life expectancy of < 12 months
9. Chronic hemodialysis
10. Stage 4 or 5 renal dysfunction defined as eGFR < 30
11. Grade 4 mitral valve regurgitation
12. Noncardiac implanted electrical stimulation therapy devices
13. Patients with a prosthetic aortic valve in which the electrode cannot be implanted via a transseptal approach
14. Patients with a prosthetic mitral valve in which the electrode cannot be implanted via a retrograde aortic approach
15. Unstable angina, acute MI, CABG, or PTCA within the past 1 month
16. Correctable valvular disease that is the primary cause of heart failure
17. Recent CVA or TIA (within the previous 3 months)
18. Patients with a history of paroxysmal or persistent atrial fibrillation/flutter are excluded if they have had a documented AF episode > 30 min or a cardioversion in the past 1 month.
19. Patients with permanent AF are excluded if they have intact AV node conduction (RV pacing <95%)
20. Already included in another clinical study that could confound the results of this study
21. Pregnancy
22. Known drug or alcohol addiction or abuse
23. Moderate or severe aortic stenosis
24. Subject unable to attend follow-up at the investigative center or unable, for physical or mental reasons, or to comply with the trial's procedures
25. For Part II Randomized patients only, those who will not tolerate being randomized to the Control Group for 6 months
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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
Other
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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
17/01/2018
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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
1/06/2025
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Actual
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Sample size
Target
300
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
CanberraNSW,QLD,SA,VIC,WA
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Recruitment hospital [1]
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Canberra Hospital - Garran
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John Hunter Hospital - New Lambton Heights
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Prince of Wales Hospital - Randwick
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Sydney Adventist Hospital - Wahroonga
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The Prince Charles Hospital - Chermside
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Royal Adelaide Hospital - Adelaide
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Monash Heart - Clayton
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Royal Melbourne Hospital / Royal Hobart Hospital - Parkville
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Fiona Stanley Hospital - Perth
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Recruitment hospital [10]
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Royal Prince Alfred Hospital - Camperdown
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Recruitment postcode(s) [1]
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2605 - Garran
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Recruitment postcode(s) [2]
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2305 - New Lambton Heights
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Recruitment postcode(s) [3]
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2031 - Randwick
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Recruitment postcode(s) [4]
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- Wahroonga
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- Chermside
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Recruitment postcode(s) [6]
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5000 - Adelaide
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Recruitment postcode(s) [7]
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3168 - Clayton
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Recruitment postcode(s) [8]
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- Parkville
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Recruitment postcode(s) [9]
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6150 - Perth
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Recruitment postcode(s) [10]
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2050 - Camperdown
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Recruitment outside Australia
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United States of America
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Alabama
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California
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Rennes
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Bernau
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Middlesbrough
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Oxford
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
EBR Systems, Inc.
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
This study is a prospective, multi-center, pivotal trial to study the safety and efficacy of the WiSE-CRT System for Cardiac Re-synchronization Therapy.
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Trial website
https://clinicaltrials.gov/study/NCT02922036
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Trial related presentations / publications
Singh JP, Abraham WT, Auricchio A, Delnoy PP, Gold M, Reddy VY, Sanders P, Lindenfeld J, Rinaldi CA. Design and rationale for the Stimulation Of the Left Ventricular Endocardium for Cardiac Resynchronization Therapy in non-responders and previously untreatable patients (SOLVE-CRT) trial. Am Heart J. 2019 Nov;217:13-22. doi: 10.1016/j.ahj.2019.04.002. Epub 2019 Apr 9.
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Public notes
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Contacts
Principal investigator
Name
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Jagmeet Singh, MD, PhD
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Address
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Massachusetts General Hospital
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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 not provided in
https://clinicaltrials.gov/study/NCT02922036