Summary

Eligibility
for people ages 18 years and up (full criteria)
Healthy Volunteers
healthy people welcome
Location
at La Jolla, California and other locations
Dates
study started
estimated completion
Principal Investigator
by Ulrika Birgersdotter-Green, MD
Headshot of Ulrika Birgersdotter-Green
Ulrika Birgersdotter-Green

Description

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.

Official Title

Stimulation Of the Left Ventricular Endocardium for Cardiac Resynchronization Therapy in Non-Responders, Previously Untreatable and High Risk Upgrade Patients (SOLVE CRT)

Details

The WiSE-CRT System is an implantable cardiac pacing system capable of delivering pacing energy to the left ventricle of the heart without using a pacing lead.

Keywords

Heart Failure WiSE System

Eligibility

For people ages 18 years and up

Inclusion/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)):
  2. Class I: NYHA II, III, IV, EF ≤ 35%, LBBB, QRS ≥ 150ms
  3. Class IIa (1): NYHA II, III, IV, EF≤ 35%, LBBB, QRS ≥ 130 to < 150ms
  4. Class IIa (2): NYHA II, III, IV, EF≤ 35%, non-LBBB, QRS ≥ 150ms
  5. Patient is a:
  6. '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:
  7. EF has remained unchanged or worsened (defined as < 5% increase since implant), and
  8. 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

  1. '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:
  2. Patients in whom CS lead implantation for CRT has failed
  3. 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

  1. '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
  • Patients on a stable Guideline Directed Medical Therapy (GDMT)
  • Patient must be 18 years old or over
  • Patient has signed and dated informed consent
  • 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

Locations

  • University of California, San Diego accepting new patients
    La Jolla California 92037 United States
  • Keck Medical Center of USC withdrawn
    Los Angeles California 90033 United States

Lead Scientist at UCSD

Details

Status
accepting new patients
Start Date
Completion Date
(estimated)
Sponsor
EBR Systems, Inc.
ID
NCT02922036
Study Type
Interventional
Participants
Expecting 192 study participants
Last Updated