NCT01486316

Brief Summary

The purpose of this study is to characterize the feasibility and impact of a diagnostic tool that may help clinicians identify when patients are at higher risk of visiting the hospital for a heart failure event. The study will use a non-experimental device that is inserted just under the skin of the chest, which continuously monitors the heart rhythm in combination with an experimental web-based heart failure risk status. Patients with atrial fibrillation and heart failure will be evaluated to collect data about the potential of this risk status to help improve patient outcome.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
24

participants targeted

Target at below P25 for not_applicable atrial-fibrillation

Timeline
Completed

Started Nov 2011

Typical duration for not_applicable atrial-fibrillation

Geographic Reach
1 country

11 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

November 1, 2011

Completed
3 days until next milestone

First Submitted

Initial submission to the registry

November 4, 2011

Completed
1 month until next milestone

First Posted

Study publicly available on registry

December 6, 2011

Completed
3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2014

Completed
2 months until next milestone

Study Completion

Last participant's last visit for all outcomes

February 1, 2015

Completed
3.4 years until next milestone

Results Posted

Study results publicly available

July 12, 2018

Completed
Last Updated

July 12, 2018

Status Verified

June 1, 2018

Enrollment Period

3.1 years

First QC Date

November 4, 2011

Results QC Date

May 1, 2015

Last Update Submit

June 12, 2018

Conditions

Outcome Measures

Primary Outcomes (1)

  • Correlation of Heart Failure Risk Score (HFRS) With Heart Failure Events

    Evaluate the HFRS Algorithm prior to Heart Failure (HF) related clinical events among patients with HF and documented or suspected AF. Daily HFRS scores were calculated each day for each patient with an implanted Reveal XT device, and the scores were ordinal, with possible values of "Low", "Medium", "High", and "Very High". The objective was to assess the association between the daily scores before and after HF events (HF-related hospitalizations, clinic visits) among subjects experiencing such visits. This would only be done during follow-up periods in which physicians were blinded to the scores (see Time Frame). The score could only be generated if the subject performed a CareLink transmission of their device data during follow-up. Because of the small number of subjects enrolled, formal statistical analyses were not performed. Subjects were partitioned by whether they (1) experienced a HF event, and (2) whether they experienced a High or Very High HFRS score.

    0 to 6 months post-implant (HFRS Guided Arm), 0-12 months (Control Arm)

Other Outcomes (2)

  • Correlation of HFRS Status With Actions/Testing

    6 to 18 months post-implant (HFRS Guided Arm), 13-18 months (Control Arm)

  • Clinical Status Measures

    0 to 18 months post-implant

Study Arms (2)

Control arm

OTHER

Subjects in the Control arm will be observed between implant and month 12. During this time, the standard device diagnostic suite will be used as it would normally, in the office using the programmer, or by data transmission from the patient's home (or another remote location). At month 12 through study close (month 18), study doctors for the all subjects will have access to the risk status.

Device: Reveal XT® Insertable Cardiac MonitorOther: Heart Failure Risk Status Diagnostic

Risk Status Guided

EXPERIMENTAL

Study doctors will have access to the experimental IDENTIFY-HF Risk Status for subjects in the Guided arm between months 6 and 18. At all times during the study, study doctors will also be able to use the standard device diagnostics in the office using the programmer, or by data transmission from the patient's home (or another remote location).

Device: Reveal XT® Insertable Cardiac MonitorOther: Heart Failure Risk Status Diagnostic

Interventions

If not previously implanted, a non-experimental insertable cardiac monitor will be implanted to collect information on the patients' heart condition as inputs into the heart failure risk status algorithm (during guided follow-up only, Guided arm: 6-18 months, Control arm: 12-18 months).

Also known as: Reveal XT®
Control armRisk Status Guided

The experimental IDENTIFY-HF Risk Status developed for this study will be used to change standard device data to a heart failure risk status. The risk status and standard device trend data are provided to study doctors for remote management of their patients' heart failure using study specific protocols. The risk status inputs are: night heart rate, heart rate variability, atrial fibrillation burden, ventricular rate during atrial fibrillation, patient activity. Based on pre-defined thresholds for each of the above inputs, as well as data trends, a heart failure score is derived. The heart failure score is then classified as: "Low", "Medium", "High", or "Very High".

Control armRisk Status Guided

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patient is 18 years of age or older
  • Patient (or patient's legally authorized representative) is willing and able to provide written informed consent
  • Patient is willing and able to comply with the protocol, including follow-up visits
  • Documented paroxysmal or persistent atrial fibrillation or strong suspicion of atrial fibrillation (i.e, palpitations)
  • Patient is indicated for the Reveal XT insertable cardiac monitor or other commercially-available and substantially equivalent Medtronic insertable cardiac monitor
  • Recent HF event within prior 120 days (HF event defined as meeting any one of the following two criteria: 1. Admission with primary diagnosis of HF 2. Intravenous HF therapy (e.g. IV diuretics/vasodilators) or ultrafiltration at any one of the following settings: admission with secondary/tertiary diagnosis of HF, emergency department, ambulance, observation unit, urgent care, HF/cardiology clinic, patient's home
  • Willing and able to transmit data via CareLink

You may not qualify if:

  • Patient is pregnant
  • Patient has been participating in another study that may interfere with the IDENTIFY-HF protocol required procedures
  • Endstage (Stage D or New York Heart Association class IV) heart failure
  • Asymptomatic (Stage B or New York Heart Association class I) heart failure
  • Severe aortic stenosis or insufficiency
  • Existing insertable cardiac monitor implanted for more than 1 year
  • Existing implantable pulse generator, implantable cardioverter defibrillator, cardiac resynchronization therapy device
  • Severe renal impairment (estimated glomerular filtration rate \<25mL/min)
  • Myocardial infarction within prior 30 days

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (11)

Scripps Green

La Jolla, California, 92037, United States

Location

Aurora Denver Cardiology Associates

Aurora, Colorado, 80012, United States

Location

Spectrum Health

Grand Rapids, Michigan, 49503, United States

Location

The Valley Hospital

Ridgewood, New Jersey, 07450, United States

Location

Carolinas Medical Center/Sanger Heart & Vascular

Charlotte, North Carolina, 28203, United States

Location

The Ohio State University

Columbus, Ohio, 43210, United States

Location

Lancaster Heart & Stroke Foundation

Lancaster, Pennsylvania, 17602, United States

Location

Medical University of South Carolina

Charleston, South Carolina, 29425, United States

Location

St. Thomas Research Institute

Nashville, Tennessee, 37205, United States

Location

University of Texas Southwestern Medical Center

Dallas, Texas, 75390, United States

Location

Heart Clinic PLLC

McAllen, Texas, 78503, United States

Location

MeSH Terms

Conditions

Atrial FibrillationHeart Failure

Condition Hierarchy (Ancestors)

Arrhythmias, CardiacHeart DiseasesCardiovascular DiseasesPathologic ProcessesPathological Conditions, Signs and Symptoms

Results Point of Contact

Title
Rachael Rose, Clinical Research Specialist
Organization
Medtronic, Inc

Study Officials

  • IDENTIFY-HF Team

    Medtronic

    STUDY CHAIR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
DIAGNOSTIC
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 4, 2011

First Posted

December 6, 2011

Study Start

November 1, 2011

Primary Completion

December 1, 2014

Study Completion

February 1, 2015

Last Updated

July 12, 2018

Results First Posted

July 12, 2018

Record last verified: 2018-06

Locations