NCT03425422

Brief Summary

A multi-center randomized controlled clinical trial to evaluate Autonomic Regulation Therapy with the VITARIA system in patients with symptomatic heart failure and reduced ejection fraction.

Trial Health

57
Monitor

Trial Health Score

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

Enrollment
533

participants targeted

Target at P75+ for not_applicable heart-failure

Timeline
Completed

Started May 2018

Longer than P75 for not_applicable heart-failure

Geographic Reach
1 country

22 active sites

Status
terminated

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

First Submitted

Initial submission to the registry

January 26, 2018

Completed
12 days until next milestone

First Posted

Study publicly available on registry

February 7, 2018

Completed
3 months until next milestone

Study Start

First participant enrolled

May 1, 2018

Completed
5.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 31, 2023

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

May 31, 2023

Completed
Last Updated

October 10, 2023

Status Verified

October 1, 2023

Enrollment Period

5.1 years

First QC Date

January 26, 2018

Last Update Submit

October 6, 2023

Conditions

Keywords

Vagus nerve stimulation

Outcome Measures

Primary Outcomes (2)

  • Event-free rate

    The event-free rate, through 90 days after VITARIA implantation, from all VITARIA system-related and VITARIA implantation-related serious adverse events, as adjudicated by the Clinical Events Committee

    90 days

  • Cardiovascular mortality and HF hospitalization

    A composite of cardiovascular mortality or heart failure hospitalization, as adjudicated by the Clinical Events Committee, based on time to first event after randomization

    Through study completion, an average of 2 years

Study Arms (2)

Therapy

EXPERIMENTAL

VITARIA system implantation on the right cervical vagus nerve in addition to stable guideline-directed medical therapy

Device: VITARIA System

Control

NO INTERVENTION

Stable guideline-directed medical therapy

Interventions

Chronic stimulation of the right cervical vagus nerve

Therapy

Eligibility Criteria

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

You may qualify if:

  • Age 18 or above
  • Willing and capable of providing informed consent
  • Capable of participating in all testing associated with this clinical investigation
  • Stable, guideline-directed medical therapy for at least 4 weeks before subject screening. Unrestricted changes in diuretics are allowed during the 4 weeks, as long as the subject remains on a diuretic. If the use of an ARNI is being contemplated for a study subject, ARNI should be administered, and GDMT optimized, before the subject is randomized. No more than a 100% increase or 50% decrease of the dosage of any medication other than a diuretic is permitted. For these medications, medication changes within a class are allowed, as long as the equivalent dosage is within these specified limits
  • Stable symptomatic heart failure NYHA class III; or NYHA class II with a heart failure hospitalization in the previous 12 months. HF hospitalization may include an overnight hospital or hospital-based observation unit stay with a primary diagnosis of HF, or an emergency department visit with a primary diagnosis of HF, and will in either case include documentation of intravenous HF therapy administration or other intervention for HF
  • Left ventricular ejection fraction (EF) ≤ 35% and left ventricular end-diastolic diameter (LVEDD) \< 8.0 cm, as confirmed by the core echocardiography laboratory during screening
  • N-terminal pro-BNP (NT-proBNP) level of at least 800 pg/mL, as determined by the core laboratory; or NT-proBNP level of at least 1200 pg/mL, as determined by the core laboratory, for patients with permanent atrial fibrillation or reporting signs or symptoms of atrial fibrillation at the time that the NT-proBNP sample is drawn
  • Received a standard cardiac assessment, including history, physical exam, and electrocardiogram, and determined by a heart failure cardiologist and study surgeon to be an appropriate candidate for the study's surgical procedure
  • Physically capable and willing to perform repeated 6-minute walk tests associated with the study, and having a baseline distance of between 150 and 450 meters. Symptoms limiting the duration of the 6 minute walk test must be due primarily to heart failure

You may not qualify if:

  • Refractory symptomatic hypotension (systolic blood pressure below 80 mmHg)
  • Complete AV block treated with unipolar pacemaker therapy
  • Currently implanted vagus nerve stimulation (VNS) device, baroreceptor activation therapy (BAT) device, other nerve stimulator, artificial or donor heart, or ventricular assist device (VAD)
  • Heart failure of non-ischemic origin for less than 6 months, or due to congenital heart disease, hypertrophic obstructive cardiomyopathy, or infiltrative cardiomyopathy (e.g. amyloidosis, sarcoidosis)
  • Moderate (3+) or severe (4+) aortic valve or mitral valve stenosis; moderate (3+) or severe (4+) aortic valve insufficiency; or severe (4+) mitral valve insufficiency
  • Symptomatic uncontrolled bradycardia
  • On renal dialysis
  • Involvement in any concurrent clinical study with an investigational therapy

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (22)

University of Alabama

Birmingham, Alabama, 35294, United States

Location

University of Arizona

Tucson, Arizona, 85724, United States

Location

Central Arkansas Veterans Healthcare System

Little Rock, Arkansas, 72205, United States

Location

Long Beach Memorial Hospital

Long Beach, California, 90806, United States

Location

Greater Los Angeles VA Medical Center

Los Angeles, California, 90073, United States

Location

Hartford Hospital

Hartford, Connecticut, 06102, United States

Location

First Coast Cardiovascular Institute

Jacksonville, Florida, 32256, United States

Location

UnityPoint Health - Methodist Hospital

Peoria, Illinois, 61606, United States

Location

Indiana University Health Ball Memorial Hospital

Muncie, Indiana, 47303, United States

Location

Tufts Medical Center

Boston, Massachusetts, 02111, United States

Location

Lahey Medical Center

Burlington, Massachusetts, 01805, United States

Location

Michigan Heart, PC

Ypsilanti, Michigan, 48197, United States

Location

University of Mississippi Medical Center

Jackson, Mississippi, 39216, United States

Location

Mount Sinai School St. Luke's

New York, New York, 10025, United States

Location

MetroHealth System

Cleveland, Ohio, 44109, United States

Location

ProMedica Northwest Ohio Cardiology Consultants

Toledo, Ohio, 43606, United States

Location

Penn State Health Milton Hershey Medical Center

Hershey, Pennsylvania, 17033, United States

Location

Pinnacle Health

Wormleysburg, Pennsylvania, 17043, United States

Location

Baylor St. Luke's Medical Center

Houston, Texas, 77030, United States

Location

Tyler Cardiovascular Consultants

Tyler, Texas, 75701, United States

Location

Providence Sacred Heart Medical Center

Spokane, Washington, 99204, United States

Location

University of Wisconsin

Madison, Wisconsin, 53792, United States

Location

Related Publications (3)

  • Premchand RK, Sharma K, Mittal S, Monteiro R, Dixit S, Libbus I, DiCarlo LA, Ardell JL, Rector TS, Amurthur B, KenKnight BH, Anand IS. Autonomic regulation therapy via left or right cervical vagus nerve stimulation in patients with chronic heart failure: results of the ANTHEM-HF trial. J Card Fail. 2014 Nov;20(11):808-16. doi: 10.1016/j.cardfail.2014.08.009. Epub 2014 Sep 1.

    PMID: 25187002BACKGROUND
  • Premchand RK, Sharma K, Mittal S, Monteiro R, Dixit S, Libbus I, DiCarlo LA, Ardell JL, Rector TS, Amurthur B, KenKnight BH, Anand IS. Extended Follow-Up of Patients With Heart Failure Receiving Autonomic Regulation Therapy in the ANTHEM-HF Study. J Card Fail. 2016 Aug;22(8):639-42. doi: 10.1016/j.cardfail.2015.11.002. Epub 2015 Nov 11.

    PMID: 26576716BACKGROUND
  • Konstam MA, Udelson JE, Butler J, Klein HU, Parker JD, Teerlink JR, Wedge PM, Saville BR, Ardell JL, Libbus I, DiCarlo LA. Impact of Autonomic Regulation Therapy in Patients with Heart Failure: ANTHEM-HFrEF Pivotal Study Design. Circ Heart Fail. 2019 Nov;12(11):e005879. doi: 10.1161/CIRCHEARTFAILURE.119.005879. Epub 2019 Nov 14.

Related Links

MeSH Terms

Conditions

Heart FailureHeart Failure, Systolic

Condition Hierarchy (Ancestors)

Heart DiseasesCardiovascular Diseases

Study Design

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

Study Record Dates

First Submitted

January 26, 2018

First Posted

February 7, 2018

Study Start

May 1, 2018

Primary Completion

May 31, 2023

Study Completion

May 31, 2023

Last Updated

October 10, 2023

Record last verified: 2023-10

Data Sharing

IPD Sharing
Will not share

Locations