CHF, Left Ventricle Dilated, Left Ventricle Remodeling
Conditions
Keywords
Left Ventricle Reverse remodeling
Brief summary
A prospective, multi-center randomized trial comparing the Revivent System plus GDMT to GDMT alone. A total of approximately 135 subjects will be randomized in a 2:1 allocation ratio (90 treatment and 45 control), with approximately 128 evaluable patients and assuming 5% loss to follow-up. A primary safety endpoint will be evaluated at 30 days. Primary efficacy endpoint will be at 1 year. Interim efficacy endpoints will be evaluated at 6 months.
Detailed description
The purpose of the study is to assess the safety and effectiveness of the BioVentrix Revivent System plus GDMT compared to GDMT alone for the treatment of LV anterior/apical scar/aneurysm with possible additional involvement of the lateral, septal, and/or inferior regions in patients with symptomatic heart failure. Safety will be assessed compared with a Performance Goal based on surgical ventriculoplasty outcomes (MAE's at 30 days).
Interventions
DEVICERevivent System
BioVentrix has developed the Revivent System to mirror Surgical Ventricular Restoration (SVR). The Revivent System is used to place permanent cardiac implants to the epicardial surface for the purpose of reconfiguring abnormal cardiac geometry that is contributing to the dysfunction.
Sponsors
BioVentrix
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. 18 years old or older 2. LV Aneurysm or Scar Presence: Defined by presence of a contiguous acontractile (akinetic and/or dyskinetic) non-calcified scar 3. LV Aneurysm/Scar Location: Defined as a scar involving anterior, apical or anterolateral ± septal regions of the left ventricle as evidenced by cardiac imaging (Viability of myocardium in regions remote from area of intended scar exclusion as evidenced by cardiac imaging) 4. Left Ventricular Ejection Fraction \< 40% 5. Left ventricular end-systolic volume index ≥60 mL/m2 6. Suffering from heart failure symptoms as defined by NYHA Classification \> 2 not responsive to medical therapy 7. Patient completed 6 Minute Walk Test and KCCQ Quality of Life Questionnaire (can be performed at baseline visit) 8. Patient is on adequate Guideline Directed Medical Therapy (GDMT) 9. Subject or a legally authorized representative must provide written informed consent 10. Agree to required follow-up visits 11. Female subject of childbearing potential does not plan pregnancy for at least one year following the index procedure. For a female of childbearing potential, a pregnancy test must be performed with negative results known within seven days prior to index procedure
Exclusion criteria
Candidates will be excluded from the study if ANY of the following conditions is present: 1. Cardiac Resynchronization Therapy (CRT) or ICD pacing lead placement ≤ 90 days prior to enrollment 2. Valvular heart disease, which in the opinion of the investigator, will require intervention (transcatheter or surgical) 3. Mitral Regurgitation greater than moderate (\>2+) 4. Need for coronary revascularization, in the opinion of the investigator 5. Peak Systolic Pulmonary Arterial Pressure \> 70 mm Hg via echo or right heart catheterization 6. Myocardial Infarction within 90 days prior to enrollment 7. Within the last six months, a prior CVA or TIA, or intracranial hemorrhage 8. Co-morbid disease process with life expectancy of less than one year or active malignancy not in remission 9. Severe pulmonary disease that would preclude general anesthesia 10. Any solid organ transplant or is on waiting list for any solid organ transplant other than cardiac 11. Chronic renal failure with a GFR\<30ml/min 12. Subject is currently participating in another clinical trial that has not yet completed its primary endpoint
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Major Adverse Events Composite Performance Goal | 30 days | Composite of Major Adverse Events at 30 days comprised of Clinical Events Committee (CEC) Adjudication of Mortality, Myocardial Infarction (MI), Major Stroke, Prolonged Intubation \>48hrs, Need for Inotropic support \>24hrs, Mech circulatory support intra or post op, BARC 4 or 5 bleeding, reoperation, serious infection related to device or procedure, Cardiac tamponade, or Initiation of renal replacement therapy, with a Performance Goal (PG) of 70% (upper bound of the 97.5% one sided CI) |
| Composite Effectiveness Endpoint | 6 Months | Using Finkelstein Schoenfeld (FS) hierarchical approach. This approach compares each treatment subject versus each control subject in a hierarchal fashion beginning with Kansas City Cardiomyopathy Questionnaire (+10 point improvement with higher score being better), 6 Minute Walk Test (+25meter improvement with longer distance being better), change in New York Heart Association (NYHA) Class (+1 point improvement with scale being 1 to 4 with lower value being better). Begin comparing at highest hierarchal assessment. If one group is "better than" the other, count as "win". If treatment and control subject equal at that assessment, compare to next hierarchal measure, if equal again, go to next until you have a "win". Compare overall wins versus loses for an overall win ratio. |
Countries
United States
Contacts
CONTACTSteve Chartier
PRINCIPAL_INVESTIGATORVinod THourani, MD
Piedmont Healthcare
PRINCIPAL_INVESTIGATORMarat Fudim, MD
Duke University
Outcome results
None listed