Chronic Evaluation of Respicardia Therapy
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Purpose
The purpose of this study is to determine the chronic safety and efficacy of phrenic nerve stimulation on central sleep apnea (CSA). Clinically, CSA events translate into sleep fragmentation, excessive daytime sleepiness, reduced exercise capacity, and possibly ventricular arrhythmias.
The study is chronic in nature, such that subjects will undergo the implantation of an implantable pulse generator and stimulation lead. A sensing lead may also be placed during the initial implant procedure. Subjects will be followed for up to six-months on therapy to assess respiratory and heart failure outcomes. Following the six-month therapy visit, subjects will enter into a long-term follow-up phase until the completion of the study.
It is anticipated that data obtained in this study will show that the proposed intervention can modify respiration with a low incidence of adverse effects. The results of this trial are intended to be used to develop a subsequent protocol for pivotal study.
| Condition | Intervention | Phase |
|---|---|---|
|
Sleep Disordered Breathing Cheyne Stokes Respiration Periodic Breathing Sleep Apnea Central Sleep Apnea |
Device: remedē (TM) system |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Safety and Efficacy Evaluation of Respicardia Therapy for Central Sleep Apnea |
- AHI Reduction [ Time Frame: 3 months on therapy ] [ Designated as safety issue: No ]The primary hypothesis of the study is that the Apnea Hypopnea Index (AHI) after 3 months of therapy will be significantly reduced over baseline.
- Adverse Events [ Time Frame: Up to 2 years ] [ Designated as safety issue: Yes ]All serious, cardiovascular, pulmonary, and system/implant related adverse events will be evaluated to further characterize the safety of the therapy delivered by the implantable system
- Quality of Life Results [ Time Frame: 3 months on therapy ] [ Designated as safety issue: No ]
A battery of qualified instruments will be used to assess quality of life and functional improvements, including:
- Epworth Sleepiness Scale
- Minnesota Living with Heart Failure Questionnaire
- Heart Failure Clinical Composite
- Six-minute Hall Walk Test
- NYHA Functional Class
Subject acclimation and preference assessments will be recorded as well.
| Estimated Enrollment: | 50 |
| Study Start Date: | May 2010 |
| Estimated Study Completion Date: | December 2014 |
| Estimated Primary Completion Date: | March 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Treatment
All enrolled subjects will undergo attempted system implantation and therapeutic assessment. Subjects' baseline assessment values will serve as control parameters for the therapy evaluation.
|
Device: remedē (TM) system
Implantation of the remedē (TM) system, including implantable pulse generator, stimulation lead, and (optional) sensing lead. Nightly provision of unilateral transvenous phrenic nerve therapy during sleep periods.
Other Names:
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Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Candidate is at least 18 years old
Candidates with known recent history of Periodic Breathing, as evidenced by an overnight polysomnogram (PSG) within 60 days of the implant procedure demonstrating:
- Apnea-Hypopnea Index (AHI) greater than or equal to 20 events/hr
- Predominantly central origin (central apnea events comprise 50% or more of all apnea events)
- Limited obstructive events (obstructive apneas comprise less than 20% of the AHI)
Exclusion Criteria:
- Candidates who are pregnant
- Candidates with baseline oxygen saturation less than or equal to 90% on a stable FiO2
- Candidates with severe COPD
- Candidates with a history of cerebrovascular accident (CVA), myocardial infarction, coronary artery bypass grafting (CABG) surgery, or percutaneous coronary intervention (PCI) within the 3 months prior to the study
- Candidates with unstable angina
- Candidates with history of primary pulmonary hypertension
Contacts and Locations| United States, Nebraska | |
| BryanLGH Heart Institute | |
| Lincoln, Nebraska, United States, 68506 | |
| United States, Ohio | |
| The Ohio State University | |
| Columbus, Ohio, United States | |
| United States, Pennsylvania | |
| Lancaster Heart and Stroke Foundation | |
| Lancaster, Pennsylvania, United States, 17602 | |
| United States, Tennessee | |
| St. Thomas Heart | |
| Nashville, Tennessee, United States | |
| United States, Virginia | |
| Sentara Cardiovascular Research Institute | |
| Norfolk, Virginia, United States, 23507 | |
| Germany | |
| Heart and Diabetes Center | |
| Bad Oeynhausen, Germany | |
| University of Kiel | |
| Kiel, Germany | |
| Köln University | |
| Köln, Germany | |
| St. Adolf-Stift Hospital | |
| Reinbek, Germany | |
| Italy | |
| Policlinico di Monza-IRCCS | |
| Monza, Italy | |
| Poland | |
| Jagiellonian University | |
| Krakow, Poland | |
| Medical Military Institute | |
| Warsaw, Poland | |
| 4th Military Hospital | |
| Wroclaw, Poland | |
| Principal Investigator: | Piotr Ponikowski, MD | 4th Military Hospital, Poland |
| Principal Investigator: | William T Abraham, MD | Ohio State University |
More Information
No publications provided
| Responsible Party: | Respicardia, Inc. |
| ClinicalTrials.gov Identifier: | NCT01124370 History of Changes |
| Other Study ID Numbers: | Respicardia - Chronic Study I |
| Study First Received: | May 13, 2010 |
| Last Updated: | November 1, 2012 |
| Health Authority: | United States: Food and Drug Administration Poland: Ministry of Health Germany: Ministry of Health Italy: Ministry of Health |
Keywords provided by Respicardia, Inc.:
|
Sleep Disordered Breathing Cheyne Stokes Respiration Periodic Breathing Sleep Apnea Central Sleep Apnea |
Additional relevant MeSH terms:
|
Sleep Apnea Syndromes Sleep Apnea, Central Apnea Respiratory Aspiration Cheyne-Stokes Respiration Respiration Disorders Respiratory Tract Diseases |
Signs and Symptoms, Respiratory Signs and Symptoms Sleep Disorders, Intrinsic Dyssomnias Sleep Disorders Nervous System Diseases |
ClinicalTrials.gov processed this record on June 17, 2013