Quartet Lead and Resynchronization Therapy Options

Phase 4

Completed

• Conditions: Heart Failure
• Interventions: Device: Cardiac Resynchronization Therapy Defibrillator

• Registration Number: NCT01295840
• Lead Sponsor: Abbott Medical Devices

Brief Summary

The purpose of this Clinical Trial is to determine the percentage of patients whose hemodynamic response improves with the different configurations offered by the new Quartet® left ventricular lead, as a result of its four electrodes, with respect to the configurations offered by a standard bipolar lead.

Furthermore, the optimal stimulation configuration will be determined from a comparison with traditional configurations.

Detailed Description

This is a prospective, non-randomised, multi-centre, national, interventional clinical trial of a medical device.

This trial involves two visits: one at the beginning of the study, which will be undertaken in the seven days following implant, and another visit at 6 months after enrollment. It is recommended that the enrollment visit is undertaken as soon as possible after implantation, although the time window allows the timing to be adapted to each centre's standard practice. Resynchronization therapy in those patients suitable for participation in this trial is expected to begin once this enrollment visit has been completed.

Once data collection at enrollment visit has been completed, final device programming will be based on each investigator's criteria and will be undertaken following the standard practice of each centre.

Study Timeline

• Study Start: 2011-01
• Study First Submitted: 2011-02-03
• Study First Submitted QC: 2011-02-10
• Study First Posted: 2011-02-15
• Primary Completion: 2012-04
• Study Completion: 2012-09
• Results First Submitted: 2014-06-06
• Results First Submitted QC: 2015-03-05
• Results First Posted: 2015-03-06
• Status Verified: 2019-02
• Last Update Submitted: 2019-02-01
• Last Update Posted: 2019-02-20

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 51

Inclusion Criteria

1. Patients with a Cardiac resynchronization Therapy Defibrillator device (CRT-D) and a Quartet® quadripolar electrode from St Jude Medical (used in "Single Site Pacing" mode) implanted in the left ventricle.
2. Patients who have provided written informed consent
3. Patients who are in sinus rhythm.
4. Patients older than 18 years of age.

Exclusion Criteria

1. Patients in atrial fibrillation at the time of the echocardiographic study of the enrollment visit.
2. Patients with valvular disease.
3. Patients in functional class New York Heart Association (NYHA) IV
4. Patients for whom echocardiography images suitable for determining the cardiac output cannot be obtained.
5. Patients whose device has been changed/upgraded.
6. Pregnant patients.
7. Patients who do not fulfill all the inclusion criteria.
8. Patients who are unable to provide written informed consent

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
CRT therapy	Cardiac Resynchronization Therapy Defibrillator	Cardiac Resynchronization Therapy Defibrillator (CRT-D)

Primary Outcome Measures

Name	Time	Method
Number of Patients Whose Cardiac Output (CO) Value in Acute, as Measured Echocardiographically, Improves With the Different Stimulation Vectors Offered by the Quartet® Left Ventricular Electrode.	Enrollment visit (in the seven days after implantation of the device)

Secondary Outcome Measures

Name	Time	Method
Capture Threshold	6 months post-implant	Capture and phrenic threshold data will be recorded for each of the stimulation vectors studied.; Attempts will also be made to avoid phrenic stimulation in those patients who suffer from it, whilst maintaining good capture thresholds, by changing between the new configurations offered by the Quartet® electrode.
Percent Difference Between the Best CO From Non-traditional Vectors and Best CO From Traditional Vectors	At enrollment	In patients with best CO obtained from Non-traditional, to calculate the percent difference between the best CO from Non-traditional vectors and best CO from Traditional vectors, vectors.This percentage was the CO from Non-traditional vectors minus CO from Traditional vectors then divided by CO from Traditional vectors.; The Quartet® lead has 4 poles: Distal (D1), Mid 2 (M2), Mid 3 (M3) and Proximal (P4). The 3 Traditional vectors are the traditional configurations available in a standard bipolar lead: D1-M2, D1-Right Ventricular Coil (RVC) and M2-RVC. The 7 Non-traditional vectors are the additional configurations available in a Quartet® lead: D1-P4, M2-P4, M3-M2, M3-RVC, M3-P4, P4-M2 and P4-RVC.
Cardiac Output (CO) With Different Configurations at Enrollment	Enrollment visit (in the seven days after implantation of the device)	Means of baseline non-paced CO, best CO obtained from traditional configurations and best CO obtained from all quadripolar configurations at enrollment.
Number of Vectors With Phrenic Nerve Stimulation (PNS)	At 6 months	Capture and phrenic threshold data will be recorded for each of the stimulation vectors studied.; Attempts will also be made to avoid phrenic stimulation in those patients who suffer from it, whilst maintaining good capture thresholds, by changing between the new configurations offered by the Quartet® electrode.
Number of Patients With PNS in All Vectors	At 6 months	To calculate the number of patients that exhibit PNS in all traditional vector
Number of Patients With PNS in All Vectors, That Could be Avoided With a Non-traditional Vector	At 6 months	To calculate the number of patients, who exhibit PNS in all traditional vector, in which PNS could be avoided using a non-traditional vector

Trial Locations

Locations (1)

Hospital Clínico Universitario Virgen de la Victoria; 🇪🇸 Málaga, Spain