MedPath

World-wide Randomized Antibiotic Envelope Infection Prevention Trial

Phase 4
Completed
Conditions
CIED Related Infection
Interventions
Device: TYRX™ Absorbable Antibacterial Envelope
Registration Number
NCT02277990
Lead Sponsor
Medtronic Cardiac Rhythm and Heart Failure
Brief Summary

Medtronic , Inc. is sponsoring the World-wide Randomized Antibiotic Envelope Infection Prevention Trial (WRAP-IT), a randomized, prospective, multi-center, single blinded, post-market, interventional clinical study. This study will evaluate the ability of the TYRX™ envelope to reduce major Cardiac Implantable Electronic Device (CIED) infections through 12-months post-procedure following CIED generator replacement, upgrade, revision, or de novo cardiac resynchronization therapy defibrillator (CRT-D) implant. Additionally, this large device study provides the unique opportunity to prospectively characterize the performance of Medtronic's lead monitoring features in subjects whose CIED system includes a transvenous right ventricular (RV) defibrillation lead. Finally, the WRAP-IT study will serve as a post-approval study for those geographies requiring a post-approval study of the TYRX™ envelope.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
7075
Inclusion Criteria
  • Patient is willing to sign and date the study patient informed consent (PIC) form

  • Patient is at least 18 years of age and meets age requirements per local law

  • Patient is planned to undergo at least one of the following:

    a. Patient has existing cardiac implantable electronic device (CIED) and is undergoing implantable pulse generator (IPG) (including cardiac resynchronization therapy pacemaker [CRT-P]), implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) replacement or upgrade with a new Medtronic generator

    i. Subjects planned to have leads added, or extracted and added for upgrades can be enrolled OR

    b. Patient will undergo a de novo Medtronic CRT-D system implant per approved indications

OR

c. Patient has existing study eligible Medtronic CIED in which the pocket was not accessed within the last 365 days, and is undergoing pocket or lead revision

  • Willing to provide the contact information for the physician who provides followup for his/her CIED
  • Willing and able to comply with scheduled follow-up and study related activities
Exclusion Criteria
  • Known allergy to minocycline or rifampin or their derivatives, or any other known contraindications to implantation of the TYRX envelope.
  • Current therapy with chronic oral immunosuppressive agents or ≥ 20mg/day of Prednisone or equivalent.
  • Hemodialysis or peritoneal dialysis.
  • Prior Cardiac transplantation or existing Ventricular Assist Device (VAD).
  • Require long-term vascular access for any reason.
  • Prior history of a CIED infection, other prosthetic device infection, or endovascular infection, including endocarditis, in the past 12 months.
  • Physical, clinical, or laboratory signs or symptoms consistent with an active infection (including but not limited to pneumonia, urinary tract, cellulitis, or bacteremia)
  • Systemic lupus erythematous, because minocycline has been reported to aggravate this condition
  • Female patient who is pregnant, or of childbearing potential and not on a reliable form of birth control. Women of childbearing potential are required to have a negative pregnancy test within 7 days prior to device procedure
  • Participation in another study that may confound the results of this study. Co-enrollment in concurrent trials is only allowed when documented pre-approval is obtained from the Medtronic study manager.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
TYRX™ envelopeTYRX™ Absorbable Antibacterial EnvelopeThe Medtronic TYRX™ Absorbable Antibacterial Envelope is an absorbable sterile prosthesis designed to hold a pacemaker pulse generator or defibrillator to create a stable environment when implanted in the body. The purpose of the absorbable coating is to act as a carrier for the antimicrobial agents.
Primary Outcome Measures
NameTimeMethod
12 Month Kaplan-Meier Estimate of Major CIED Infection RateImplant to 12 months

CIED infections are defined as (1) superficial cellulitis in the region of the CIED pocket with wound dehiscence, erosion, or purulent drainage, (2) deep incisional or organ/space (generator pocket) surgical site infection that meets the Centers for Disease Control and Prevention criteria, independent from time of surgery, (3) persistent bacteremia, or (4) endocarditis.

Major CIED infections are defined as a CIED infection resulting in one or more of the following:

* CIED system removal

* Any invasive procedure (e.g. pocket opened) without system removal

* Treatment with antibiotic therapy if the subject is not a candidate for system removal and infection recurrence after completion of antibiotic therapy or evidence of deep infection with wound dehiscence, erosion, or purulent drainage

* Death

Secondary Outcome Measures
NameTimeMethod
Kaplan-Meier Estimate of a Major Infection Throughout Follow-upThroughout study follow-up Kaplan-Meier Estimate is at 36 Months

CIED infections are defined as (1) superficial cellulitis in the region of the CIED pocket with wound dehiscence, erosion, or purulent drainage, (2) deep incisional or organ/space (generator pocket) surgical site infection that meets the Centers for Disease Control and Prevention criteria, independent from time of surgery, (3) persistent bacteremia, or (4) endocarditis.

Major CIED infections are defined as a CIED infection resulting in one or more of the following:

* CIED system removal

* Any invasive procedure (e.g. pocket opened) without system removal

* Treatment with antibiotic therapy if the subject is not a candidate for system removal and infection recurrence after completion of antibiotic therapy or evidence of deep infection with wound dehiscence, erosion, or purulent drainage

* Death

12 Month Kaplan-Meier Estimate of Major or Minor CIED InfectionImplant to 12 months

Major CIED infections are defined above. Minor CIED infections are defined as CIED infections that do not meet the definition of a major CIED infection

12 Month Kaplan-Meier Estimate of a CIED Procedure Related or System Related ComplicationImplant to 12 months

* A CIED system related event is defined as an adverse event related to the CIED system which includes the device, leads, implant tool(s), programmer, or TYRX envelope (if applicable)

* A CIED procedure related event is defined as an adverse event that occurs due to any procedure related to the implantation or surgical modification of the system including the TYRX envelope (if applicable)

* A procedure or system related complication is defined as an adverse event related to a CIED procedure or the CIED system that results in at least one of the following:

Death,Termination of significant device function, Invasive intervention

Trial Locations

Locations (181)

Cardiology Associates of Corpus Christi

🇺🇸

Corpus Christi, Texas, United States

Baylor Heart & Vascular Hospital

🇺🇸

Dallas, Texas, United States

MedStar Health Research Institute

🇺🇸

Baltimore, Maryland, United States

OhioHealth Riverside Methodist Hospital

🇺🇸

Columbus, Ohio, United States

The Ohio State University

🇺🇸

Columbus, Ohio, United States

Allegheny General Hospital

🇺🇸

Pittsburgh, Pennsylvania, United States

University of Pittsburgh Medical Center UPMC Presbyterian

🇺🇸

Pittsburgh, Pennsylvania, United States

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

University Hospitals Case Medical Center

🇺🇸

Cleveland, Ohio, United States

Sinai Hospital of Baltimore

🇺🇸

Baltimore, Maryland, United States

Danbury Hospital

🇺🇸

Danbury, Connecticut, United States

Swedish Medical Center

🇺🇸

Englewood, Colorado, United States

Szpital Kliniczny Przemienienia Panskiego

🇵🇱

Poznań, Poland

King Faisal Specialist Hospital & Research Center

🇸🇦

Riyadh, Saudi Arabia

Hospital de Santa Maria-Centro Hospitalar Lisboa Norte, EPE

🇵🇹

Lisboa, Portugal

Centre Hospitalier Universitaire Vaudois

🇨🇭

Lausanne, Switzerland

Minneapolis Heart Institute Foundation

🇺🇸

Minneapolis, Minnesota, United States

University of Minnesota Medical Center

🇺🇸

Minneapolis, Minnesota, United States

Duke University Medical Center (DUMC)

🇺🇸

Durham, North Carolina, United States

The Lindner Research Center

🇺🇸

Cincinnati, Ohio, United States

University of California San Francisco UCSF Medical Center

🇺🇸

San Francisco, California, United States

Centennial Heart Cardiovascular Consultants LLC

🇺🇸

Nashville, Tennessee, United States

Saint Thomas Research Institute

🇺🇸

Nashville, Tennessee, United States

Saint Joseph's Hospital Health Center

🇺🇸

Liverpool, New York, United States

Lourdes Cardiology Services

🇺🇸

Voorhees, New Jersey, United States

Novant Health Heart and Vascular Institute

🇺🇸

Charlotte, North Carolina, United States

Akron General Medical Center

🇺🇸

Akron, Ohio, United States

University General Hospital of Heraklion

🇬🇷

Heraklion, Greece

Universitair Ziekenhuis Brussel

🇧🇪

Brussel, Belgium

Oklahoma Heart Institute

🇺🇸

Tulsa, Oklahoma, United States

Universitätsmedizin Rostock

🇩🇪

Rostock, Germany

Saint Mary Medical Center (Langhorne PA)

🇺🇸

Newtown, Pennsylvania, United States

Drexel University College of Medicine

🇺🇸

Philadelphia, Pennsylvania, United States

Pennsylvania Hospital

🇺🇸

Philadelphia, Pennsylvania, United States

Temple University Hospital

🇺🇸

Philadelphia, Pennsylvania, United States

Thomas Jefferson University Hospital

🇺🇸

Philadelphia, Pennsylvania, United States

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

The Stern Cardiovascular Foundation

🇺🇸

Germantown, Tennessee, United States

The Miriam Hospital

🇺🇸

East Providence, Rhode Island, United States

North Texas Heart Center

🇺🇸

Dallas, Texas, United States

Baylor Research Institute

🇺🇸

Plano, Texas, United States

Universitätsklinikum Krems

🇦🇹

Krems, Austria

Hospital San Juan de Dios

🇨🇱

Santiago, Chile

Turun Yliopistollinen keskussairaala

🇫🇮

Turku, Finland

Centre Hospitalier Regional de la Citadelle

🇧🇪

Liège, Belgium

EP Heart LLC

🇺🇸

The Woodlands, Texas, United States

Grantham Hospital

🇨🇳

Hong Kong, China

Centre Hospitalier Universitaire Saint Étienne - Hôpital Nord

🇫🇷

Saint Priest en Jarez, France

Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ)

🇨🇦

Quebec, Canada

Helsinki University Hospital

🇫🇮

Helsinki, Finland

Princess Margaret Hospital

🇨🇳

Hong Kong, China

Centre Hospitalier Régional Universitaire de Lille

🇫🇷

Lille, France

Hamilton General Hospital / Hamilton Health Sciences

🇨🇦

Hamilton, Ontario, Canada

CHU Hôpiteaux de Rouen - Hôpital Charles Nicolle

🇫🇷

Rouen Cedex 1, France

Universitäts-Herz-Zentrum Freiburg - Bad Krozingen

🇩🇪

Bad Krozingen, Germany

Onassis Cardiac Surgery Center

🇬🇷

Kallithea, Greece

Presidio Ospedaliero Sant'Anna

🇮🇹

Como, Italy

Rabin Medical Center - Beilinson Hospital

🇮🇱

Petah Tikva, Israel

Universiti Malaya Medical Centre

🇲🇾

Kuala Lumpur, Malaysia

University Hospital of Ioannina

🇬🇷

Ioannina, Greece

Hospital Universitari Bellvitge

🇪🇸

Barcelona, Spain

St. Antonius Ziekenhuis

🇳🇱

Nieuwegein, Netherlands

Policlinico Sant' Orsola - Malpighi

🇮🇹

Bologna, Italy

Chaim Sheba Medical Center

🇮🇱

Ramat Gan, Israel

Helse Bergen HF - Haukeland Universitetssjukehus

🇳🇴

Bergen, Norway

Central Manchester University Hospitals NHS - Manchester Royal Infirmary

🇬🇧

Manchester, United Kingdom

Centro Hospitalar do Porto

🇵🇹

Porto, Portugal

National Heart Centre Singapore

🇸🇬

Singapore, Singapore

Catharina Ziekenhuis

🇳🇱

Eindhoven, Netherlands

Samodzielny Publiczny Szpital Kliniczny nr 4 w Lublinie

🇵🇱

Lublin, Poland

Narodny ustav srdcovych a cievnych chorob, a.s. (NUSCH)

🇸🇰

Bratislava 37, Slovakia

Stredoslovensky ustav srdcovych a cievnych chorob a.s

🇸🇰

Banska Bystrica, Slovakia

Hospital Marqués de Valdecilla

🇪🇸

Santander, Cantabria, Spain

Royal Brompton & Harefield NHS Foundation Trust - Harefield Hospital

🇬🇧

London, United Kingdom

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Vychodoslovensky ustav srdcovych a cievnych chorob, a.s.

🇸🇰

Kosice, Slovakia

Karolinska Universitetssjukhuset

🇸🇪

Stockholm, Sweden

Hospital Universitario Ramón y Cajal

🇪🇸

Madrid, Spain

Alingsås Lasarett

🇸🇪

Goteborg, Sweden

Sahlgrenska Universitetssjukhuset

🇸🇪

Goteborg, Sweden

The Newcastle upon Tyne Hospitals NHS Foundation Trust - Freeman Hospital

🇬🇧

Newcastle Upon Tyne, United Kingdom

Oklahoma Heart Hospital Research Foundation

🇺🇸

Oklahoma City, Oklahoma, United States

University of Oklahoma Health Science Center (OUHSC)

🇺🇸

Oklahoma City, Oklahoma, United States

Alaska Heart Institute

🇺🇸

Anchorage, Alaska, United States

Tri-City Cardiology Consultants

🇺🇸

Mesa, Arizona, United States

Cardiovascular Consultants Heart Center

🇺🇸

Fresno, California, United States

Stanford Hospital & Clinics

🇺🇸

Stanford, California, United States

UCSD Medical Center

🇺🇸

La Jolla, California, United States

Chula Vista Cardiac Center

🇺🇸

Chula Vista, California, United States

Florida Electrophysiology Associates

🇺🇸

Atlantis, Florida, United States

Saint Vincent Medical Group

🇺🇸

Indianapolis, Indiana, United States

SCL Physicians Heart Institute of Colorado

🇺🇸

Lafayette, Colorado, United States

Hartford Hospital

🇺🇸

Hartford, Connecticut, United States

Iowa Heart Center

🇺🇸

West Des Moines, Iowa, United States

Advanced Cardiovascular Specialists

🇺🇸

Shreveport, Louisiana, United States

Sparrow Clinical Research Institute

🇺🇸

Lansing, Michigan, United States

Clearwater Cardiovascular & Interventional Consultants

🇺🇸

Clearwater, Florida, United States

MedStar Washington Hospital Center

🇺🇸

Washington, District of Columbia, United States

Kootenai Heart Clinics Northwest

🇺🇸

Coeur d'Alene, Idaho, United States

NorthShore University Health System

🇺🇸

Evanston, Illinois, United States

The University Kansas Medical Center Research Institute Inc

🇺🇸

Kansas City, Kansas, United States

Maine Medical Center

🇺🇸

Scarborough, Maine, United States

CentraCare Heart & Vascular Center

🇺🇸

Saint Cloud, Minnesota, United States

Great Lakes Heart and Vascular Institute PC

🇺🇸

Saint Joseph, Michigan, United States

Delmarva Heart Research Foundation Inc

🇺🇸

Salisbury, Maryland, United States

Beaumont Hospital - Royal Oak

🇺🇸

Royal Oak, Michigan, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

DLP Marquette Physicians Practices Inc

🇺🇸

Marquette, Michigan, United States

North Memorial Heart and Vascular Institute

🇺🇸

Robbinsdale, Minnesota, United States

Upper Michigan Cardiovascular Associates PC

🇺🇸

Marquette, Michigan, United States

NYU

🇺🇸

New York, New York, United States

United Heart and Vascular Clinic

🇺🇸

Saint Paul, Minnesota, United States

Hattiesburg Clinic/ Forrest General

🇺🇸

Hattiesburg, Mississippi, United States

Jersey Shore University Medical Center

🇺🇸

Neptune, New Jersey, United States

Mercy Hospital Springfield

🇺🇸

Springfield, Missouri, United States

Raleigh Cardiology Associates

🇺🇸

Raleigh, North Carolina, United States

Asheville Cardiology Associate PA

🇺🇸

Asheville, North Carolina, United States

The Valley Hospital

🇺🇸

Ridgewood, New Jersey, United States

Saint Anthonys Medical Center

🇺🇸

Saint Louis, Missouri, United States

New York Presbyterian Hospital

🇺🇸

New York, New York, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Rigshospitalet

🇩🇰

København, Denmark

Sjukhuset i Varberg

🇸🇪

Varberg, Sweden

Azienda Ospedaliera Spedali Civili di Brescia

🇮🇹

Brescia, Italy

Liverpool Heart and Chest Hospital NHS Foundation Trust

🇬🇧

Liverpool, United Kingdom

Mayo Clinic

🇺🇸

Rochester, Minnesota, United States

Legacy Medical Group

🇺🇸

Portland, Oregon, United States

Oregon Health & Science University Hospital

🇺🇸

Portland, Oregon, United States

Providence Health & Services

🇺🇸

Portland, Oregon, United States

University of Nebraska

🇺🇸

Omaha, Nebraska, United States

Saint Joseph's Medical Center

🇺🇸

Stockton, California, United States

Norton Cardiovascular Associates

🇺🇸

Louisville, Kentucky, United States

University of Michigan

🇺🇸

Ann Arbor, Michigan, United States

Novant Health Forsyth Medical Center

🇺🇸

Winston-Salem, North Carolina, United States

Lehigh Valley Hospital Cedar Crest

🇺🇸

Allentown, Pennsylvania, United States

Arizona Arrhythmia Consultants

🇺🇸

Scottsdale, Arizona, United States

Eisenhower Desert Cardiology Center

🇺🇸

Rancho Mirage, California, United States

Penrose St. Francis Hospital

🇺🇸

Colorado Springs, Colorado, United States

Prairie Education & Research Cooperative (Springfield IL)

🇺🇸

Springfield, Illinois, United States

Loyola University Medical Center

🇺🇸

Maywood, Illinois, United States

Cardiovascular Research Foundation of Louisiana

🇺🇸

Baton Rouge, Louisiana, United States

Englewood Hospital & Medical Center

🇺🇸

Englewood, New Jersey, United States

Cornell University Medical Center

🇺🇸

New York, New York, United States

Mount Sinai Saint Luke's Hospital

🇺🇸

New York, New York, United States

University of Rochester Medical Center

🇺🇸

Rochester, New York, United States

Westchester Medical Center

🇺🇸

Valhalla, New York, United States

Wake Forest University Health Sciences / Baptist Medical Center / North Carolina Baptist Hospital

🇺🇸

Winston-Salem, North Carolina, United States

Northeast Ohio Cardiovascular Specialists

🇺🇸

Akron, Ohio, United States

Saint Elizabeth Health Center

🇺🇸

Poland, Ohio, United States

Mount Carmel East

🇺🇸

Westerville, Ohio, United States

Saint Luke's Hospital

🇺🇸

Bethlehem, Pennsylvania, United States

Geisinger Medical Center

🇺🇸

Danville, Pennsylvania, United States

University of Pittsburgh Medical Center UPMC Hamot

🇺🇸

Erie, Pennsylvania, United States

Doylestown Cardiology Associates - VIAA

🇺🇸

Doylestown, Pennsylvania, United States

Jackson Clinic

🇺🇸

Jackson, Tennessee, United States

Wellmont CVA Heart Institute

🇺🇸

Kingsport, Tennessee, United States

Amarillo Heart Group

🇺🇸

Amarillo, Texas, United States

Plaza Medical Center of Fort Worth

🇺🇸

Fort Worth, Texas, United States

Longview Regional Medical Center

🇺🇸

Longview, Texas, United States

Scott & White Health Science Ctr

🇺🇸

Temple, Texas, United States

Aurora BayCare Medical Center

🇺🇸

Green Bay, Wisconsin, United States

University of Ottawa Heart Institute

🇨🇦

Ottawa, Ontario, Canada

The University of Vermont Medical Center Inc

🇺🇸

Burlington, Vermont, United States

Saint Mary's Medical Center

🇺🇸

Huntington, West Virginia, United States

Hôpital de la Timone - Centre Hospitalier Universitaire de Marseille

🇫🇷

Marseille, France

Bellin Memorial Hospital, Inc.

🇺🇸

Green Bay, Wisconsin, United States

Nouvelles Cliniques Nantaises

🇫🇷

Nantes, France

Azienda Ospedaliero Universitaria Pisana - Stabilimento di Cisanello

🇮🇹

Pisa, Italy

Institut Jantung Negara - National Heart Institute

🇲🇾

Kuala Lumpur, Malaysia

Hospital Sultanah Bahiyah

🇲🇾

Alor Setar, Kedah, Malaysia

Robert Wood Johnson Medical School

🇺🇸

New Brunswick, New Jersey, United States

Changi General Hospital

🇸🇬

Singapore, Singapore

Kantonsspital St.Gallen

🇨🇭

St. Gallen, Switzerland

Cardiocentro Ticino

🇨🇭

Lugano, Switzerland

Saint Paul's Hospital (Vancouver BC)

🇨🇦

Vancouver, British Columbia, Canada

Ziekenhuis Oost Limburg - Campus St.-Jan

🇧🇪

Genk, Belgium

The Cardiac & Vascular Institute

🇺🇸

Gainesville, Florida, United States

Virginia Commonwealth University Health System

🇺🇸

Richmond, Virginia, United States

University of Florida Health Shands Hospital

🇺🇸

Gainesville, Florida, United States

Mid America Heart Institute (MAHI)

🇺🇸

Kansas City, Missouri, United States

Lexington Cardiac Research Foundation

🇺🇸

Lexington, Kentucky, United States

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