Evaluation of ACUITY™ X4 Quadripolar Coronary Venous Leads and RELIANCE™ 4-FRONT Defibrillation Leads
- Conditions
- Cardiac Resynchronization Therapy
- Interventions
- Device: ACUITY X4 quadripolar coronary venous lead and RELIANCE 4-FRONT defibrillation lead
- Registration Number
- NCT02071173
- Lead Sponsor
- Boston Scientific Corporation
- Brief Summary
The objective of the NAVIGATE X4 Clinical Study is to gather data to establish the safety, performance and effectiveness of the ACUITY™ X4 quadripolar coronary venous leads and the RELIANCE 4-FRONT™ ventricular defibrillation leads to satisfy FDA requirements for pre-market submission. Additionally, data from this study will be used to support post-market approval requirements for the ACUITY X4 and RELIANCE 4-FRONT leads.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 2244
Subjects indicated for a CRT-D that fulfill one of the following 5 criteria[1]:
-
Subject with left ventricular ejection fraction (LVEF) less than or equal to 35%, sinus rhythm, left bundle branch block (LBBB) with a QRS duration greater than or equal to 150 ms, and a NYHA class II, III or ambulatory IV symptoms on Guideline-Directed Medical Therapy (GDMT)*
-
Subject with LVEF less than or equal to 35%, sinus rhythm, LBBB with a QRS duration 120 to 149 ms, and NYHA class II, III, or ambulatory IV symptoms on GDMT*
-
Subject with LVEF less than or equal to 35%, sinus rhythm, a non-LBBB pattern with a QRS duration greater than or equal to 150 ms, and NYHA class III/ ambulatory class IV symptoms on GDMT*
-
Subject with atrial fibrillation and LVEF less than or equal to 35% on GDMT* if a) the subject requires ventricular pacing or otherwise meets CRT criteria [listed here] and b) AV nodal ablation or pharmacologic rate control will allow near 100% ventricular pacing with CRT
-
Subject on GDMT* who have LVEF less than or equal to 35% and are undergoing new device placement with anticipated requirement for significant (>40%) ventricular pacing *GDMT = Guideline-directed medical therapy (formerly known as optimal pharmaceutical therapy (OPT)), represents optimal medical therapy as defined by ACCF/ AHA guideline-recommended therapies (primarily Class I)
- Subject is intended to receive the ACUITY X4 LV lead and RELIANCE 4-FRONT RV lead (optional in Study Phase 1) and BSC CRT-D with quadripolar header as their initial (de novo) cardiac implants
- Subject is willing and capable of providing informed consent (which can include the use of a legally authorized representative [LAR] for documentation of informed consent) and participating in all testing associated with this investigation at an approved center and at the intervals defined by this protocol
- Subject is age 18 or above, or of legal age to give informed consent specific to state and national law
Subjects who meet any one of the following criteria will be excluded from this clinical study.
- Subject has a known or suspected sensitivity to dexamethasone acetate (DXA)
- Subject has a mechanical tricuspid heart valve
- Subject is enrolled in any other concurrent study, with the exception of local mandatory governmental registries and observational studies/registries* that are not in conflict and do not affect the following:
- Schedule of procedures for the Study (i.e. should not cause additional or missed visits);
- Study outcome (i.e. involve medications that could affect the heart rate of the subject);
- Conduct of the Study per good clinical practice (GCP) / International Organization for Standardization (ISO) 14155:2011/ 21 Code of Federal Regulations (CFR) 812, local regulations
- Subject is currently on the active heart transplant list
- Subject has a documented life expectancy of less than twelve months
- Women of childbearing potential who are or might be pregnant at the time of study enrollment or CRT-D System implant (method of assessment upon physician's discretion)
- Subjects currently requiring chronic dialysis *Sponsors of such studies/registries should be informed and Boston Scientific must be informed by the investigator about the parallel conduct of these projects in the subject and of the project's basic nature. The decision if a desired mandatory governmental registry or observational study/ registry is in conflict with this exclusion criterion is up to the enrolling investigator.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Enrolled Patients ACUITY X4 quadripolar coronary venous lead and RELIANCE 4-FRONT defibrillation lead Subjects undergo an implant procedure to receive at least one investigational lead -- ACUITY X4 left ventricular (LV) CRT lead, RELIANCE 4-FRONT right ventricular (RV) ICD lead
- Primary Outcome Measures
Name Time Method Percentage of ACUITY X4 Straight Leads Free From Complication Through 6 Months Implant through 6 months Lead-related complication-free rate of ACUITY X4 Straight Leads from implant through 6 months post implant.
Percentage of RELIANCE 4-FRONT Leads Free From Complication From 3 Through 24 Months 3 months through 24 months Lead-related complication-free rate of RELIANCE 4-FRONT Leads from 3 through 24 months post implant.
Mean Pacing Capture Threshold (PCT) of RELIANCE 4-FRONT Leads at 3 Months Implant through 3 months PCT measurements from RELIANCE 4-FRONT leads were collected at 3 months post-implant. Measurements were performed using 0.5 millisecond pulse width.
Percentage of ACUITY X4 Spiral Leads Free From Complication Through 6 Months Implant through 6 months Lead-related complication-free rate of ACUITY X4 Spiral Leads from implant through 6 months post implant.
Percentage of ACUITY X4 Leads With Acceptable Pacing Capture Thresholds (PCT) Implant through 3 months PCT measurements in the programmed configuration were collected at 3 months post-implant. Programmed configuration refers to the pacing configuration that was selected by the physician to provide LV pacing therapy. The percentage of measurements with PCT ≤ 2.5 V were calculated.
Percentage of ACUITY X4 Spiral Leads With Acceptable Pacing Capture Thresholds (PCT) Using the Best Proximal Electrode 3 months PCT measurements in the in the proximal zone (electrodes 2, 3, 4) were collected at 3 months post-implant. Physician investigators were instructed to use the best proximal electrode (E2, E3 or E4) as the cathode and the RV lead coil or pulse generator as the anode; best was defined as the electrode with the lowest PCT without phrenic nerve stimulation. The percentage of measurements with PCT ≤ 2.5 V were calculated.
Percentage of RELIANCE 4-FRONT Leads Free From Complication Through 3 Months Implant through 3 months Lead-related complication-free rate of RELIANCE 4-FRONT Leads from implant through 3 months post implant.
- Secondary Outcome Measures
Name Time Method Mean Detection Time of Induced Ventricular Tachycardia / Ventricular Fibrillation (VT/VF) Episodes Using RELIANCE 4-FRONT Leads Within 30 days of implant The mean detection time, in seconds, of induced VT/VF episodes occurring within 30 days of implant were evaluated. Subjects were required to implanted with RELIANCE 4-FRONT leads to be evaluated.
Mean Pacing Impedance of RELIANCE 4-FRONT Passive Fixation Leads at 3 Months 3 months Pacing impedance measurements from RELIANCE 4-FRONT Passive Fixation leads were collected at 3 months post-implant.
Mean Pacing Impedance of ACUITY X4 Spiral Leads at 3 Months 3 months Pacing impedance measurements from ACUITY X4 Spiral leads were collected at 3 months post-implant.
Mean Pacing Impedance ACUITY X4 Straight Leads at 3 Months 3 months Pacing impedance measurements from ACUITY X4 Straight leads were collected at 3 months post-implant.
Mean Sensed Amplitude of RELIANCE 4-FRONT Leads at 3 Months 3 months Sensed amplitude measurements from RELIANCE 4-FRONT leads were collected at 3 months post-implant.
Mean Pacing Impedance of RELIANCE 4-FRONT Active Fixation Leads at 3 Months 3 months Pacing impedance measurements from RELIANCE 4-FRONT Active Fixation leads were collected at 3 months post-implant.
Percentage of Successfully Converted Induced Ventricular Tachycardia / Ventricular Fibrillation (VT/VF) Episodes Using RELIANCE 4-FRONT Leads Within 30 days of implant Ventricular Tachyarrhythmia (VT/VF) Shock Conversion Efficacy, analyzed within 30 days of implant
Mean Sensed Amplitude of ACUITY X4 Spiral Leads at 3 Months 3 months Sensed amplitude measurements from ACUITY X4 Spiral leads were collected at 3 months post-implant.
Mean Sensed Amplitude of ACUITY X4 Straight Leads at 3 Months 3 months Sensed amplitude measurements from ACUITY X4 Straight leads were collected at 3 months post-implant.
Trial Locations
- Locations (96)
Union Memorial Hospital
🇺🇸Baltimore, Maryland, United States
Wheeling Hospital Inc.
🇺🇸Steubenville, Ohio, United States
Eastern Maine Medical Center
🇺🇸Bangor, Maine, United States
Medical City Dallas Hospital
🇺🇸Dallas, Texas, United States
Cleveland Clinic Foundation
🇺🇸Cleveland, Ohio, United States
University of Chicago
🇺🇸Chicago, Illinois, United States
Beth Israel Deaconess Medical Center
🇺🇸Boston, Massachusetts, United States
St. Vincent's Hospital
🇺🇸Indianapolis, Indiana, United States
Duke University Medical Center
🇺🇸Durham, North Carolina, United States
Texas Cardiac Arrhythmia Research
🇺🇸Austin, Texas, United States
Providence Alaska Medical Center
🇺🇸Anchorage, Alaska, United States
Banner Baywood Heart Hospital
🇺🇸Mesa, Arizona, United States
Scottsdale Healthcare - Osborn
🇺🇸Scottsdale, Arizona, United States
Cardiology Associates of Northeast Arkansas, P.A.
🇺🇸Jonesboro, Arkansas, United States
Kaiser Permanente
🇺🇸Los Angeles, California, United States
USC Medical Center
🇺🇸Los Angeles, California, United States
Alta Bates Medical Center
🇺🇸Oakland, California, United States
Sharp Memorial Hospital
🇺🇸San Diego, California, United States
Hartford Hospital
🇺🇸Hartford, Connecticut, United States
Lakeland Regional Medical Center
🇺🇸Lakeland, Florida, United States
Delray Medical Center
🇺🇸Fort Lauderdale, Florida, United States
West Florida Cardiology Network, LLC
🇺🇸Largo, Florida, United States
Emory University Hospital
🇺🇸Atlanta, Georgia, United States
Tallahassee Memorial Hospital
🇺🇸Tallahassee, Florida, United States
Gwinnett Hospital System Inc.
🇺🇸Lawrenceville, Georgia, United States
Alexian Brothers Medical Center
🇺🇸Elk Grove Village, Illinois, United States
St. John's Hospital
🇺🇸Springfield, Illinois, United States
Porter Memorial Hospital
🇺🇸Dyer, Indiana, United States
Lutheran Medical Group
🇺🇸Fort Wayne, Indiana, United States
Ball Memorial Hospital
🇺🇸Muncie, Indiana, United States
University of Iowa Hospitals and Clinics
🇺🇸Iowa City, Iowa, United States
Spectrum Health Hospitals
🇺🇸Grand Rapids, Michigan, United States
St. Joseph Mercy Hospital
🇺🇸Ypsilanti, Michigan, United States
St. Mary's Duluth Clinic Regional Heart Center
🇺🇸Duluth, Minnesota, United States
St. Cloud Hospital
🇺🇸Saint Cloud, Minnesota, United States
HealthEast St. Joseph's Hospital
🇺🇸Saint Paul, Minnesota, United States
United Heart and Vascular Clinic
🇺🇸Saint Paul, Minnesota, United States
Boone Hospital Center
🇺🇸Columbia, Missouri, United States
Cox Health
🇺🇸Springfield, Missouri, United States
Nebraska Heart Institute
🇺🇸Lincoln, Nebraska, United States
Deborah Heart and Lung Center
🇺🇸Browns Mills, New Jersey, United States
Cooper Hospital - University Medical Center
🇺🇸Haddon Heights, New Jersey, United States
Jersey Shore University Medical Center
🇺🇸Neptune, New Jersey, United States
Valley Hospital
🇺🇸Ridgewood, New Jersey, United States
Maimonides Medical Center
🇺🇸Brooklyn, New York, United States
Long Island Jewish Medical Center
🇺🇸New Hyde Park, New York, United States
Columbia University Medical Center
🇺🇸New York, New York, United States
Stony Brook University Hospital
🇺🇸Stony Brook, New York, United States
Buffalo General Hospital
🇺🇸Williamsville, New York, United States
Mercy Hospital of Buffalo, Catholic Health System
🇺🇸Williamsville, New York, United States
Aultman Hospital
🇺🇸Canton, Ohio, United States
Good Samaritan Hospital
🇺🇸Cincinnati, Ohio, United States
Ohio State University Medical Center
🇺🇸Columbus, Ohio, United States
OhioHealth Research and Innovation Institute - Riverside Methodist Hospital
🇺🇸Columbus, Ohio, United States
Barnes Jewish Hospital
🇺🇸Saint Louis, Missouri, United States
The Toledo Hospital
🇺🇸Toledo, Ohio, United States
Lehigh Valley Hospital
🇺🇸Allentown, Pennsylvania, United States
Abington Memorial Hospital
🇺🇸Abington, Pennsylvania, United States
York Hospital
🇺🇸York, Pennsylvania, United States
PeeDee Cardiology Associates PA
🇺🇸Florence, South Carolina, United States
Rapid City Regional Hospital
🇺🇸Rapid City, South Dakota, United States
Spartanburg Regional Medical Center
🇺🇸Spartanburg, South Carolina, United States
Avera Heart Hospital of South Dakota
🇺🇸Sioux Falls, South Dakota, United States
Stern Cardiovascular Foundation, Inc.
🇺🇸Germantown, Tennessee, United States
Plaza Medical Center of Fort Worth
🇺🇸Fort Worth, Texas, United States
Walnut Hill Medical Center
🇺🇸Dallas, Texas, United States
SouthEast Texas Clinical Research Center
🇺🇸Beaumont, Texas, United States
University of Texas Houston Health Science Center
🇺🇸The Woodlands, Texas, United States
Bon Secours Heart & Vascular Institute
🇺🇸Mechanicsville, Virginia, United States
Sentara Norfolk General Hospital
🇺🇸Norfolk, Virginia, United States
PeaceHealth St. Joseph Medical Center
🇺🇸Bellingham, Washington, United States
Kootenai Heart Clinics
🇺🇸Spokane, Washington, United States
Providence Health & Services - Washington
🇺🇸Spokane, Washington, United States
Charleston Area Medical Center
🇺🇸Charleston, West Virginia, United States
Monongalia General Hospital
🇺🇸Morgantown, West Virginia, United States
Huntsville Hospital
🇺🇸Huntsville, Alabama, United States
Intermountain Medical Center
🇺🇸Murray, Utah, United States
Providence Regional Medical Center Everett
🇺🇸Everett, Washington, United States
Asante Rogue Regional Medical Center
🇺🇸Medford, Oregon, United States
University of Kansas Hospital
🇺🇸Kansas City, Kansas, United States
Mercy General Hospital
🇺🇸Sacramento, California, United States
University of Alabama at Birmingham
🇺🇸Birmingham, Alabama, United States
Yale University School of Medicine
🇺🇸New Haven, Connecticut, United States
Tampa General Hospital
🇺🇸Tampa, Florida, United States
University of Louisville Hospital
🇺🇸Louisville, Kentucky, United States
Medical University of South Carolina
🇺🇸Charleston, South Carolina, United States
St. Thomas Research Institute, LLC
🇺🇸Nashville, Tennessee, United States
St. Luke's Hospital of Kansas City
🇺🇸Kansas City, Missouri, United States
University of North Carolina Hospital
🇺🇸Chapel Hill, North Carolina, United States
Vanderbilt University Medical Center
🇺🇸Nashville, Tennessee, United States
Providence St. Vincent Medical Center
🇺🇸Portland, Oregon, United States
Heart Hospital of Austin
🇺🇸Austin, Texas, United States
Virginia Cardiovascular Specialist
🇺🇸Richmond, Virginia, United States
Baptist Health Lexington
🇺🇸Lexington, Kentucky, United States
Trinity Mother Frances Health System
🇺🇸Tyler, Texas, United States
Montefiore Medical Center
🇺🇸Bronx, New York, United States