This trial is active, not recruiting.

Condition heart failure
Treatments image guided cardiac resynchronization therapy (crt) device lead placement., optimizing myocardial lead placement for cardiac resynchronization therapy (crt) devices
Sponsor Lawson Health Research Institute
Start date May 2011
End date May 2013
Trial size 50 participants
Trial identifier NCT01638754, 17696, R-11-074


Patients with heart failure and cardiomyopathy that have been referred for Cardiac Resynchronization Therapy (CRT) will have their CRT devices implanted using an image guided treatment plan for optimal lead delivery. The validation of image-guided CRT lead delivery will significantly advance the field of heart failure therapy.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Endpoint classification efficacy study
Intervention model single group assignment
Masking open label
Primary purpose treatment

Primary Outcomes

improvement in LVESV by greater than/equal to 15%
time frame: 3-6 months

Secondary Outcomes

improvement in ejection fraction greater than or equal to 5%,
time frame: 3-6 months
improvement in 6 minute walk equal to or greater than 30 meters
time frame: 3-6 months
improvement in NYHA functional class by 1
time frame: 3-6 months
improved QoL by 10 points
time frame: 3-6 months

Eligibility Criteria

Male or female participants at least 41 years old.

Inclusion Criteria: - any patient (> or equal to 40 years old) referred for cardiac resynchronization therapy - New York Heart Association (NYHA) greater than or equal to 2 - ejection fraction /=120 msec - Patient has been on stable heart failure medications for at least 6 weeks and in the investigator's opinion reached optimal medical therapy for treatment of heart failure over the past 6 months Exclusion Criteria: - patients with contraindications to MRI - recent myocardial infarction within last 6 weeks - cardiac revascularization procedure within the past 3 months - glomerular filtration rate (GFR)

Additional Information

Official title Multi-Modality Imaging Assessment for Pacing Interventions in Heart Failure: Targeting Optimal Sites and Outcomes
Principal investigator James White, MD, FRCPC
Description Objective 1: Using established study data from our previous study (Multimodality imaging Assessment of Pacing InTervention in Heart Failure Heart Failure or MAPIT HF) define characteristics of the "optimal myocardial target" that maximally yields clinical response to CRT. Objective 2: Using established MAPIT-HF study data identify whether alternate coronary venous pathways to "optimal myocardial targets" exists in clinical non-responders. Objective 3: Evaluate the feasibility of guiding the delivery of CRT leads to "optimal myocardial targets" through the use of an interactive, 3D "integrated cardiac model" of coronary vein anatomy, myocardial scar and mechanical dyssynchrony. Currently there is no standard definition for response to CRT. Of importance is that measures of clinical response appear to be incongruent with echocardiographic parameters of reverse remodeling following CRT. The primary endpoint of clinical response will be an improvement in Left ventricular end systolic volume (LVESV) by ≥ 15% at 3 months following CRT, as validated in prior studies. Secondary clinical endpoints will also be evaluated; 1) Improvement in ejection fraction ≥ 5 percentage points, 2) Improvement in 6-minute hall walk ≥ 30 meters or ≥ 10%, 3) Improvement in NYHA (New York Heart Association) functional class by 1, or Specific Activity Score by 1, and 4) Improvement in Quality of Life (Minnesota Living with Heart Failure) by 10 points. Our hypothesis is that a single 3D dataset can be developed from multiple MRI datasets for the simultaneous display of coronary venous anatomy, myocardial scar, and mechanical dyssynchrony, the latter being derived from tagged MRI data. The investigators hypothesize that the availability of this 3D model during fluoroscopic CRT lead placement will result in improved rates of lead tip delivery to "optimal myocardial targets" and improved clinical response. Our specific hypotheses of Project 2 are as follows; 1. The generation of an integrated cardiac model of venous anatomy, myocardial scar and dyssynchrony is feasible using multiple MRI-derived datasets. 2. The availability of this interactive 3D cardiac model during fluoroscopic CRT lead delivery will increase the occurrence of CRT lead tips being delivered to "optimal myocardial segments" when compared to historic control data within the MAPIT-HF study cohort.
Trial information was received from ClinicalTrials.gov and was last updated in July 2012.
Information provided to ClinicalTrials.gov by Lawson Health Research Institute.