Atrial FibrillationAVAILNCT00356057
Investigational Device Exemption (IDE) Study for the Approval of Closed Loop Stimulation (CLS) and Cardiac Resyncronization Pacing Therapies (CRT) for the Treatment of Atrial Fibrillation (AF) With Ablate and Pace
A study testing Protos DR/CLS and Stratos LV CRT pacemakers in people with Atrial Fibrillation and Congestive Heart Failure, run by Biotronik, Inc. at 10 sites in United States.
Trial summary
The purpose of this study is to demonstrate the safety and effectiveness of biventricular pacing over conventional right ventricular pacing in patients with persistent or permanent, symptomatic atrial fibrillation undergoing atrioventricular (AV) node ablation and permanent pacing therapy. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Atrial Fibrillation, Congestive Heart Failure
- What is being tested?
- Protos DR/CLS and Stratos LV CRT pacemakers
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 153 participants
- Where
- 10 sitesUnited States
- Study dates
- Dec 2004to Jun 2008
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Meet the indications for therapy
- Persistent, symptomatic AF with poorly controlled rapid ventricular rates or permanent, symptomatic AF with poorly controlled rapid ventricular rates.
- Eligible for AV nodal ablation and permanent pacemaker implantation
- NYHA Class II or III heart failure
- Age ≥ 18 years
- Understand the nature of the procedure
Show all 10Show fewer
- Ability to tolerate the surgical procedure required for implantation
- Give informed consent
- Able to complete all testing required by the clinical protocol
- Available for follow-up visits on a regular basis at the investigational site
Who cannot join
- Meet one or more of the contraindications
- Have a life expectancy of less than six months
- Expected to receive heart transplantation within six months
- Enrolled in another cardiovascular or pharmacological clinical investigation
- Patients with an ICD, or being considered for an ICD
- Patients with previously implanted biventricular pacing systems
Show all 12Show fewer
- Patients with previously implanted single or dual chamber pacing system with > 50% documented ventricular pacing
- Patients with previous AV node ablation
- Six-minute walk test distance greater than 450 meters
- Any condition preventing the patient from being able to perform required testing
- Presence of another life-threatening, underlying illness separate from their cardiac disorder
- Conditions that prohibit placement of any of the lead systems
Trial locations and contacts
10 sites in 1 country.
10 sites in 1 country
United States10 sites
Lone Star Arrhythmia
Amarillo, Texas
St. Joseph Mercy
Ann Arbor, Michigan
University of Alabama
Birmingham, Alabama
Caritas St. Elizabeth's Medical Center
Boston, Massachusetts
Aultman Hospital
Canton, Ohio
Ohio State University
Columbus, Ohio
Lake Charles Memorial
Lake Charles, Louisiana
McLaren Heart Foundation
Lapeer, Michigan
NYU Medical Center
New York, New York
Spartanburg Regional
Spartanburg, South Carolina
About this study
Official title: AVAIL CLS/CRT: AV-node Ablation With CLS and CRT Pacing Therapies for the Treatment of AF
The purpose of this study is to demonstrate the safety and effectiveness of biventricular pacing over conventional right ventricular pacing in patients with persistent or permanent, symptomatic atrial fibrillation undergoing atrioventricular (AV) node ablation and permanent pacing therapy.
Read the detailed description
This study is a multi-center, prospective, randomized, blinded trial. The study will consist of approximately 265 patients who require treatment of persistent or permanent, symptomatic atrial fibrillation by atrioventricular (AV) node ablation and permanent pacing therapy i.e. "Ablate and Pace" therapy. All patients enrolled into the clinical study will be randomly assigned to one of three groups using a randomization ratio of 2:2:1. Patients will be assigned to receive either biventricular (biV) pacing with CLS-based rate adaptive pacing using the legally marketed Protos DR/CLS (Group 1), or biventricular pacing with accelerometer-based rate adaptive pacing using the Stratos LV (Group 2), or right ventricular (RV) pacing with accelerometer-based rate adaptive pacing using the Stratos LV (Group 3). Patients in all three groups will be implanted with legally marketed right and left ventricular pacing leads. The patients, the core lab used to interpret the echocardiographic data and the Clinical Events Committee adjudicating crossover, patient death and congestive heart failure (CHF) hospitalizations will be blinded to the randomization assignment.
- Conditions
- Atrial Fibrillation, Congestive Heart Failure
- Being tested
- Protos DR/CLS and Stratos LV CRT pacemakers
- Keywords
- atrial fibrillation, AV node ablation, pacemaker, congestive heart failure
- Medical subject headings
- Atrial Fibrillation, Heart Failure
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Protos DR/CLS and Stratos LV CRT pacemakersDevice
Also called Protos DR/CLS dual chamber pacemaker
Protos DR/CLS is a dual chamber pacemaker with CLS rate adaption, Stratos LV is a biventricular pacemaker with accelerometer based rate adaption
| Study group | Role | What they receive |
|---|---|---|
| 1 | Active comparator | Biventricular pacing group with Closed Loop Stimulation rate adaptation (Protos CLS device) Receives: Device: Protos DR/CLS and Stratos LV CRT pacemakers |
| 2 | Active comparator | Biventricular pacing group with accelerometer based rate adaption (Stratos LV device) Receives: Device: Protos DR/CLS and Stratos LV CRT pacemakers |
| 3 | Active comparator | Right Ventricular pacing group with accelerometer based rate adaption (Stratos LV device) Receives: Device: Protos DR/CLS and Stratos LV CRT pacemakers |
What is being measured
The primary outcome is the main question the study is designed to answer.
Average Percentage Improvement From Baseline of the 6-minute Walk Test Distance and Minnesota Living With Heart Failure Quality of Life Score at 6-months
Combined, average percentage improvement in 6-minute walk test distance and Minnessota Living With Heart Failure Quality of Life score from baseline to 6-month follow-up for the Protos DR/CLS (Group 1) and Stratos LV (Group 2) compared with the active control (Group 3). The 6-minute walk test is a test that measure how far a patient can walk in 6 minutes in a standardized walking course. Percent Change (0% (worst)-100% (best))
Measured: Change from baseline to six months post-procedure
Number of Participants Free of System-related Complications (Related to the Device, Leads, or Implant Procedure) at 6 Months Post-procedure
Complication-free rate was evaluated in an equivalence (non-inferiority) format compared to a target of 85% minus delta (10%), where delta is the clinically significant difference for establishing equivalence. This endpoint evaluated system-related complications.
Measured: At six months post-procedure
Number of Participants Free of System-related Complications (Related to the Device, Leads, or Implant Procedure) at 6 Months Post-procedure
Complication-free rate was evaluated in an equivalence (non-inferiority) format compared to a target of 85% minus delta (10%), where delta is the clinically significant difference for establishing equivalence. This endpoint evaluated system-related complications. All Stratos systems (in both the biV and RV pacing arms) were evaluated together as pre-specified in the protocol.
Measured: At six months post-procedure
Secondary outcomes (10)
Change in Six-minute Walk Test
Measured: Change from baseline to 6 months post-procedure
Change in Quality Of Life (QOL) Score Over 6 Months Calculated as QOL Score at Baseline - QOL Score at 6 Months
Quality of Life was evaluated using the Minnesota Living with Heart Failure (MLHF) Quality of Life (QOL) Questionnaire.The questionnaire consists of 21 questions to measure the subjects' perception of how their HF and its treatment affected their ability to live as they wanted during the last month. The questions describe different ways in which some people are affected (i.e. physical, socioeconomic, and psychological impairments). If a question does not apply to a subject or is not related to their HF, then they can answer with a 0. If it does apply to them, then they can rate (from 1 to 5) how much it has affected them. From the 21 questions, the lowest possible total score is 0, and the highest possible total score is 105. A lower score is desirable. This outcome was calculated as QOL score at baseline minus QOL score at 6 months. Therefore, a positive change in QOL score represents an improvement in quality of life, while a negative change in QOL score represents a worsening.
Measured: Change from baseline to six months post-procedure
Cardiac Remodeling Assessments by Echocardiography - Change in Left Ventricular Ejection Fraction
Measured: Change from baseline to six months post-procedure
Changes in New York Heart Association (NYHA) Classification
The purpose is to evaluate the change in the participant's NYHA classification.
There are four NYHA classes:
Class I: Patients with cardiac disease, but without resulting limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea, or anginal pain.
Class II: Patients with cardiac disease resulting in slight limitation of physical activity. They are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain.
Class III: Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary activity causes fatigue, palpitation, dyspnea, or anginal pain.
Class IV: Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.
Measured: Change from baseline to six months post-procedure
Percentage of Patients With Congestive Heart Failure (CHF) Related Hospitalizations
Measured: At six months post-procedure
Mortality Rate
Measured: At six months post-procedure
Cardiac Remodeling Assessments by Echocardiography - Change in Left Atrial Volume
Measured: Change from baseline to six months post-procedure
Cardiac Remodeling Assessments by Echocardiography - Change in Left Ventricular Mass
Measured: Change from baseline to six months post-procedure
Cardiac Remodeling Assessments by Echocardiography - Change in Left Ventricular End Systolic Volume
Measured: Change from baseline to six months post-procedure
Cardiac Remodeling Assessments by Echocardiography - Change in Left Ventricular End Diastolic Volume
Measured: Change from baseline to six months post-procedure
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Jul 2006 (estimated)
- Study startDec 2004
- Primary completionMay 2008
- Study completionJun 2008
Why it stopped: Slow enrollment.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Atrial FibrillationStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 153 participants (actual)
Sponsor and investigators
- Lead sponsor
- Biotronik, Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Michael Orlov, MD, Principal investigator, Caritas Elizabeth, Boston, MA
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00356057
- Sponsor's protocol ID
- G040150
- Acronym
- AVAIL
- Status last verified
- Jan 2018
- First submitted
- 21 Jul 2006
- Last updated
- 27 Feb 2018
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 27 Feb 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- AVAIL CLS/CRT: AV-node Ablation With CLS and CRT Pacing Therapies for the Treatment of AF
- ClinicalTrials.gov ID
- NCT00356057
- Acronym / sponsor ID
- AVAIL / G040150
- Conditions
- Atrial Fibrillation, Congestive Heart Failure
- Keywords
- atrial fibrillation, AV node ablation, pacemaker, congestive heart failure
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Slow enrollment.
- Enrolment
- 153 participants (actual)
- Lead sponsor
- Biotronik, Inc.Industry (pharma, biotech, devices)
- Study start
- Dec 2004
- Primary completion
- May 2008 (actual)
- Study completion
- Jun 2008 (actual)
- First posted
- 25 Jul 2006 (estimated)
- Results
- Posted 8 Jul 2011
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to demonstrate the safety and effectiveness of biventricular pacing over conventional right ventricular pacing in patients with persistent or permanent, symptomatic atrial fibrillation undergoing atrioventricular (AV) node ablation and permanent pacing therapy.
Detailed description
This study is a multi-center, prospective, randomized, blinded trial. The study will consist of approximately 265 patients who require treatment of persistent or permanent, symptomatic atrial fibrillation by atrioventricular (AV) node ablation and permanent pacing therapy i.e. "Ablate and Pace" therapy. All patients enrolled into the clinical study will be randomly assigned to one of three groups using a randomization ratio of 2:2:1. Patients will be assigned to receive either biventricular (biV) pacing with CLS-based rate adaptive pacing using the legally marketed Protos DR/CLS (Group 1), or biventricular pacing with accelerometer-based rate adaptive pacing using the Stratos LV (Group 2), or right ventricular (RV) pacing with accelerometer-based rate adaptive pacing using the Stratos LV (Group 3). Patients in all three groups will be implanted with legally marketed right and left ventricular pacing leads. The patients, the core lab used to interpret the echocardiographic data and the Clinical Events Committee adjudicating crossover, patient death and congestive heart failure (CHF) hospitalizations will be blinded to the randomization assignment.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| 1 | Active comparator | Device: Protos DR/CLS and Stratos LV CRT pacemakersBiventricular pacing group with Closed Loop Stimulation rate adaptation (Protos CLS device) |
| 2 | Active comparator | Device: Protos DR/CLS and Stratos LV CRT pacemakersBiventricular pacing group with accelerometer based rate adaption (Stratos LV device) |
| 3 | Active comparator | Device: Protos DR/CLS and Stratos LV CRT pacemakersRight Ventricular pacing group with accelerometer based rate adaption (Stratos LV device) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- Meet the indications for therapy
- Persistent, symptomatic AF with poorly controlled rapid ventricular rates or permanent, symptomatic AF with poorly controlled rapid ventricular rates.
- Eligible for AV nodal ablation and permanent pacemaker implantation
- NYHA Class II or III heart failure
- Age ≥ 18 years
Key exclusion criteria (12 listed)
- Meet one or more of the contraindications
- Have a life expectancy of less than six months
- Expected to receive heart transplantation within six months
- Enrolled in another cardiovascular or pharmacological clinical investigation
- Patients with an ICD, or being considered for an ICD
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Protos DR/CLS and Stratos LV CRT pacemakersAlso: Protos DR/CLS dual chamber pacemakerProtos DR/CLS is a dual chamber pacemaker with CLS rate adaption, Stratos LV is a biventricular pacemaker with accelerometer based rate adaption | Device | 1, 2, 3 |
Primary outcome
Average Percentage Improvement From Baseline of the 6-minute Walk Test Distance and Minnesota Living With Heart Failure Quality of Life Score at 6-months
Time frame: Change from baseline to six months post-procedure
Combined, average percentage improvement in 6-minute walk test distance and Minnessota Living With Heart Failure Quality of Life score from baseline to 6-month follow-up for the Protos DR/CLS (Group 1) and Stratos LV (Group 2) compared with the active control (Group 3). The 6-minute walk test is a test that measure how far a patient can walk in 6 minutes in a standardized walking course. Percent Change (0% (worst)-100% (best))
Number of Participants Free of System-related Complications (Related to the Device, Leads, or Implant Procedure) at 6 Months Post-procedure
Time frame: At six months post-procedure
Complication-free rate was evaluated in an equivalence (non-inferiority) format compared to a target of 85% minus delta (10%), where delta is the clinically significant difference for establishing equivalence. This endpoint evaluated system-related complications.
Number of Participants Free of System-related Complications (Related to the Device, Leads, or Implant Procedure) at 6 Months Post-procedure
Time frame: At six months post-procedure
Complication-free rate was evaluated in an equivalence (non-inferiority) format compared to a target of 85% minus delta (10%), where delta is the clinically significant difference for establishing equivalence. This endpoint evaluated system-related complications. All Stratos systems (in both the biV and RV pacing arms) were evaluated together as pre-specified in the protocol.
10 secondary outcomes
Change in Six-minute Walk Test
Time frame: Change from baseline to 6 months post-procedure
Change in Quality Of Life (QOL) Score Over 6 Months Calculated as QOL Score at Baseline - QOL Score at 6 Months
Time frame: Change from baseline to six months post-procedure
Cardiac Remodeling Assessments by Echocardiography - Change in Left Ventricular Ejection Fraction
Time frame: Change from baseline to six months post-procedure
Changes in New York Heart Association (NYHA) Classification
Time frame: Change from baseline to six months post-procedure
Percentage of Patients With Congestive Heart Failure (CHF) Related Hospitalizations
Time frame: At six months post-procedure
Mortality Rate
Time frame: At six months post-procedure
Cardiac Remodeling Assessments by Echocardiography - Change in Left Atrial Volume
Time frame: Change from baseline to six months post-procedure
Cardiac Remodeling Assessments by Echocardiography - Change in Left Ventricular Mass
Time frame: Change from baseline to six months post-procedure
Cardiac Remodeling Assessments by Echocardiography - Change in Left Ventricular End Systolic Volume
Time frame: Change from baseline to six months post-procedure
Cardiac Remodeling Assessments by Echocardiography - Change in Left Ventricular End Diastolic Volume
Time frame: Change from baseline to six months post-procedure
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Feb 2018.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
Related trials for Atrial Fibrillation
Active, not recruiting
Horizon 360 Protocol for the Treatment of Paroxysmal Atrial Fibrillation With the Sphere-360™ Catheter and Affera™ Mapping and Ablation System (Horizon 360)
Paroxysmal AF
Active, not recruitingObservational study
Concomitant Left Atrial Appendage Closure and Pulsed Field Ablation-Asia
Concomitant Procedures, Atrial Fibrillation
Active, not recruiting
CONVERGE Post-Approval Study (PAS)
Chronic Atrial Fibrillation
Recruiting
Early Closure of Left Atrial Appendage for Patients With Atrial Fibrillation and Ischemic Stroke Despite Anticoagulation Therapy
Ischemic Stroke, Atrial Fibrillation
RecruitingPhase 2
Safety in Adult Participants With Atrial Fibrillation Who Are Treated With Anticoagulation
Atrial Fibrillation (AF)
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Michael Orlov, MD principal investigator
Caritas Elizabeth, Boston, MA
10 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Protos DR/CLS and Stratos LV CRT pacemakers in people with Atrial Fibrillation and Congestive Heart Failure, run by Biotronik, Inc. at 10 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 10 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 27 Feb 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 10 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 8 Jul 2011). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Average Percentage Improvement From Baseline of the 6-minute Walk Test Distance and Minnesota Living With Heart Failure Quality of Life Score at 6-months (time frame: Change from baseline to six months post-procedure). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Feb 2018.