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ArrhythmiaCONNECTNCT00402246

CONNECT Study - Clinical Evaluation Of Remote NotificatioN to rEduCe Time to Clinical Decision

A study testing Remote Management and In-Office Care in people with Arrhythmia and Tachycardia, run by Medtronic Cardiac Rhythm and Heart Failure at 127 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to determine whether the ability of clinicians to receive and review information from patients implanted with a heart device over the internet (remote care) is comparable to patients who are seen in-office for routine visits to check the status of their device. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Arrhythmia, Tachycardia, Atrial Fibrillation
What is being tested?
Remote Management and In-Office Care
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,009 participants
Where
127 sitesUnited States
Study dates
Nov 2006to Sep 2009
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

  • Patient will be implanted with a Medtronic Conexus-enabled Cardiac Resynchronization Therapy Defibrillator (CRT-D) or Implantable Cardioverter-Defibrillator (DR-ICD) device.

Who cannot join

  • Patient has permanent rapid beats in the upper chamber of the heart (Atrial Fibrillation) - (constant atrial fibrillation in which pharmacological therapy or cardioversion failed or not attempted).
  • Patient plans to be on chronic warfarin therapy post-implant and is no longer receiving therapies to attempt to control the rhythm of the beats in their atrium.
  • Patient has a previous ICD, CRT-D, Implantable Pulse Generator (IPG) or Cardiac Resynchronization Therapy Pacemaker (CRT-P).

Trial locations and contacts

127 sites in 1 country.

127 sites in 1 country

United States127 sites
  • Study site

    Abington, Pennsylvania

  • Study site

    Amarillo, Texas

  • Study site

    Ames, Iowa

  • Study site

    Ann Arbor, Michigan

  • Study site

    Ashland, Kentucky

  • Study site

    Atlanta, Georgia

  • Study site

    Aurora, Illinois

  • Study site

    Baltimore, Maryland

  • Study site

    Bismarck, North Dakota

  • Study site

    Bloomington, Indiana

  • Study site

    Boston, Massachusetts

  • Study site

    Bridgeport, Connecticut

  • Study site

    Brooksville, Florida

  • Study site

    Chattanooga, Tennessee

  • Study site

    Chelmsford, Massachusetts

  • Study site

    Cherry Hill, New Jersey

  • Study site

    Chicago, Illinois

  • Study site

    Cincinnati, Ohio

  • Study site

    Clearwater, Florida

  • Study site

    Cleveland, Ohio

  • Study site

    Colorado Springs, Colorado

  • Study site

    Columbia, Missouri

  • Study site

    Columbia, South Carolina

  • Study site

    Corpus Christi, Texas

  • Study site

    Covington, Louisiana

  • Study site

    Dallas, Texas

  • Study site

    Dayton, Ohio

  • Study site

    Daytona Beach, Florida

  • Study site

    Doylestown, Pennsylvania

  • Study site

    East Palo Alto, California

  • Study site

    Erie, Pennsylvania

  • Study site

    Eugene, Oregon

  • Study site

    Evansville, Indiana

  • Study site

    Fairfax, Virginia

  • Study site

    Fairview Park, Ohio

  • Study site

    Florence, South Carolina

  • Study site

    Flushing, New York

  • Study site

    Fort Smith, Arkansas

  • Study site

    Fredericksburg, Virginia

  • Study site

    Gainesville, Georgia

  • Study site

    Gastonia, North Carolina

  • Study site

    Germantown, Tennessee

  • Study site

    Glen Burnie, Maryland

  • Study site

    Grand Blanc, Michigan

  • Study site

    Greenwood, South Carolina

  • Study site

    Hattiesburg, Mississippi

  • Study site

    Hollywood, Florida

  • Study site

    Houston, Texas

  • Study site

    Indianapolis, Indiana

  • Study site

    Inglewood, California

  • Study site

    Jacksonville, Florida

  • Study site

    Kankakee, Illinois

  • Study site

    Kansas City, Kansas

  • Study site

    Kearney, Nebraska

  • Study site

    Kettering, Ohio

  • Study site

    Knoxville, Tennessee

  • Study site

    Lakeland, Florida

  • Study site

    Lancaster, Pennsylvania

  • Study site

    Langhorne, Pennsylvania

  • Study site

    Lanham, Maryland

  • Study site

    Little Rock, Arkansas

  • Study site

    Los Angeles, California

  • Study site

    Louisville, Kentucky

  • Study site

    Lynchburg, Virginia

  • Study site

    Madison, Wisconsin

  • Study site

    Manchester, New Hampshire

  • Study site

    Mayfield Heights, Ohio

  • Study site

    Mesa, Arizona

  • Study site

    Mexico, Missouri

  • Study site

    Milwaukee, Wisconsin

  • Study site

    Mineola, New York

  • Study site

    Minneapolis, Minnesota

  • Study site

    Mobile, Alabama

  • Study site

    Moline, Illinois

  • Study site

    Morgantown, West Virginia

  • Study site

    Napa, California

  • Study site

    Nashville, Tennessee

  • Study site

    New York, New York

  • Study site

    Newark, New Jersey

  • Study site

    Oklahoma City, Oklahoma

  • Study site

    Omaha, Nebraska

  • Study site

    Orlando, Florida

  • Study site

    Overland Park, Kansas

  • Study site

    Owensboro, Kentucky

  • Study site

    Pensacola, Florida

  • Study site

    Petoskey, Michigan

  • Study site

    Philadelphia, Pennsylvania

  • Study site

    Portland, Oregon

  • Study site

    Portsmouth, Virginia

  • Study site

    Poughkeepsie, New York

  • Study site

    Raleigh, North Carolina

  • Study site

    Rancho Mirage, California

  • Study site

    Randallstown, Maryland

  • Study site

    Ridgewood, New Jersey

  • Study site

    Rochester, New York

  • Study site

    Rockford, Illinois

  • Study site

    Safety Harbor, Florida

  • Study site

    Saginaw, Michigan

  • Study site

    Saint Cloud, Minnesota

  • Study site

    Saint Joseph, Michigan

  • Study site

    Saint Paul, Minnesota

  • Study site

    Salisbury, Maryland

  • Study site

    San Antonio, Texas

  • Study site

    San Bernardino, California

  • Study site

    San Diego, California

  • Study site

    Santa Rosa, California

  • Study site

    Sarasota, Florida

  • Study site

    Scottsdale, Arizona

  • Study site

    Springfield, Illinois

  • Study site

    Springfield, Missouri

  • Study site

    St Louis, Missouri

  • Study site

    St. Petersburg, Florida

  • Study site

    Takoma Park, Maryland

  • Study site

    Tampa, Florida

  • Study site

    The Woodlands, Texas

  • Study site

    Tucson, Arizona

  • Study site

    Vero Beach, Florida

  • Study site

    Washington D.C., District of Columbia

  • Study site

    Wayne, New Jersey

  • Study site

    West Orange, New Jersey

  • Study site

    Whitehall, Ohio

  • Study site

    Williamsville, New York

  • Study site

    Winston-Salem, North Carolina

  • Study site

    Wormleysburg, Pennsylvania

  • Study site

    Wyomissing, Pennsylvania

  • Study site

    York, Pennsylvania

  • Study site

    Ypsilanti, Michigan

Other trials in United States

About this study

The purpose of this study is to determine whether the ability of clinicians to receive and review information from patients implanted with a heart device over the internet (remote care) is comparable to patients who are seen in-office for routine visits to check the status of their device.

Being tested
Remote Management, In-Office Care
Keywords
Randomized Controlled Trials, Defibrillators, Remote Consultation
Medical subject headings
Arrhythmias, Cardiac, Tachycardia, Atrial Fibrillation, Ventricular Fibrillation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Remote ManagementOther

    The Remote Management method of treating patients consists of 3 components:

    CareAlerts: Device alerts that are triggered by either device integrity issues or arrhythmic issues with the patient (e.g. multiple shocks delivered for a ventricular arrhythmia, more than 12 hours of atrial arrhythmias occurring in a day)

    Conexus: the device feature which allows the device to wirelessly transmit information (possibly triggered by a CareAlert) to a patient monitor that is hooked up a patient's phone line

    CareLink: the Medtronic system which allows device data to be transmitted from a patient's monitor through the phone line to ultimately be displayed on a secure website for viewing by the patient's physician.

    The combination of these 3 components allow the patient's device to transmit information relating to either a device issue or patient issue to be viewed by a clinician without the patient having to take direct action.

  • In-Office CareOther

    Routine in-office care

Study groups in NCT00402246
Study groupRoleWhat they receive
Remote ArmExperimentalRemote Management
Receives: Other: Remote Management
In-office ArmActive comparatorIn-Office Care
Receives: Other: In-Office Care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Time Per Patient From a Clinical Event to a Clinical Decision in Response to Arrhythmias, Cardiovascular (CV) Disease Progression, and Device Issues

    Days from device detection of a clinical event to a decision being made in response to the event, as reported by the clinician or as evidenced by device data obtained at interrogation. A clinical event could be any of the following that satisfied pre-specified thresholds: arrhythmias (e.g. at least 12 hours of atrial tachycard/atrial fibrillation in a day), cardiovascular disease progression (e.g. multiple device shocks delivered to terminate a single episode), or device issues (e.g. low battery).

    Measured: Enrollment to last visit (up to 15 month post-implant)

Secondary outcomes (16)
  1. Health Care Utilization (HCU)

    Count of HCU visits for each HCU type (cardiovascular (CV) hospitalizations, cardiovascular (CV) emergency department (ED), and cardiovascular (CV) unscheduled clinic office/urgent care visits)

    Measured: Enrollment to last visit (up to 15 month post-implant)

  2. Health Care Utilization: TEEs

    Count of Transesophageal echocardiograms (TEEs) performed

    Measured: Enrollment to last visit (up to 15 months post-implant)

  3. Actions Taken for HCU Visits

    Count of HCU visits that involved specific actions taken

    Measured: Enrollment to last visit (up to 15 month post-implant)

  4. Clinically Meaningful Alerts

    Count of clinically meaningful alerts as classified by the clinician

    Measured: Enrollment to last visit (up to 15 month post-implant)

  5. Symptomatic AT/AF Alerts

    AT/AF represents atrial tachycardia or atrial fibrillation which are arrhythmias involving rapid beating of the atrial chambers of the heart. The devices in this study store how many hours each day that a patient experiences AT/AF. The patient may not be aware they are experiencing these atrial arrhythmias, but if the AT/AF is accompanied by symptoms, the AT/AF is said to be symptomatic AT/AF. Devices in this study have an alert that fires if the patient experiences at least a programmed amount of AT/AF in a day. Measure is count of symptomatic AT/AF alerts as classified by the clinician

    Measured: Enrollment to last visit (up to 15 month post-implant)

  6. AT/AF Alert Treatment

    Count of the treatment (i.e. hospitalization, ED visit, unscheduled clinic office/urgent care visits) in response to the AT/AF alerts

    Measured: Enrollment to last visit (up to 15 month post-implant)

  7. Time Per Patient From a Clinical Event Onset to a Clinical Decision for Symptom-driven Device Interrogations

    Days from a symptom-driven device interrogation event onset to a clinical decision being made in response to the event as reported by the clinician. An event is defined as a subject complaint received by the managing clinician in which the clinician determines that he/she must interrogate the subject's device to properly treat the subject.

    Measured: Enrollment to last visit (up to 15 month post-implant)

  8. Time Per Patient From a Clinical Event Onset to a Clinical Decision for Both Device Events and Symptom-driven Device Interrogations

    Days from device detection of a clinical event or a symptom-driven device interrogation event onset to a clinical decision, as reported by the clinician or as evidenced by device data obtained at interrogation. A clinical event is an event as defined in the primary objective. A symptom-driven device interrogation event is defined as a subject complaint received by the managing clinician in which the clinician determines that he/she must interrogate the subject's device to properly treat the subject.

    Measured: From event onset to clinical decision

  9. CareLink Transmission Compliance

    The CareLink Transmission Compliance Rate for a particular visit (e.g. 3 month visit) is the proportion (ranging from 0 to 1) of subjects with device interrogation data remotely transmitted via the CareLink system on the date it was scheduled to be sent for that visit. The proportion is a fraction in which the denominator is the number of subjects in the Remote Arm who were not exited from the trial prior to the visit of interest, and the numberator is the number of Remote Arm subjects who successfully transmitted device data via the CareLink system on the date it was scheduled to be sent.

    Measured: 3, 6, 9, 12 months visits

  10. Variability in Left Ventricular (LV) Threshold as Measured by Left Ventricular Capture Management (LVCM)

    LV Capture Threshold is the required energy(volts) necessary to cause the left ventricule to contract. It is important that a device which paces the left ventricule be set to a threshold such that current conducted through the left ventricular lead will induce contraction in the left ventricle. However, these thresholds may vary over time.

    The standard deviation and range (maximum LVCM threshold - minimum LVCM threshold) of the most recent 14 days of LVCM results prior to each follow-up visit were determined for each subject and used to assess within-patient variability in LV thresholds.

    Measured: 1, 3, 6, 9, 12, and 15 months visits

  11. State-Anxiety Scale

    The State-Anxiety scales for each subject were obtained at multiple time points. The State-Anxiety scale was derived by summing the 20 scores in the State section of the State-Trait Anxiety Inventory (STAI) questionnaire. The State-Anxiety scales can vary from a minimum of 20 (best possible) to a maximum of 80 (worst possible).

    Measured: 1, 3, 6, 9, 12, and 15 month visit

  12. Trait-Anxiety Scale

    The Trait-Anxiety scales for each subject were obtained at multiple time points. The Trait-Anxiety scale was derived by summing the 20 scores in the Trait section of the STAI questionnaire. The Trait-Anxiety scales can vary from a minimum of 20 (best possible) to a maximum of 80 (worst possible).

    Measured: 1, 3, 6, 9, 12, and 15 months visits

  13. Clinic Personnel Satisfaction With Wireless Telemetry (Telemetry + Leadless ECG).

    Following the completion of enrollment in the study, participating clinicians were asked to complete a survey assessing their overall satisfaction with the wireless telemetry feature. Clinicians' rating (1=strongly disagree, 5=strongly agree) of the overall satisfaction with the wireless telemetry feature of the device

    Measured: After study enrollment has been completed; on average 15.8 months after the center had enrolled its first subject

  14. In-office Follow-up Burden: Distance Traveled

    Subjects' responses to the survey. Subjects were asked to provide the distance (in miles) from their home to the clinic/hospital.

    Measured: 1 month visit

  15. In-office Follow-up Burden: Patient Expenses

    On a survey at the one month visit, the patient estimated their expenses in traveling to that visit.

    Measured: 1 month

  16. In-office Follow-up Burden: Hours Absent From Work Due to Visit

    Subjects were asked at their one month visit to indicate on a survey how many hours of work they were missing to attend that visit.

    Measured: 1 month

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Nov 2006 (estimated)
  2. Study startNov 2006
  3. Primary completionSep 2009
  4. Study completionSep 2009

Resources

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
Diagnosis
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
2,009 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00402246
Sponsor's protocol ID
605
Acronym
CONNECT
Status last verified
Feb 2011
First submitted
17 Nov 2006
Last updated
25 Feb 2011
Data monitoring committee
No

Publications

  • Crossley GH, Boyle A, Vitense H, Chang Y, Mead RH; CONNECT Investigators. The CONNECT (Clinical Evaluation of Remote Notification to Reduce Time to Clinical Decision) trial: the value of wireless remote monitoring with automatic clinician alerts. J Am Coll Cardiol. 2011 Mar 8;57(10):1181-9. doi: 10.1016/j.jacc.2010.12.012. Epub 2011 Jan 20.

    PubMed 21255955
  • Crossley G, Boyle A, Vitense H, Sherfesee L, Mead RH. Trial design of the clinical evaluation of remote notification to reduce time to clinical decision: the Clinical evaluation Of remote NotificatioN to rEduCe Time to clinical decision (CONNECT) study. Am Heart J. 2008 Nov;156(5):840-6. doi: 10.1016/j.ahj.2008.06.028. Epub 2008 Sep 11.

    PubMed 19061696

Questions about this trial

What is this clinical trial studying?

A study testing Remote Management and In-Office Care in people with Arrhythmia and Tachycardia, run by Medtronic Cardiac Rhythm and Heart Failure at 127 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 1 inclusion and 3 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: finished, as of the sponsor's last update on 25 Feb 2011. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 127 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 16 Feb 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?

Time Per Patient From a Clinical Event to a Clinical Decision in Response to Arrhythmias, Cardiovascular (CV) Disease Progression, and Device Issues (time frame: Enrollment to last visit (up to 15 month post-implant)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00402246, which also lists 2 linked publications.

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 25 Feb 2011.

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