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Sleep ApneaADVENT-HFNCT01128816

Effect of Adaptive Servo Ventilation (ASV) on Survival and Hospital Admissions in Heart Failure

A study testing Adaptive Servo Ventilation in people with Sleep Apnea and Heart Failure, run by Toronto Rehabilitation Institute at 49 sites in 9 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Sleep Apnea (SA) is a disorder that causes pauses in breathing during sleep that expose the heart to oxygen deprivation. It is common in patients with heart failure (HF) where it is associated with increased risk of hospitalizations and death. It is not known however whether treating SA reduces these risks. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Sleep Apnea, Heart Failure
What is being tested?
Adaptive Servo Ventilation
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
732 participants
Where
49 sitesin 9 countries
Study dates
May 2010to 31 Mar 2022
Phase
Interventional
Are there results?
None posted in the registry

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

  • American Heart Association Stage B-D Heart failure due to ischemic, idiopathic or hypertensive causes, present for at least 3 months
  • Left Ventricular Ejection Fraction ≤ 45 %
  • Optimal medical therapy for heart failure
  • No change in active cardiac medications for 2 weeks prior to randomization, beta-blockers must be started 3 months prior to randomization
  • Sleep apnea with an AHI ≥ 15. Subjects with obstructive sleep apnea must also have an Epworth Sleepiness Scale score of ≤ 10 and no or mild daytime sleepiness
  • Written informed consent

Who cannot join

  • Heart failure due to primary valvular heart disease
  • Presence of moderate to severe mitral insufficiency due to intrinsic mitral valve disease
  • Hypertrophic obstructive or restrictive or post partum cardiomyopathy
  • Exercise capacity limited by class IV angina pectoris
  • Acute MI, cardiac surgery, PCI, AICD, or CRT within 3 months of randomization
  • Active myocarditis
Show all 14Show fewer
  • Planned AICD or CRT
  • Presence of a left-ventricular assist device
  • Transplanted heart or expected to receive a transplanted heart within the next 6 months
  • Pregnancy
  • Current use of ASV or CPAP or mandibular advancement device for treatment of sleep apnea or treated with any investigational therapy during the last 4 weeks (including approved therapies being used in unapproved indications)
  • A clinical history that would interfere with the objectives of this study or that would in the investigator's opinion preclude safe conclusion of the study
  • Any other medical, social, or geographical factor, which would make it unlikely that the patient will comply with the study procedures (e.g. alcohol abuse, lack of permanent residence, severe depression, disorientation, distant location, or history of non-compliance)
  • Any contraindication to ASV therapy as detailed in the device provider manual

Trial locations and contacts

49 sites in 9 countries.

49 sites in 9 countries

Canada13 sites
  • Capital District Health Authority

    Halifax, Nova Scotia, B3H 2E2

  • McMaster University Medical Centre, Hamilton Health Sciences

    Hamilton, Ontario, L8S 2X2

  • Kingston General Hospital Sleep Disorders Laboratory/Queen's University

    Kingston, Ontario, K7L 2V6

  • St. Mary's General Hospital

    Kitchener, Ontario, N2M 1B2

  • London Health Sciences Centre - Victoria Hospital

    London, Ontario, N6C 2R5

  • Hôpital Hôtel-Dieu du CHUM

    Montreal, Quebec, H2X 0C1

  • McGill University Health Centre, Glen Site

    Montreal, Quebec, H4A 3J1

  • University of Ottawa-Ottawa Heart Institute

    Ottawa, Ontario, K1Y 4W7

  • Institut Universitaire de Cardiologie et de Pneumologie de Québec- Université Laval

    Québec, Quebec, G1V 4G5

  • St. Michael's Hospital

    Toronto, Ontario, M5B 1W8

  • University Health Network/TRI/Mount Sinai

    Toronto, Ontario, M5G 2C4

  • Vancouver General Hospital/UBC/VCHA

    Vancouver, British Columbia, V5Z 1M9

  • St. Boniface General Hospital

    Winnipeg, Manitoba, R2H 2A6

Other trials in Canada

Spain9 sites
  • Hospital de la Santa Creu i Sant Pau

    Barcelona, 08025

  • Hospital Universitari Vall d'Hebron

    Barcelona, 08035

  • Hospital San Pedro de Alcántara

    Cáceres, 10003

  • Hospital Arnau de Vilanova

    Lleida, 25198

  • Fundación Jiménez Diaz-CAPIO

    Madrid, 28040

  • Hospital Universitario Marques de Valdecilla

    Santander, 39008

  • Hospital Universitario Rio Hortega

    Valladolid, 47012

  • Hospital Universitario Txagorritxu

    Vitoria-Gasteiz, Álava, 01009

  • Hospital Universitario Miguel Servet

    Zaragoza, 50009

Other trials in Spain

France7 sites
  • Centre Hospitalier de Béziers

    Béziers, 34500

  • Pole d'exploration de L' apnée du sommeil, Nouvelle Clinique Bel Air

    Bordeaux, 33200

  • Groupe Hospitalier Ambroise Paré, AP-HP

    Boulogne-Billancourt, 92100

  • Hôpital Antoine Béclère, AP-HP

    Clamart, 92141

  • Laboratoire d'Explorations Fonctionnelles Cardio-Respiratoires, Centre Hospitalier Universitaire de Grenoble

    Grenoble, 38043

  • Hôpital Bichat- Claude Bernard, AP-HP

    Paris, 75018

  • Groupe Hospitalier Pitié-Salpêtrière Charles Foix, AP-HP

    Paris, 75651

Other trials in France

Italy5 sites
  • Prima Medicina-Spedali Civili

    Brescia, 25123

  • ASST Franciacorta, Ospedale di Chiari

    Chiari, BS, 25032

  • Istituto Auxologico Italiano - Ospedale San Luca

    Milan, 20149

  • Istituto Scientifico di Montescano, Istituti Clinici Scientifici Maugeri (ICS Maugeri)

    Pavia, 27040

  • Istituto Scientifico di Veruno, Istituti Clinici Scientifici Maugeri

    Veruno, 28010

Other trials in Italy

Japan5 sites
  • Saiseikai Futsukaichi Hospital

    Fukuoka, 818-8516

  • Kyoto University Hospital

    Kyoto, 606-8507

  • Toranomon Hospital

    Tokyo, 105-8470

  • Juntendo University School of Medicine

    Tokyo, 113-8421

  • Tokyo Medical University Hospital

    Tokyo, 160-0023

Other trials in Japan

Brazil4 sites
  • Pronto Socorro Cardiologico de Pernambuco

    Recife, Pernambuco, CEP 50100-060

  • Instituto Dante Pazzanese de Cardiologia

    São Paulo, São Paulo, CEP 04012-909

  • CDEC Brasil - Centro de Desenvolvimento em Estudos Clínicos Brasil

    São Paulo, São Paulo, CEP 04020-060

  • Instituto do Coração do Hospital das Clínicas da FMUSP

    São Paulo, São Paulo, CEP 05403-000

Other trials in Brazil

United States3 sites
  • MetroHealth Medical Centre

    Cleveland, Ohio, 44109-1998

  • Glacier View Research Institute, Kalispell Regional Medical Center

    Kalispell, Montana, 59901

  • University of Arizona/Southern Arizona VA Health Care System

    Tucson, Arizona, 85723

Other trials in United States

Germany2 sites
  • University of Regensburg

    Regensburg, Bavaria, 93053

  • Wissenschaftliches Institut Bethanien e.V.

    Solingen, 42699

Other trials in Germany

United Kingdom1 site
  • The Sleep Disorders Centre -Nuffield House, Guy's Hospital

    London, SE1 9RT

Other trials in United Kingdom

About this study

Official title: A Multi-Centre, Randomized Study to Assess the Effects of Adaptive Servo Ventilation (ASV) on Survival and Frequency of Hospital Admissions in Patients With Heart Failure (HF) and Sleep Apnea (SA)-The ADVENT-HF Trial

Sleep Apnea (SA) is a disorder that causes pauses in breathing during sleep that expose the heart to oxygen deprivation. It is common in patients with heart failure (HF) where it is associated with increased risk of hospitalizations and death. It is not known however whether treating SA reduces these risks. This study is looking at whether a respiratory device known as Adaptive Servo Ventilation (ASV) can reduce the rate of cardiovascular hospitalizations and death in subjects with HF and SA. Study subjects will randomly receive either their regular medications OR their regular medications plus ASV. They will be followed for approximately 5 years and information relevant to their health will be collected and compared.

Being tested
Adaptive Servo Ventilation
Keywords
obstructive sleep apnea, central sleep apnea, heart failure, congestive heart failure, adaptive servo ventilation, ASV
Medical subject headings
Sleep Apnea Syndromes, Heart Failure, Sleep Apnea, Obstructive, Sleep Apnea, Central

What participants receive

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

  • Adaptive Servo VentilationDevice

    Also called BiPAP autoSV ADVANCED, ASV, Respironics

    BiPAP autoSV ADVANCED device worn nightly during sleep

Study groups in NCT01128816
Study groupRoleWhat they receive
Standard HF therapyNo interventionSubjects will receive optimal standard therapy for heart failure conforming to national guidelines as determined by the referring cardiologist
Standard therapy for HF + ASVActive comparatorSubjects will receive treatment with Adaptive Servo Ventilation in addition to optimal standard therapy for heart failure conforming to national guidelines, as determined by the referring cardiologist
Receives: Device: Adaptive Servo Ventilation

What is being measured

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

  1. The time to the composite outcome of death or first CV hospital admission or new onset atrial fibrillation/flutter requiring anti-coagulation but not hospitalization or delivery of an appropriate shock from an ICD not resulting in hospitalization.

    The study will end once 540 primary endpoints have occurred. The maximum follow-up period for all randomized subjects is 5 years.

    Measured: The expected study follow-up period is five years

Secondary outcomes (10)
  1. Time to death from any cause

    The study will end once 540 primary endpoints have occurred.

    Measured: The expected study follow-up period is 5 years

  2. Number of cardiovascular hospitalizations per year of follow-up

    Measured: The minimum time of follow-up is expected to be 2 years. The maximum time of follow-up is expected to be 5 years

  3. Number of days alive not hospitalized

    The number of days the patient is hospitalized are subtracted from the total number of days in the study from randomization. This number will be compared between the 2 groups.

    Measured: Time from randomization to censoring (death, primary event or end of study)

  4. Changes in left ventricular function

    Changes in LV function will be assessed by echocardiography at baseline and at 6 months post randomization

    Measured: 6 months from randomization

  5. Changes in plasma BNP levels

    Changes in plasma NT-proBNP levels will be assessed at baseline and at 6 months post randomization

    Measured: 6 months from randomization

  6. Cardiac resynchronization therapy or defibrillator implantations

    The average number of days from randomization to the first occurrence of CRT or defibrillator implantation will be calculated and compared between each treatment arm.

    Measured: Average number of days until first cardiac resynchronization or first defibrillator implantation

  7. Changes in 6 minute walk test distance

    Changes in the 6-minute walk distance between baseline and 6 months will be compared between the 2 groups

    Measured: 6 months from randomization

  8. Percentage of patients with changes in stages of heart failure and functional class

    New York Heart Association classification and AHA/ACC Stages of Heart Failure will be assessed at each visit.

    Measured: Values obtained at study termination will be compared to those obtained at randomization

  9. Changes in apnea/hypopnea index

    Measured: 1 month from randomization

  10. Changes in Quality of life assessments

    Minnesota living with Heart Failure Questionnaire and Epworth Sleepiness Scale will be used. Scores will be compared between the 2 groups.

    Measured: Assessments made at baseline, 1, 6, 12 and every 6 months thereafter

Timeline

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

  1. First posted24 May 2010 (estimated)
  2. Study startMay 2010
  3. Primary completion31 Mar 2022
  4. Study completion31 Mar 2022

Why it stopped: Philips Global Field Safety Notice for PAP Devices \& Ventilators, June 14, 2021 (June 15, 2021 censor date for trial). Patient final visits and collection of endpoints prior to censor date continued to March 31, 2022.

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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
732 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01128816
Sponsor's protocol ID
ADVENT-HF trial
Acronym
ADVENT-HF
Status last verified
Nov 2022
First submitted
26 Apr 2010
Last updated
22 Nov 2022
Results posted
No
Data monitoring committee
Yes

Publications

  • Floras JS, Logan AG, Tomlinson G, Bradley TD; ADVENT-HF Investigators. Win Ratio Analysis for Peak-Flow Adaptive Servoventilation in Treating Sleep Apnoea in Heart Failure With Reduced Ejection Fraction. Can J Cardiol. 2026 Jul;42(7):1529-1537. doi: 10.1016/j.cjca.2026.03.019. Epub 2026 Mar 20.

    PubMed 41865991
  • Horvath CM, Fisser C, Floras JS, Sossalla S, Wang S, Tomlinson G, Rankin F, Yatsu S, Ryan CM, Bradley TD, Arzt M; ADVENT-HF Investigators. Nocturnal Cardiac Arrhythmias in Heart Failure With Obstructive and Central Sleep Apnea. Chest. 2024 Dec;166(6):1546-1556. doi: 10.1016/j.chest.2024.08.003. Epub 2024 Aug 20.

    PubMed 39168180
  • Bradley TD, Logan AG, Lorenzi Filho G, Kimoff RJ, Duran Cantolla J, Arzt M, Redolfi S, Parati G, Kasai T, Dunlap ME, Delgado D, Yatsu S, Bertolami A, Pedrosa R, Tomlinson G, Marin Trigo JM, Tantucci C, Floras JS; ADVENT-HF Investigators. Adaptive servo-ventilation for sleep-disordered breathing in patients with heart failure with reduced ejection fraction (ADVENT-HF): a multicentre, multinational, parallel-group, open-label, phase 3 randomised controlled trial. Lancet Respir Med. 2024 Feb;12(2):153-166. doi: 10.1016/S2213-2600(23)00374-0. Epub 2023 Dec 21.

    PubMed 38142697
  • Perger E, Inami T, Lyons OD, Alshaer H, Smith S, Floras JS, Logan AG, Arzt M, Duran Cantolla J, Delgado D, Fitzpatrick M, Fleetham J, Kasai T, Kimoff RJ, Leung RST, Lorenzi Filho G, Mayer P, Mielniczuk L, Morrison DL, Parati G, Parthasarathy S, Redolfi S, Ryan CM, Series F, Tomlinson GA, Woo A, Bradley TD; ADVENT-HF Investigators. Distinct Patterns of Hyperpnea During Cheyne-Stokes Respiration: Implication for Cardiac Function in Patients With Heart Failure. J Clin Sleep Med. 2017 Nov 15;13(11):1235-1241. doi: 10.5664/jcsm.6788.

    PubMed 29065956

Questions about this trial

What is this clinical trial studying?

A study testing Adaptive Servo Ventilation in people with Sleep Apnea and Heart Failure, run by Toronto Rehabilitation Institute at 49 sites in 9 countries.

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 6 inclusion and 14 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 22 Nov 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 49 sites in Canada, Spain, France, Italy, Japan and 4 more countries. 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?

The study was stopped early (reason given: Philips Global Field Safety Notice for PAP Devices \& Ventilators, June 14, 2021 (June 15, 2021 censor date for trial). Patient final visits and collection of endpoints prior to censor date continued to March 31, 2022.). Results are not available in the source record.

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?

The time to the composite outcome of death or first CV hospital admission or new onset atrial fibrillation/flutter requiring anti-coagulation but not hospitalization or delivery of an appropriate shock from an ICD not resulting in hospitalization. (time frame: The expected study follow-up period is five years). 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 NCT01128816, which also lists 4 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 22 Nov 2022.

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