Hypertension Resistant to Conventional TherapyNCT02837445
Moderato System: A Double-Blind Randomized Trial Ver 1.1
A study testing PHC ON and PHC OFF in people with Hypertension Resistant to Conventional Therapy and Bradycardia, run by BackBeat Medical Inc at 12 sites in 7 countries.
Trial summary
The purpose of this double blind randomized study is the evaluation of the safety and efficacy of the Moderato System. The Moderato implantable pulse generator is indicated for patients who have hypertension and also require a dual chamber pacemaker in order to reduce their blood pressure. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Hypertension Resistant to Conventional Therapy, Bradycardia, Atrioventricular Block
- What is being tested?
- PHC ON and PHC OFF
- Type of treatment
- Medical device
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 70 participants
- Where
- 12 sitesin 7 countries
- Study dates
- 12 Jul 2016to 13 May 2021
- 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
- Subject requires an implant or replacement a of dual chamber pacemaker
- Stable (at least one month) hypertension treatment with at least 1 anti-hypertensive drug, which is anticipated to be maintained for 7 months.
- Average day time (7AM-10PM) ambulatory systolic blood pressure ≥ 130 mmHg and office blood pressure ≥140 mmHg.
- Subject lives in the proximity of the study center, which permits compliance with study visits for at least 7 months.
Who cannot join
- Known secondary cause of HTN.
- Average ambulatory or office systolic BP > 195 mmHg.
- Permanent atrial fibrillation.
- History of significant paroxysmal atrial fibrillation/flutter burden (defined as >25% of beats).
- Cardiac ejection fraction <50%.
- Symptoms of heart failure, NYHA Class II or greater.
Show all 17Show fewer
- Hypertrophic cardiomyopathy, restrictive cardiomyopathy or inter-ventricular septal thickness ≥ 15 mm.
- Subject is on dialysis.
- Subject has an estimated Glomerular Filtration Rate < 30 ml/min/1.73 m²
- Prior neurological events (stroke or TIA) within the past year or events at a prior time that has resulted in residual neurologic deficit.
- Carotid artery disease.
- Known autonomic dysfunction.
- History of clinically significant untreated ventricular tachyarrhythmia or has experienced sudden death.
- Previous active device-based treatment for HTN.
- Existing implant, other than a pacemaker that needs replacing.
- Subject is or has the possibility of becoming pregnant and is unwilling of contraception during the study.
- Subject is unwilling or cannot provide Informed Consent
Trial locations and contacts
12 sites in 7 countries.
12 sites in 7 countries
Poland5 sites
Medical University of Gdansk
Gdansk, 80-952
Szpital Kliniczny Przemiemienia Panskiego
Poznan, 61-848
Pomeranian Medical University Hospital no. 2
Szczecin, 70-111
Samodzielnym Publicznym Centralnym Szpitalem Klinicznym
Warsaw, 02-097
Silesian Center for Heart Diseases
Zabrze, 41-800
Austria2 sites
Krankenhaus der Elisabethinen
Linz, 4020
Medical University Vienna
Vienna, 1090
Lithuania1 site
Vilnius University Hospital Santariskiu Klinikos
Vilnius, 08661
About this study
Official title: Clinical Evaluation of Safety and Effectiveness of the BackBeat Medical Moderato System in Patients With Hypertension: A Double-Blind Randomized Trial
The purpose of this double blind randomized study is the evaluation of the safety and efficacy of the Moderato System.
The Moderato implantable pulse generator is indicated for patients who have hypertension and also require a dual chamber pacemaker in order to reduce their blood pressure.
Read more
The primary objectives of this study are to provide evidence of safety and clinical efficacy of the anti-hypertensive effects of the Moderato System. This will be accomplished by evaluating changes in blood pressure in an active treatment vs. a control patient population for a period of 6 months.
The device will be considered to have a clinical effectiveness with regard to its anti-hypertension functions if there is a statistically significant and clinically meaningful reduction in mean 24-hour ambulatory systolic blood pressure in the treatment group compared to the control group.
Read the detailed description
Protocol CS-03 Ver 1.1 (NCT02837445) was amended at the advice of the Scientific Advisory to protocol CS-03 Version 3.0 with more stringent hypertension inclusion criteria and different observation intervals for efficacy and safety.
In CS-03 Version 3.0 the time of the primary efficacy endpoint was reduced from 6 months to 3 months post randomization which was deemed a suitable interval for the chronic effect, whereas for the safety endpoint, the period was lengthened from 6 month to 12 months post randomization to better monitor potential risks of the treatment on cardiac function (Blinding period was increased from 6 to 12 months). Protocols were thus split in order to allow better clarification to the difference in the time to the primary endpoints for efficacy and safety between the two CIP versions and simplify data analysis.
Protocol Ver 3.0 prescribes data analysis of all patients randomized under version 1.1 to be performed once they complete the 6 months follow-up as set in protocol version 1.1 (NCT0283744). It is expected that ~40 patients will be randomized according to protocol version 1.1 prior to the enrollment of patients according to protocol version 3.0. The results will be considered as interim analysis.
The recruitment for the protocol version 1.1 is now completed. Total of 47 patients were randomized according to protocol version 1.1 and all patients completed the follow-up period for the primary endpoint.
Patients are currently being followed up for the study "extension period".
- Being tested
- PHC ON, PHC OFF
- Medical subject headings
- Hypertension Resistant to Conventional Therapy, Bradycardia, Atrioventricular Block
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PHC ONDevice
Eligible patients randomized after optimization phase to PHC ON for 6 months. Patients continue standard or modified anti-hypertension medical regime at discretion of the investigator
PHC OFFDevice
Eligible patients randomized after optimization phase to PHC OFF for 6 months. Patients continue standard or modified anti-hypertension medical regime at discretion of the investigator.
| Study group | Role | What they receive |
|---|---|---|
| Treatment | Active comparator | Eligible patients randomized after optimization phase to PHC ON for 6 months Patients continue standard or modified anti-hypertension medical regime at discretion of the investigator Receives: Device: PHC ON |
| Control | Placebo comparator | Eligible patients randomized after optimization phase to pacemaker only (PHC OFF) for 6 months. Patients continue standard or modified anti-hypertension medical regime at discretion of the investigator Receives: Device: PHC OFF |
What is being measured
The primary outcome is the main question the study is designed to answer.
Rate of composite of major cardiac events
including heart failure, clinically significant arrhythmias eg, persistent or increased atrial fibrillation, serious ventricular arrhythmias, myocardial infarction, stroke, heart failure, renal failure and/or related safety events that result in death
Measured: 6 months post Randomization
Change in average 24 hour systolic ambulatory blood pressure
Measured: Week 3 pre Randomization and 6 months post Randomization
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Jul 2016 (estimated)
- Study start12 Jul 2016
- Primary completion13 May 2021
- Study completion13 May 2021
Why it stopped: Recruitment for this study was initially suspended as a larger global study was initiated in parallel. Later on, this study was terminated.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Hypertension Resistant to Conventional TherapyStudies 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
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 70 participants (actual)
Sponsor and investigators
- Lead sponsor
- BackBeat Medical Inc
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Massachusetts General Hospital, MLM Medical Labs GmbH, nabios GmbH
- Responsible party
- Sponsor
- Investigators
- Karl-Heinz Kuck, Prof. MD, Principal investigator, Asklepios Klinik St. Georg
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02837445
- Sponsor's protocol ID
- CS-03 Ver 1.1
- Status last verified
- Jun 2026
- First submitted
- 8 Jul 2016
- Last updated
- 18 Jun 2026
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Chovanec M, Merkely B, Sokal A, Petru J, Kralovec S, Drtina T, Mudroch M, Geller L, Osztheimer I, Morawski S, Mika YH, Fischer A, Evans SJ, Aviv R, Rosenthal N, Burkhoff D, Kuck KH, Neuzil P. Pressure-Volume Analysis Demonstrates Short- and Long-Term Hemodynamic Effects of Atrioventricular Interval Modulation Therapy in Hypertension. JACC Clin Electrophysiol. 2025 Nov;11(11):2493-2504. doi: 10.1016/j.jacep.2025.06.017. Epub 2025 Aug 13.
PubMed 40801869Kalarus Z, Merkely B, Neuzil P, Grabowski M, Mitkowski P, Marinskis G, Erglis A, Kazmierczak J, Sturmberger T, Sokal A, Pluta S, Geller L, Osztheimer I, Malek F, Kolodzinska A, Mika Y, Evans SJ, Hastings HM, Burkhoff D, Kuck KH. Pacemaker-Based Cardiac Neuromodulation Therapy in Patients With Hypertension: A Pilot Study. J Am Heart Assoc. 2021 Aug 17;10(16):e020492. doi: 10.1161/JAHA.120.020492. Epub 2021 Aug 13.
PubMed 34387126
Study at a glance
From the registry record, last updated by the sponsor on 18 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Clinical Evaluation of Safety and Effectiveness of the BackBeat Medical Moderato System in Patients With Hypertension: A Double-Blind Randomized Trial
- ClinicalTrials.gov ID
- NCT02837445
- Acronym / sponsor ID
- CS-03 Ver 1.1
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Recruitment for this study was initially suspended as a larger global study was initiated in parallel. Later on, this study was terminated.
- Enrolment
- 70 participants (actual)
- Lead sponsor
- BackBeat Medical IncIndustry (pharma, biotech, devices)
- Collaborators
- Massachusetts General Hospital, MLM Medical Labs GmbH, nabios GmbH
- Study start
- 12 Jul 2016 (actual)
- Primary completion
- 13 May 2021 (actual)
- Study completion
- 13 May 2021 (actual)
- First posted
- 19 Jul 2016 (estimated)
- Results
- Not posted in the source record
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 double blind randomized study is the evaluation of the safety and efficacy of the Moderato System.
The Moderato implantable pulse generator is indicated for patients who have hypertension and also require a dual chamber pacemaker in order to reduce their blood pressure.
The primary objectives of this study are to provide evidence of safety and clinical efficacy of the anti-hypertensive effects of the Moderato System. This will be accomplished by evaluating changes in blood pressure in an active treatment vs. a control patient population for a period of 6 months.
The device will be considered to have a clinical effectiveness with regard to its anti-hypertension functions if there is a statistically significant and clinically meaningful reduction in mean 24-hour ambulatory systolic blood pressure in the treatment group compared to the control group.
Detailed description
Protocol CS-03 Ver 1.1 (NCT02837445) was amended at the advice of the Scientific Advisory to protocol CS-03 Version 3.0 with more stringent hypertension inclusion criteria and different observation intervals for efficacy and safety.
In CS-03 Version 3.0 the time of the primary efficacy endpoint was reduced from 6 months to 3 months post randomization which was deemed a suitable interval for the chronic effect, whereas for the safety endpoint, the period was lengthened from 6 month to 12 months post randomization to better monitor potential risks of the treatment on cardiac function (Blinding period was increased from 6 to 12 months). Protocols were thus split in order to allow better clarification to the difference in the time to the primary endpoints for efficacy and safety between the two CIP versions and simplify data analysis.
Protocol Ver 3.0 prescribes data analysis of all patients randomized under version 1.1 to be performed once they complete the 6 months follow-up as set in protocol version 1.1 (NCT0283744). It is expected that ~40 patients will be randomized according to protocol version 1.1 prior to the enrollment of patients according to protocol version 3.0. The results will be considered as interim analysis.
The recruitment for the protocol version 1.1 is now completed. Total of 47 patients were randomized according to protocol version 1.1 and all patients completed the follow-up period for the primary endpoint.
Patients are currently being followed up for the study "extension period".
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Treatment | Active comparator | Device: PHC ONEligible patients randomized after optimization phase to PHC ON for 6 months Patients continue standard or modified anti-hypertension medical regime at discretion of the investigator |
| Control | Placebo comparator | Device: PHC OFFEligible patients randomized after optimization phase to pacemaker only (PHC OFF) for 6 months. Patients continue standard or modified anti-hypertension medical regime at discretion of the investigator |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Subject requires an implant or replacement a of dual chamber pacemaker
- Stable (at least one month) hypertension treatment with at least 1 anti-hypertensive drug, which is anticipated to be maintained for 7 months.
- Average day time (7AM-10PM) ambulatory systolic blood pressure ≥ 130 mmHg and office blood pressure ≥140 mmHg.
- Subject lives in the proximity of the study center, which permits compliance with study visits for at least 7 months.
Key exclusion criteria (17 listed)
- Known secondary cause of HTN.
- Average ambulatory or office systolic BP > 195 mmHg.
- Permanent atrial fibrillation.
- History of significant paroxysmal atrial fibrillation/flutter burden (defined as >25% of beats).
- Cardiac ejection fraction <50%.
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 |
|---|---|---|
| PHC ONEligible patients randomized after optimization phase to PHC ON for 6 months. Patients continue standard or modified anti-hypertension medical regime at discretion of the investigator | Device | Treatment |
| PHC OFFEligible patients randomized after optimization phase to PHC OFF for 6 months. Patients continue standard or modified anti-hypertension medical regime at discretion of the investigator. | Device | Control |
Primary outcome
Rate of composite of major cardiac events
Time frame: 6 months post Randomization
including heart failure, clinically significant arrhythmias eg, persistent or increased atrial fibrillation, serious ventricular arrhythmias, myocardial infarction, stroke, heart failure, renal failure and/or related safety events that result in death
Change in average 24 hour systolic ambulatory blood pressure
Time frame: Week 3 pre Randomization and 6 months post Randomization
Results and safety
The study was stopped early (reason given: Recruitment for this study was initially suspended as a larger global study was initiated in parallel. Later on, this study was terminated.). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Jun 2026.
- Derived from this study: PubMed 40801869Chovanec M, Merkely B, Sokal A, Petru J, Kralovec S, Drtina T, Mudroch M, Geller L, Osztheimer I, Morawski S, Mika YH, Fischer A, Evans SJ, Aviv R, Rosenthal N, Burkhoff D, Kuck KH, Neuzil P. Pressure-Volume Analysis Demonstrates Short- and Long-Term Hemodynamic Effects of Atrioventricular Interval Modulation Therapy in Hypertension. JACC Clin Electrophysiol. 2025 Nov;11(11):2493-2504. doi: 10.1016/j.jacep.2025.06.017. Epub 2025 Aug 13.
- Derived from this study: PubMed 34387126Kalarus Z, Merkely B, Neuzil P, Grabowski M, Mitkowski P, Marinskis G, Erglis A, Kazmierczak J, Sturmberger T, Sokal A, Pluta S, Geller L, Osztheimer I, Malek F, Kolodzinska A, Mika Y, Evans SJ, Hastings HM, Burkhoff D, Kuck KH. Pacemaker-Based Cardiac Neuromodulation Therapy in Patients With Hypertension: A Pilot Study. J Am Heart Assoc. 2021 Aug 17;10(16):e020492. doi: 10.1161/JAHA.120.020492. Epub 2021 Aug 13.
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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.
Karl-Heinz Kuck, Prof. MD principal investigator
Asklepios Klinik St. Georg
12 sites in 7 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing PHC ON and PHC OFF in people with Hypertension Resistant to Conventional Therapy and Bradycardia, run by BackBeat Medical Inc at 12 sites in 7 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 4 inclusion and 17 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 18 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 12 sites in Poland, Austria, Belgium, Czechia, Hungary and 2 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. Some participants in this study may receive a placebo. 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: Recruitment for this study was initially suspended as a larger global study was initiated in parallel. Later on, this study was terminated.). 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?
Rate of composite of major cardiac events (time frame: 6 months post Randomization). The study lists 2 primary outcomes in all. 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 NCT02837445, 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 18 Jun 2026.