Clinical trial NCT04632160: Extended IASD Investigation: REDUCE LAP-HF IV
Official title: A Study to Evaluate the Corvia Medical, Inc. IASD® System II to REDUCE Elevated Left Atrial Pressure in Patients With Heart Failure
Study type: INTERVENTIONAL
Overall status: WITHDRAWN
Phase: NA
Conditions: Heart Failure With Preserved Ejection Fraction
Heart Failure With Mid Range Ejection Fraction
Lead sponsor: Corvia Medical
Sponsor class: INDUSTRY
First posted: 2020-11-17
Enrollment: 0
Sex: ALL
Minimum age (years): 40
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: Multicenter, Prospective, Open Label, Single Arm, Clinical Trial.

The primary objective of this clinical trial is to further evaluate the safety and clinical efficacy of the IASD System II in symptomatic heart failure patients with an left ventricular ejection fraction (LVEF) ≥ 40%, and elevated left sided filling pressures despite standard Guideline Directed Medical Therapy (GDMT); and to compare the safety and efficacy results to those from the treatment arm of the REDUCE LAP-HF Randomized Trial II (Corvia protocol 1601).

Detailed description: Participants are screened against non-invasive eligibility criteria and scheduled for a hemodynamic evaluation. Following right heart catheterization at rest and during supine bicycle exercise, patients will undergo a brief intracardiac echocardiography (ICE) or transesophageal echocardiography (TEE) exam for septal suitability.

Eligible patients continue with, fluoroscopically and echo guided transseptal puncture and IASD System II implant procedure. If a previously unknown protocol exclusion is discovered during the index procedure, and device is not implanted, participant is followed for 30 days, and then exits the study.

Participants return for follow-up exams 30 days after the implant procedure and annually for 5 years after the implant procedure. In-person visits will take place for the first 2 years. Telephone follow-up and medical chart review will be conducted for years 3-5.

Eligibility criteria: Select Inclusion Criteria:

* Chronic symptomatic heart failure with preserved or mid-range left ventricular ejection fraction (HFpEF or HFrEF)
* Participant is willing to comply with clinical investigation procedures and agrees to return for all required follow-up visits, tests, and exams

Select Exclusion Criteria:

* Myocardial infarction and/or percutaneous cardiac intervention within past 3 months; Coronary artery bypass surgery in past 3 months, or current indication for coronary revascularization; AVR (surgical AVR or TAVR) within the past 12 months
* Advanced heart failure
* History of stroke, transient ischemic attack (TIA), deep vein thrombosis (DVT), or pulmonary emboli within the past 6 months
* Significant heart valve disease
* Chronic pulmonary disease
* Women of childbearing potential
* Severe obstructive sleep apnea not treated with CPAP or other measures

Primary outcomes:
measure: Incidence of and time-to-cardiovascular mortality or first non-fatal, ischemic stroke through 12 months
timeFrame: 12 Month
measure: Total rate (first plus recurrent) per patient year of heart failure (HF) admissions or healthcare facility visits for IV diuresis for HF up to 24 months, analyzed when the last subject completes 12 month follow-up, and time-to-first HF event
timeFrame: Up to 24 Months
measure: Change in baseline Kansas City Cardiomyopathy Questionnaire (KCCQ) total summary score at 12 months
timeFrame: 12 Month
Secondary outcomes:
measure: Cardiovascular mortality through 12 months
timeFrame: 12 Months
measure: Non-fatal, ischemic stroke through 12 months
timeFrame: 12 Months
measure: New onset or worsening of kidney dysfunction (defined as eGFR decrease of > 20 ml/min/1.73 m2) through 12 months
timeFrame: 12 Months
measure: Incidence of Major Cardiac Events i. Cardiac death ii. Myocardial infarction iii. Cardiac tamponade iv. Emergency cardiac surgery.
timeFrame: 12 Months
measure: Thrombo-embolic complications (TIA, systemic embolization) through 12 months
timeFrame: 12 Months
measure: ≥30% increase in right ventricular size/decrease in TAPSE through 12 months
timeFrame: 12 Months
measure: Newly acquired persistent or permanent AF or atrial flutter through 12 months
timeFrame: 12 Months
measure: Total rate per patient year of heart failure admissions or healthcare facility visits for IV diuresis or visits with intensification of oral diuresis for HF through 24 months, analyzed when the last subject completes 12 months follow-up
timeFrame: Up to 24 months
measure: Change in New York Heart Association (NYHA) functional Class between baseline and 12 months
timeFrame: 12 Months
measure: Change in Kansas City Cardiomyopathy Questionnaire (KCCQ) score between baseline and 12 months, categorized as ≤0, >0 - 5, >5 - 10, >10 - 15, >15 - 20, >20 - 25, >25.
timeFrame: 12 Months
Other outcomes:
Locations:
Study officials:
affiliation: Northwestern Memorial Hospital
name: Sanijv Shah, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Columbia University
name: Marty Leon, MD
role: PRINCIPAL_INVESTIGATOR
References: