Clinical trial NCT01221649: Monitoring of Fluid Status in Heart Failure Patients by Intrathoracic Impedance Measurement in Japan (J-HomeCARE II)
Official title: Monitoring of Fluid Status in Heart Failure Patients by Intrathoracic Impedance Measurement in Japan
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE4
Conditions: Heart Failure
Arrhythmias, Cardiac
Lead sponsor: Biotronik Japan, Inc.
Sponsor class: INDUSTRY
First posted: 2010-10-15
Enrollment: 198
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: SUPPORTIVE_CARE

Brief summary: The new BIOTRONIK implantable cardioverter defibrillator (ICD) family Lumax 540 is capable of measuring the intrathoracic impedance on a daily basis and transmission of impedance trend data via the Home Monitoring technology. In future, this will allow for automatic early detection of imminent decompensation at a presymptomatic stage and immediate initialization of clinical meaningful therapeutic interventions preventing heart failure (HF) related hospitalizations. The aim of this investigation is to record long-term impedance trends in heart failure patients with and without heart failure related events (hospitalizations due to acute decompensation) in order to develop algorithms for device-based early detection and warning of HF deterioration accompanied by pulmonary congestion.

Detailed description: The new BIOTRONIK ICD family Lumax 540 is capable of measuring the intrathoracic impedance on a daily basis and transmission of impedance trend data via the Home Monitoring technology. In future, this will allow for automatic early detection of imminent decompensation at a presymptomatic stage and immediate initialization of clinical meaningful therapeutic interventions preventing heart failure related hospitalizations. The aim of this investigation is to record long-term impedance trends in heart failure patients with and without HF related events (hospitalizations due to acute decompensation) in order to develop algorithms for device-based early detection and warning of HF deterioration accompanied by pulmonary congestion.

Lumax is the name of a family of implantable ICDs. The primary objective of the therapy is the prevention of sudden cardiac death. The aim is to automatically detect and terminate cardiac arrest caused by ventricular tachyarrhythmia. All major therapeutical approaches from the field of cardiology and electrophysiology are contained within the Lumax family.

Furthermore, the device is capable of treating bradycardia arrhythmias and congestive heart failure. Congestive heart failure is treated with cardiac resynchronization therapy with multisite ventricular pacing known as cardiac resynchronization therapy (CRT).

The integrated Home Monitoring component can provide information about occurring rhythm disturbances and delivered therapies close to real time as well as by intracardiac electrogram (IEGM) Online HD®. Furthermore, statistical data about the patient's condition as well as information about the integrity status of the implant itself are sent.

The implantation of an ICD is a symptomatic therapy with the following objectives:

Termination of spontaneous ventricular fibrillation (VF) through shock delivery Termination of spontaneous ventricular tachycardia (VT) by means of antitachycardia pacing (ATP); in case of ineffective ATP or hemodynamically not tolerated VT with shock delivery Cardiac resynchronization by multisite ventricular pacing (triple-chamber implant) Compensation of bradycardia through ventricular (single-chamber implant) or atrioventricular sequential pacing (dual- and triple-chamber implant)

Eligibility criteria: Inclusion Criteria:

* Patient eligible for 1-, 2- or 3-chamber ICD implantation according to current guidelines or patient already implanted with a Lumax 540 device or successor
* New York Heart Association (NYHA)-class II to IV
* Left ventricular ejection fraction (LVEF) lower or equal to 35%
* Patient accepts Home Monitoring concept and has sufficient Global System for Mobile Communications (GSM) /General Packet Radio Service (GPRS) net coverage
* Increased risk for HF-related hospitalization according to pre-defined criteria
* Patient information
* Informed consent

Exclusion Criteria:

* Age \< 18 years
* Contraindication for ICD implantation
* Post heart transplant (HTX) or actively listed for HTX
* Cardiac surgery within the previous 3 months or planned at time of inclusion
* Acute coronary syndrome within the previous 3 months
* Chronic renal dialysis
* Pregnant or breast-feeding women
* Limited contractual capability
* Participation in another study
* Anticipated non-compliance with the follow-up scheme
* Life expectancy not longer than 1.5 years due to a non-cardiac disease

Primary outcomes:
measure: HF Events
timeFrame: 21 months follow-up
Secondary outcomes:
Other outcomes:
Locations:
city: Kitakyushu
country: Japan
facility: Kokura Kinen Hospital
state: Fukuoka
city: Ise
country: Japan
facility: Yamada Red Cross Hospital
state: Mie
city: Hiroshima
country: Japan
facility: Hiroshima Shimin Hospital
city: Tokyo
country: Japan
facility: Tokyo Women's Medical University
Study officials:
affiliation: Tokyo Women's University Hospital
name: Shoda Morio, DR
role: PRINCIPAL_INVESTIGATOR
References:
citation: Maier SKG, Paule S, Jung W, Koller M, Ventura R, Quesada A, Bordachar P, Garcia-Fernandez FJ, Schumacher B, Lobitz N, Takizawa K, Ando K, Adachi K, Shoda M. Evaluation of thoracic impedance trends for implant-based remote monitoring in heart failure patients - Results from the (J-)HomeCARE-II Study. J Electrocardiol. 2019 Mar-Apr;53:100-108. doi: 10.1016/j.jelectrocard.2019.01.004. Epub 2019 Jan 25.