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Congestive Heart FailureMIRACLE EFNCT01735916

MIRACLE EF Clinical Study

A study testing CRT-P Implant and CRT-P OFF in people with Congestive Heart Failure and Left Bundle Branch Block, run by Medtronic Cardiac Rhythm and Heart Failure at 73 sites in 5 countries.

Terminated

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

Official record
Search all trials

Trial summary

This study is looking at whether the electrical treatment provided by a special type of pacemaker called a Cardiac Resynchronization Therapy (CRT) pacemaker may keep a patient's heart failure from getting worse. When the lower heart chambers (i.e. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
CRT-P Implant and CRT-P OFF
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
44 participants
Where
73 sitesin 5 countries
Study dates
Dec 2012to Mar 2014
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 has diagnosis of chronic heart failure > 90 days in duration
  • Has left ventricular ejection fraction (LVEF) between 36% and 50%, inclusive, as documented at baseline or within 30 days prior to enrollment
  • Is either: (a) NYHA Class III at enrollment or at baseline OR (b) NYHA Class II at enrollment or at baseline, with a documented hospitalization for HF in the 12 months prior to enrollment OR (c) NYHA Class II at enrollment or at baseline, without a documented hospitalization for HF in the prior 12 months, but with BNP ≥250 pg/ml or NT-proBNP ≥1000 pg/ml
  • Has documented left bundle branch block (LBBB) with QRS ≥130ms at baseline or within 30 days prior to enrollment.
  • Is in sinus rhythm at time of enrollment or at the baseline visit.
  • Has had no additions to or subtractions from non-diuretic heart failure medical therapy within 30 days prior to enrollment
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  • Is on maximum tolerated (guideline) dosages of medications in ACC/AHA guidelines for HF, Ischemic Heart Disease, Hypertension and AF as appropriate.
  • Has signed and dated the study informed consent.
  • Is able to receive a pectoral CRT-P implant.
  • Is expected to remain available for follow-up visits.
  • Is willing and able to comply with the Clinical Investigation Plan.

Who cannot join

  • Requires permanent cardiac pacing.
  • Indicated for implantable cardioverter defibrillator (ICD), such as for secondary prevention of prior sudden cardiac arrest, related to prior history of ventricular tachycardia and/or ventricular fibrillation.
  • Less than 18 years of age, or under a higher minimum age requirement as defined by local law.
  • Unstable angina or an acute MI within 40 days prior to enrollment.
  • Coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) within the 90 days prior to enrollment.
  • Chronic (permanent) atrial arrhythmias. Chronic (permanent) atrial arrhythmias are defined as cases of long-standing atrial fibrillation (e.g., greater than 1 year) in which cardioversion has not been indicated or attempted.
Show all 21Show fewer
  • Cardioversion for atrial fibrillation within 30 days prior to enrollment.
  • Treatable pericardial constraint within 30 days prior to enrollment.
  • Restrictive (infiltrative) cardiomyopathies, such as amyloidosis, sarcoidosis, or hemochromatosis.
  • Enrolled in a concurrent study, with the exception of a study-manager approved study that is strictly observational in nature and does not confound the results of this study (e.g. registries).
  • Life expectancy of less than 24 months due to non-cardiac conditions.
  • Pregnant, or of childbearing potential and not on a reliable form of birth control.
  • CRT-P, pacemaker, ICD or CRT-D device implanted previously, or currently.
  • Restrictive, hypertrophic, or reversible cardiomyopathy.
  • Mechanical right heart valve.
  • Primary valvular disease and is indicated for valve repair or replacement.
  • Heart transplant, or is currently on a heart transplant list.
  • Significant renal dysfunction, as manifested by serum creatinine level >2.5 mg/dl or ≥275 μmol/L or estimated glomerular filtration rate (GFR) ≤30 mL/min/1.73 m2, which is documented within the 30 days prior to enrollment or at baseline.
  • Significant hepatic dysfunction, as evidenced by a hepatic function panel (serum) > 3 times upper limit of normal, which is documented within the 30 days prior to enrollment or at baseline.
  • Chronic or treatment-resistant severe anemia (hemoglobin <10.0 g/dL), which is documented within the 30 days prior to enrollment or at baseline.
  • On intravenous inotropic drug therapy.

Trial locations and contacts

73 sites in 5 countries.

73 sites in 5 countries

United States69 sites
  • New Mexico Heart Institute PA

    Albuquerque, New Mexico, 87102

  • Lehigh Valley Hospital

    Allentown, Pennsylvania, 18103

  • Amarillo Heart Group, Northwest Texas Hospital

    Amarillo, Texas, 79106

  • Cardiology Center of Amarillo, Northwest Texas Hospital

    Amarillo, Texas, 79106

  • McFarland Clinic PC

    Ames, Iowa, 50010

  • Emory University Hospital Midtown

    Atlanta, Georgia, 30308

  • Bradenton Cardiology, Manatee Memorial Hospital

    Bradenton, Florida, 34205

  • Buffalo Heart Group LLP, Buffalo Heart Group LLC-Cheektowaga, Mercy Hospital of Buffalo

    Buffalo, New York, 14215

  • Lahey Hospital & Medical Center

    Burlington, Massachusetts, 01805

  • Fletcher Allen Medical Center

    Burlington, Vermont, 05405

  • University of Virginia (UVA) Medical Center

    Charlottesville, Virginia, 22908

  • Lindner Research Center, The Christ Hospital

    Cincinnati, Ohio, 45219

  • Colorado Health Medical Group, Memorial Hospital Colorado Springs

    Colorado Springs, Colorado, 80909

  • Missouri Cardiovascular Specialists, Boone Hospital Center

    Columbia, Missouri, 65201

  • Ohio State University, Ohio State University Medical Center The Richard M Ross Heart Hospital

    Columbus, Ohio, 43210

  • John Muir Medical Center, Cor Cardiovascular Specialists, John Muir Medical Center (Concord), John Muir Cardiovascular Institute, Contra Costa Cardiology

    Concord, California, 94520

  • Samaritan Health Services

    Corvallis, Oregon, 97330

  • HeartPlace Cardiology Research, Baylor Heart & Vascular Hospital

    Dallas, Texas, 75226

  • Cardiovascular Medicine PC (Davenport IA), Trinity (Rock Island), Midwest Cardiovascular Research Foundation, Trinity Bettendorf Hospital

    Davenport, Iowa, 52803

  • Duke University Medical Center (DUMC)

    Durham, North Carolina, 27705

  • Durham VA Medical Center, Duke University Medical Center

    Durham, North Carolina, 27710

  • Advocate Medical Group, Midwest Heart Specialists (Elmhurst), Elmhurst Memorial Hospital

    Elmhurst, Illinois, 60126

  • Mercy Hospital Fairfield, Mercy Hospital Anderson, The Jewish Hospital

    Fairfield, Ohio, 45014

  • Sanford Medical Center

    Fargo, North Dakota, 58102

  • Pee Dee Cardiology, McLeod Regional Medical Center

    Florence, South Carolina, 29506

  • Arrhythmia Consultants (Greenville SC), Greenville Memorial Hospital

    Greenville, South Carolina, 29605

  • Hackensack University Medical Center

    Hackensack, New Jersey, 07601

  • Hartford Hospital

    Hartford, Connecticut, 06106

  • Methodist DeBakey Cardiology Associates, The Methodist Hospital

    Houston, Texas, 77030

  • Glacier View Research Institute Cardiology, Duplicate Glacier View Research Institute Hospital

    Kalispell, Montana, 59901

  • Cardiovascular Consultants, P.C., Saint Luke's Hospital, Mid America Heart Institute (MAHI)

    Kansas City, Missouri, 64111

  • Wellmont CVA Heart Institute, Wellmont Holston Valley Medical Center

    Kingsport, Tennessee, 37660

  • Scripps Clinic Torrey Pines, Scripps Green Hospital

    La Jolla, California, 92037

  • Sparrow Clinical Research Institute, McLaren Hospital

    Lansing, Michigan, 48910

  • VA Greater Los Angeles Healthcare System

    Los Angeles, California, 90073

  • Centra Medical Group Stroobants Cardiovascular Center, Centra Lynchburg General Hospital

    Lynchburg, Virginia, 24501

  • HealthEast HeartCare Clinic at Saint John's

    Maplewood, Minnesota, 55109

  • WellStar Cobb Hospital, WellStar Kennestone Hospital

    Marietta, Georgia, 30060

  • Richmond Cardiology Associates, Bon Secours Memorial Regional Medical Center

    Mechanicsville, Virginia, 23116

  • Melbourne Internal Medicine Associates / Century Research Associates, Holmes Regional Medical Center Hospital

    Melbourne, Florida, 32901

  • Aventura Hospital and Medical Center, Hospital Corporation of America (Aventura), Hospital Corporation of America (Miami)

    Miami, Florida, 33137

  • Aurora Cardiovascular Services, Aurora Sinai Medical Center, Aurora Saint Luke's Medical Center

    Milwaukee, Wisconsin, 53215

  • Minneapolis Heart Institute Foundation

    Minneapolis, Minnesota, 55407

  • The Cardiovascular Center, University of Minnesota Medical Center Fairview

    Minneapolis, Minnesota, 55455

  • Centennial Heart Cardiovascular Consultants LLC

    Nashville, Tennessee, 37203

  • Saint Thomas Research Institute LLC, Baptist Hospital

    Nashville, Tennessee, 37205

  • Mercer Bucks Cardiology, Saint Mary Medical Center, Arrhythmia Institute Hospital

    Newtown, Pennsylvania, 18940

  • Sentara Cardiovascular Specialist, Sentara Williamsburg Regional Medical Center, Sentara Norfolk General Hospital, Sentara Virginia Beach General Hospital

    Norfolk, Virginia, 23507

  • Advocate Christ Medical Center

    Oak Lawn, Illinois, 60453

  • Integris Baptist Medical Center

    Oklahoma City, Oklahoma, 73112

  • Midwest Cardiology Associates PA, Menorah Medical Center, Centerpoint Medical Center, Overland Park Regional Medical Center Hospital

    Overland Park, Kansas, 66209

  • FirstHealth Cardiology Services, FirstHealth Moore Regional Hospital

    Pinehurst, North Carolina, 28374

  • University of Pittsburgh Medical Center UPMC Presbyterian

    Pittsburgh, Pennsylvania, 15213

  • Baylor Research Institute (Plano TX), Legacy Heart Center

    Plano, Texas, 75204

  • Oregon Health & Science University

    Portland, Oregon, 97239

  • Eisenhower Desert Cardiology Center, Eisenhower Medical Center Hospital

    Rancho Mirage, California, 92270

  • North Memorial Heart and Vascular Institute, North Memorial Medical Center

    Robbinsdale, Minnesota, 55422

  • William Beaumont Hospital

    Royal Oak, Michigan, 48073

  • CentraCare Heart & Vascular Center

    Saint Cloud, Minnesota, 56303

  • Minneapolis Heart Institute Foundation, Mercy Hospital (Coon Rapids MN), Unity Hospital, United Hospital, Abbott Northwestern Hospital

    Saint Paul, Minnesota, 55102

  • Harborview Medical Center, University of Washington (UW) Medical Center

    Seattle, Washington, 98195

  • Cardiology Consultants PA, Spartanburg Regional Hospital

    Spartanburg, South Carolina, 29303

  • Prairie Education and Research Cooperative (Springfield IL), Prairie Education Research Consultants, St. John's Hospital (Springfield IL)

    Springfield, Illinois, 62701

  • Mercy Heart and Vascular Clinic, Mercy Hospital St. Louis

    St Louis, Missouri, 63141

  • Stony Brook Islandia Clinic, Stony Brook Hauppauge, Stony Brook University Medical Center

    Stony Brook, New York, 11794

  • Scott & White Hospital

    Temple, Texas, 76508

  • Los Robles Medical Center

    Thousand Oaks, California, 91360

  • Forsyth Medical Center, Novant Clinical Research Institute

    Winston-Salem, North Carolina, 27103

  • Cardiac Diagnostic Associates, York Hospital

    York, Pennsylvania, 17405

Other trials in United States

India1 site
  • Medanta-The Medicity

    Haryāna, 122041

Other trials in India

Russia1 site
  • Tyumen Cardiology Center

    Tyumen, 625026

Other trials in Russia

Sweden1 site
  • Karolinska University Hospital

    Stockholm, 17176

Other trials in Sweden

United Kingdom1 site
  • University Hospitals of Birmingham NHS Foundation Trust - Queen Elizabeth Hospital

    Birmingham, B15 2TH

Other trials in United Kingdom

About this study

This study is looking at whether the electrical treatment provided by a special type of pacemaker called a Cardiac Resynchronization Therapy (CRT) pacemaker may keep a patient's heart failure from getting worse. When the lower heart chambers (i.e. ventricles) are electrically paced to beat together by the CRT pacemaker, blood may be pumped to the body more efficiently.

The CRT pacemaker being studied in this clinical trial is approved by the US Food and Drug Administration (FDA) for patients with moderate to severe heart failure, whose hearts pump blood inefficiently. In the MIRACLE EF study, patients who have heart failure with slightly less inefficient hearts will be observed to see if the electrical pacing treatment is better than not getting the treatment. This study is being conducted to support FDA approval of this type of pacemaker for people whose heart failure is less inefficient.

Read the detailed description

Medtronic, Inc. is sponsoring the MIRACLE EF study, a prospective, randomized, controlled, double-blinded, global multi-center, Cardiac Resynchronization Therapy (CRT) in Heart Failure (HF) clinical study. The purpose of this study is to evaluate market released CRT pacemaker (CRT-P) devices in symptomatic HF patients with less severe left ventricular systolic dysfunction, specifically patients with reduced left ventricular ejection fraction (LVEF) in the range of 36% to 50%. This study will support expansion of indications for CRT worldwide. The outcome of this study is expected to support modification of existing U.S. and Japanese labeling for Medtronic's implantable CRT-P devices and to provide further evidence to support changes to cardiology practice guidelines (ACC/AHA, ESC guidelines) regarding the use of CRT in patients with mild to moderate HF.

Following enrollment and the baseline assessment, eligible subjects will be implanted with a CRT-P system and randomized in a 2:1 fashion to either treatment (CRT-P ON) or control (CRT-P OFF) groups. Study subjects will be followed for a minimum of 24 months or until study closure, and will remain in their randomized groups until their 60 month visit or until the study is stopped, whichever comes first. The effectiveness of CRT-P in this population will be assessed using a composite endpoint of time to first event, with event defined as All-cause mortality or HF Event. To assess the safety of CRT-P in this population, the primary safety endpoint will measure freedom from system-related complications at 6 months post-implant.

Being tested
CRT-P Implant, CRT-P OFF
Medical subject headings
Heart Failure, Bundle-Branch Block, Heart Failure, Systolic

What participants receive

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

  • CRT-P ImplantDevice

    Also called Cardiac Resynchronization Therapy Pacemaker (CRT-P), Consulta CRT-P, C4TR01

    The Medtronic Consulta CRT-P (models C3TR01, C4TR011) dual chamber implantable pacemaker with cardiac resynchronization therapy (CRT-P) is a multi-programmable cardiac device that monitors and regulates the patient's heart rate by providing single or dual chamber rate-responsive bradycardia pacing, and sequential biventricular pacing.

    The device senses the electrical activity of the patient's heart using the electrodes of the implanted atrial and right ventricular leads. It then analyzes the heart rhythm based on selectable detection parameters. The device responds to bradyarrhythmias by providing bradycardia pacing therapy.

    Simultaneous or sequential biventricular pacing is used to provide patients with cardiac resynchronization therapy. The device also provides diagnostic and monitoring information that assists with system evaluation and patient care.

  • CRT-P OFFDevice

    Device programmed to minimal pacing at 40 beats/minute. Device and arrhythmia diagnostics may remain enabled.

Study groups in NCT01735916
Study groupRoleWhat they receive
CRT-P ONActive comparatorCRT-P Implant CRT-P ON
Receives: Device: CRT-P Implant
CRT-P OFFPlacebo comparatorCRT-P Implant CRT-P OFF
Receives: Device: CRT-P Implant; Device: CRT-P OFF

What is being measured

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

  1. Mortality or Heart Failure Morbidity

    Primary Efficacy Endpoint: The time to first event, with event defined as:

    • All-cause mortality, or
    • HF Event, defined as either:
    • Inpatient hospitalization for HF, or
    • Outpatient event requiring invasive clinical intervention and management for HF (i.e. IV diuretics, ultrafiltration, or equivalent) and overnight stay

    Note: No endpoints were reached, so this objective was not analyzed

    Measured: From date of randomization to date of event, assessed for a minimum of 24 months and up to 60 months

  2. System-related Complication

    Primary Safety Endpoint: Time to first system-related complication in subjects with a successful implant.

    Note: Because of the small number of subjects, number of complications was noted between arms and a time to event analysis was not performed.

    Complication is defined as: An adverse event that results in death, involves any termination of significant device function, or requires an invasive intervention

    Measured: From the date of implant to the date of 6 month follow-up visit

Secondary outcomes (5)
  1. Mortality

    Time to death between the study groups

    Note: No endpoints were reached, so this objective was not analyzed

    Measured: From date of randomization to date of death, for a minimum of 24 months and up to 60 months

  2. Mortality or Heart Failure Morbidity or Worsening Systolic Function

    Secondary Composite Efficacy Endpoint: The time to first event, with event defined as:

    • All-cause mortality
    • HF Event, defined as either:
    • Inpatient hospitalization for HF, or
    • Outpatient event requiring invasive clinical intervention and management for HF (i.e. IV diuretics, ultrafiltration, or equivalent) and overnight stay, or
    • Worsening systolic function meeting an ICD/CRT-D indication, defined as:
    • A drop in LVEF to 35% or below, with an absolute decrease of greater than or equal to 10%, after maximum tolerated doses of guideline HF medications have been established

    Note: No endpoints were reached, so this objective was not analyzed

    Measured: From date of randomization to date of event, assessed for a minimum of 24 months and up to 60 months

  3. Recurrent HF Events

    The frequency of HF events between the study groups

    Note: No endpoints were reached, so this objective was not analyzed

    • HF Event, defined as either:
    • Inpatient hospitalization for HF, or
    • Outpatient event requiring invasive clinical intervention and management for HF (i.e. IV diuretics, ultrafiltration, or equivalent) and overnight stay

    Measured: From date of randomization to date of event, assessed for a minimum of 24 months and up to 60 months

  4. Quality of Life (QoL)

    The quality of life between study groups and the change in quality of life over time between study groups using clinically accepted quality of life measures.

    Note: No subjects completed 24 months of follow-up, so this objective could not be analyzed.

    Two QOL questionnaires were used in the study.

    EQ-5D: scores typically range from 0-1, where higher scores reflect better quality of life KCCQ: scores range from 0-100, where higher scores reflect better quality of life

    Measured: Assessed from baseline visit to 24-month follow-up visit

  5. Reverse Remodeling by Echocardiography

    The change in LVEF between study groups.

    Note: No subjects completed 24 months of follow-up, so this objective could not be analyzed.

    Measured: Assessed from baseline visit to 24-month follow-up visit

Timeline

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

  1. First posted28 Nov 2012 (estimated)
  2. Study startDec 2012
  3. Primary completionMar 2014
  4. Study completionMar 2014

Why it stopped: The study was terminated early due to low enrollment.

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
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
44 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01735916
Sponsor's protocol ID
MIRACLE EF
Acronym
MIRACLE EF
Status last verified
Oct 2017
First submitted
15 Nov 2012
Last updated
6 Nov 2017
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A study testing CRT-P Implant and CRT-P OFF in people with Congestive Heart Failure and Left Bundle Branch Block, run by Medtronic Cardiac Rhythm and Heart Failure at 73 sites in 5 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 11 inclusion and 21 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 6 Nov 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 73 sites in United States, India, Russia, Sweden, United Kingdom. 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?

Yes. Results are posted in the registry (first posted 6 Oct 2014). 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?

Mortality or Heart Failure Morbidity (time frame: From date of randomization to date of event, assessed for a minimum of 24 months and up to 60 months). 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?
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 6 Nov 2017.

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