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Heart FailureBRITISHNCT05568069

RCT of Implantable Defibrillators in Patients With Non Ischemic Cardiomyopathy, Scar and Severe Systolic Heart Failure

A study testing Implantable Cardioverter-Defibrillator (ICD) or Cardiac Resynchronisation Therapy Defibrillator (CRTD) in people with Heart Failure, run by University Hospital Southampton NHS Foundation Trust at 47 sites in United Kingdom.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

BRITISH is a UK multicentre trial of patients who have been diagnosed with heart failure due to Non-Ischemic Cardiomyopathy (NICM, or heart failure that is not caused by blocked heart arteries. Participants will be randomised into two groups. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Heart Failure
What is being tested?
Implantable Cardioverter-Defibrillator (ICD) or Cardiac Resynchronisation Therapy Defibrillator (CRTD)
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,504 participants
Where
47 sitesUnited Kingdom
Study dates
12 Apr 2023to 28 Feb 2032
Phase
Interventional
Are there results?
Not yet: the study is under way

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

  • A diagnosis of NICM on contrast-enhanced cardiovascular magnetic resonance imaging
  • LV scar on routine CMR (patient without scar can enter the registry)
  • New York Heart Association (NYHA) Heart Failure (HF) functional class I-III and severely impaired left ventricular function (LVEF ≤ 35% on any imaging modality) after a minimum of 3 months of treatment with optimal medical therapy (OMT) as recommended by National Institute for Health and Care Excellence (NICE)
  • Able and willing to provide informed consent

Who cannot join

  • New York Heart Association (NYHA) HF functional class IV after 3 months of optimal medical therapy (OMT)
  • Acute decompensated heart failure
  • Previous implantable device in situ (PPM, Cardiac Resynchronisation Therapy (CRT) or ICD)
  • Ischemic cardiomyopathy (ICM) is defined as segmental wall motion abnormalities or wall thinning in a particular coronary territory with subendocardial or transmural late gadolinium enhancement (LGE). Patients with an LVEF ≤35% and a small amount of ischemic LGE (i.e. an infarct out of keeping with the amount of LV dysfunction) will not be excluded (so-called dual pathology patients)
  • Known diagnosis of amyloidosis, sarcoidosis, arrhythmogenic right ventricular cardiomyopathy, or hypertrophic cardiomyopathy (diseases in which there are specific guidelines regarding defibrillator therapy)
  • Known Lamin gene mutation or a positive family history of a Lamin gene mutation
Show all 19Show fewer
  • Valve disease is considered likely to require surgery during the 3 years follow-up period
  • Complex congenital heart disease
  • Any secondary prevention ICD indication
  • Heart transplant recipient or admitted for cardiac transplantation/ left ventricular assist device
  • Clinically apparent myocardial ischemia which requires revascularization
  • Intracardiac mass which requires surgery
  • Active endocarditis
  • Active Septicaemia
  • Pregnancy
  • Life expectancy <2 years secondary to any other cause (i.e. malignancy)
  • Active treatment with chemotherapy
  • Severe renal failure (GFR <30)
  • Actively participating in another study without prior agreement between both Chief Investigators

Trial locations and contacts

47 sites in 1 country. Contact the study team or a site near you to ask about taking part.

47 sites in 1 country

United Kingdom47 sites, 45 recruiting
  • Aberdeen Royal Infirmary

    Aberdeen, Scotland, AB25 2ZN

    Dana Dawson, 03454566000

    Recruiting
  • Wansbeck General Hospital

    Ashington, Northumbria, NE63 9JJ

    Active, not recruiting
  • Essex Cardiothoracic Centre

    Basildon, Essex, SS16 5NL

    Jason Dungu, 01268 524900

    Recruiting
  • Blackpool Victoria Hospiatal

    Blackpool, Lancashire, FY3 8NR

    Alison Seed, Dr, 01253 300000

    Recruiting
  • Royal Bournemouth Hospital

    Bournemouth, Dorset, BH7 7DW

    Chris Critoph, 01202 303626

    Recruiting
  • Royal Sussex County Hospital

    Brighton, East Sussex, BN2 5BE

    Steve Coombs, 01273 696955

    Recruiting
  • Frimley Park Hospital

    Camberley, Surrey, GU16 7UJ

    Lydia Sturridge, Dr, 0300 614 5000

    Recruiting
  • Kent & Canterbury Hospital

    Canterbury, Kent, CT1 3NG

    Steven White, 01227 766877

    Recruiting
  • University Hospital of Wales

    Cardiff, Wales, CF14 4XW

    Abbas Zaidi, 029 2074 7747

    Recruiting
  • St Richards Hospital

    Chichester, West Sussex, PO19 6SE

    Nick Child, 01243 788122

    Recruiting
  • University Hospital Coventry

    Coventry, Warwickshire, CV2 2DX

    Michael Kuehl, 024 7696 4000

    Recruiting
  • Durham & Darlington NHS Foundation Trust

    Darlington, Durham, DL3 6HX

    Darragh Twomey, MD, 01325380100

    Recruiting
  • Royal Infirmary of Edinburgh

    Edinburgh, Scotland, EH16 4SA

    Marc Dweck, 0131 536 1000

    Recruiting
  • Royal Devon & Exeter Hospital

    Exeter, EX2 5DW

    Andrew Ludman, Dr, 01392 411611

    Recruiting
  • James Paget University Hospitals NHS FT

    Gorleston-on-Sea, Great Yarmouth, NR31 6LA

    Sunil Nair, Dr, 01493 452452

    Recruiting
  • University Hospital of North Tees

    Hardwick, Stockton-on-Tees, TS19 8PE

    Matthew Dewhurst, Dr, 01642 617617

    Recruiting
  • Wycombe Hospital

    High Wycombe, Buckinghamshire, HP11 2TT

    Nadine Ali, Dr, 01494 425958

    Recruiting
  • Castle Hill Hospital

    Hull, Yorkshire, HU16 5JQ

    Antony Renjith, 01482 875875

    Recruiting
  • Leeds General Infirmary

    Leeds, West Yorkshire, LS1 3EX

    John Greenwood, 01132432799

    Recruiting
  • Glenfield Hospital

    Leicester, Leicestershire, LE3 9QP

    Ian Loke, 01268 524900

    Recruiting
  • Liverpool Heart & Chest

    Liverpool, Lancashire, L14 3PE

    Archie Rao, 0151 600 1616

    Recruiting
  • St Bartholomew's Hospital

    London, London, EC1A 7BE

    Kostas Savvatis, 0207 3777 000

    Recruiting
  • Royal Free Hospital

    London, London, NW3 2QG

    Gabriella Captur, 020 7794 0500

    Recruiting
  • Guy's Hospital

    London, London, SE1 9RT

    Anoop Shetty, 020 7188 7188

    Recruiting
  • King's College Hospital

    London, London, SE5 9RS

    Daniel Sado, Dr, 020 3299 9000

    Recruiting
  • Royal Brompton Hospital

    London, London, SW3 6NP

    Sanjay Prasad, MD, 02073528121

    Recruiting
  • Hammersmith Hospital, Imperial College Healthcare NHS Trust

    London, London, Wq12 0HS

    Graham Cole, 020 3313 1000

    Recruiting
  • Maidstone Hospital, Maidstone & Tunbridge Wells NHS Trust

    Maidstone, Kent, ME16 9QQ

    Laurence Nunn, 01622 729000

    Recruiting
  • Fairfield General Hospital, Northern Care Alliance NHS FT

    Manchester, Manchester, BL9 7TD

    Yuran Zheng, 0161 624 0420

    Recruiting
  • Wythenshaw Hospital

    Manchester, Wythenshaw, M23 9LT

    Niall Campbell, 0161 998 7070

    Recruiting
  • The James Cook University Hospital

    Middlesbrough, North Yorkshire, TS4 3BW

    Michael Chapman, Dr, 01642 850850

    Recruiting
  • Newcastle Freeman Hospital

    Newcastle, Newcastle Upon Tyne, NE7 7DN

    Hanney Gonna, MD, 01912336161

    Recruiting
  • Nottingham City Hospital

    Nottingham, Nottinghamshire, NG5 1PB

    Jenny Chuen, Dr, 0115 969 1169

    Recruiting
  • The John Radcliffe Hospital

    Oxford, Oxfordshire, OX3 9DU

    Julian Ormerod, Dr, 0300 304 7777

    Recruiting
  • Derriford Hospital

    Plymouth, Devon, PL6 8DH

    Ben Sieniewicz, Dr, 01752 202082

    Recruiting
  • Portsmouth Hospitals University NHS Trust

    Portsmouth, Hampshire, PO6 3LY

    Geraint Morton, 02392286000

    Recruiting
  • Surrey & Sussex Healthcare NHS Trust

    Redhill, Surrey, RH1 5RH

    Cheuk Chan, Dr, 01737 768511

    Recruiting
  • Scarborough Hospital

    Scarborough, Nortrh Yorkshire, YO12 6QL

    Daniel Swarbrick, Dr, 01723 368111

    Recruiting
  • Northern General Hospital

    Sheffield, South Yorkshire, S5 7AU

    Dominic Rogers, Dr, 0114 243 4343

    Recruiting
  • Southampton Clinical Trials Unit

    Southampton, Hampshire, SO16 6YD

    Jacqui Nuttall, 023 8120 3866, J.Nuttall@soton.ac.uk

    Zina Eminton, 023 8026 8125, Z.B.Eminton@soton.ac.uk

    Not yet recruiting
  • University Hospital Southampton NHS Foundation Trust

    Southampton, Hampshire, SO16 6YD

    Andrew Flett, +44 (0)23 8120 8538, andrew.flett@uhs.nhs.uk

    Zoe Nicholas, +44 (0)23 8120 8538, zoe.nicholas@uhs.nhs.uk

    Recruiting
  • Morriston Hospital

    Swansea, SA6 6NL

    Geraint Jenkins, 01792 702222

    Recruiting
  • Musgrove Park Hospital

    Taunton, Somerset, TA1 5DA

    Active, not recruiting
  • St George's Hospital

    Tooting, London, SW17 0QT

    Fadi Jouhra, Dr, 02086721255

    Recruiting
  • Pinderfields Hospital

    Wakefield, West Yorkshire, WF1 4DG

    Peter Swaboda, 01924 541000

    Recruiting
  • New Cross Hospital

    Wolverhampton, West Midlands, WV10 0QP

    Anita Arya, 01902 307999

    Recruiting
  • Worcestershire Royal Hospital

    Worcester, Worcestershire, WR5 1DD

    David Wilson, Dr, 01905 763333

    Recruiting

Other trials in United Kingdom

About this study

Official title: Using Cardiovascular Magnetic Resonance Identified Scar as the Benchmark Risk Indication Tool for Implantable Cardioverter Defibrillators in Patients With Non-Ischemic Cardiomyopathy and Severe Systolic Heart Failure

BRITISH is a UK multicentre trial of patients who have been diagnosed with heart failure due to Non-Ischemic Cardiomyopathy (NICM, or heart failure that is not caused by blocked heart arteries. Participants will be randomised into two groups. Half the participants will receive an Implantable Cardioverter-Defibrillator (ICD) and the other half will not. The aim of the study will be to compare all-cause mortality (death from any cause) between these two groups at 36 months, and longer-term to 10 years. The study has the potential to change international heart failure treatment guidelines and to improve how patients with this condition are managed.

Read the detailed description

Patients with Non-Ischemic Cardiomyopathy (NICM) have a higher risk of experiencing serious abnormal heart rhythms that might be life-threatening. Current guidelines recommend fitting a device that can correct these serious heart rhythms (Implantable Cardioverter-Defibrillator (ICD)). However, research studies have shown that 90% of patients who have an ICD will never use it because they won't experience any serious heart rhythms. A recent large trial (DANISH) of over one thousand patients with severe Non-Ischemic Cardiomyopathy has called the current guidelines into question. The trial concluded that for patients who received an ICD, there was no difference in the likelihood of dying when compared to patients that didn't have an ICD fitted. As a result, many doctors are choosing not to implant an ICD in patients with this type of heart failure, as they believe there is no overall survival benefit. However, there are clues that some patients with NICM may still benefit from an ICD, even though the headline results suggest they are not necessary. It's likely that it's the patients who are at increased risk of having a serious abnormal heart rhythm that stand to benefit from ICDs. But having an ICD fitted carries with it a significant risk of problems developing e.g. bleeding, infection, lead problems, and inappropriate shocks. These risks may not outweigh the benefits and it is this question which BRITISH will address. The study will randomly assign (like the toss of a coin), half the study participants to receive an ICD and the other half to no ICD.

Both groups will be followed up to decide whether having an ICD fitted reduces the chances of dying.

Conditions
Heart Failure
Being tested
Implantable Cardioverter-Defibrillator (ICD) or Cardiac Resynchronisation Therapy Defibrillator (CRTD)
Keywords
Cardiac Magnetic Resonance Imaging (CMR), Implantable Cardioverter Device, Implantable Loop Recorder, Left ventricular ejection fraction (LVEF), Myocardial scar
Medical subject headings
Heart Failure

What participants receive

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

  • Implantable Cardioverter-Defibrillator (ICD) or Cardiac Resynchronisation Therapy Defibrillator (CRTD)Device

    An ICD is a device that is implanted under the skin under a local anesthetic. It has a battery/generator component and leads which are fixed into the heart chambers. It has the ability to detect dangerous heart rhythms if they occur, and deliver a shock to treat this to help prevent sudden cardiac death. A CRTD is a pacemaker with a defibrillator function.

Study groups in NCT05568069
Study groupRoleWhat they receive
InterventionExperimentalICD or CRTD fitted
Receives: Device: Implantable Cardioverter-Defibrillator (ICD) or Cardiac Resynchronisation Therapy Defibrillator (CRTD)
ControlNo interventionNo ICD fitted (with Implantable Loop Recorder) or Cardiac Resynchronisation Therapy Pacemaker (CRTP)
RegistryNo interventionUsual medical care

What is being measured

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

  1. Percentage of patients alive

    All-cause mortality

    Measured: 3 years

Secondary outcomes (13)
  1. Change in health-related quality of life measured using KCCQ-12

    Short questionnaire including questions related to heart failure symptoms and how they affect daily activities

    Measured: 3 years

  2. Change in health-related quality of life measured using EQ-5D-5L

    Questionnaire consisting of 5 questions to evaluate a patients quality of life

    Measured: 3 years

  3. Cardiovascular Death

    Percentage of patients that have cardiovascular death

    Measured: 3 years

  4. Sudden cardiac death

    Percentage of patients that have sudden cardiac death

    Measured: 3 years

  5. Aborted sudden cardiac death

    Percentage of patients that have aborted sudden cardiac death

    Measured: 3 years

  6. Appropriate ICD Therapy

    Percentage of patients that have appropriate ICD therapy

    Measured: 3 years

  7. Inappropriate ICD Therapy

    Percentage of patients that have inappropriate ICD therapy

    Measured: 3 years

  8. Significant ventricular arrhythmias

    Percentage of patients that have significant ventricular arrhythmias

    Measured: 3 years

  9. NYHA Status

    Percentage of patients in each category

    Measured: 3 years

  10. Heart failure hospitalisations

    Number of events

    Measured: 3 years

  11. Cardiac hospitalisations

    Number of events

    Measured: 3 years

  12. Procedures related to implanted device

    Number of events

    Measured: 3 years

  13. Percentage of patients alive

    Mortality

    Measured: At 5 and 10 years

Timeline

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

  1. First posted5 Oct 2022
  2. Study start12 Apr 2023
  3. Primary completion28 Feb 2029 (estimated)
  4. Study completion28 Feb 2032 (estimated)

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
Model description
Eligible patients will be randomised in a controlled fashion into two arms (n=1252): Arm A: ICD implantation Arm B: No ICD implantation Patients with no scar on CMR will be followed up in a registry (n=1252)
Masking
None (open label)
Enrolment
2,504 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05568069
Sponsor's protocol ID
RHMCAR0581
Acronym
BRITISH
Status last verified
Jun 2026
First submitted
27 Sep 2022
Last updated
16 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Implantable Cardioverter-Defibrillator (ICD) or Cardiac Resynchronisation Therapy Defibrillator (CRTD) in people with Heart Failure, run by University Hospital Southampton NHS Foundation Trust at 47 sites in United Kingdom.

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 19 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: looking for participants now, as of the sponsor's last update on 16 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 47 sites in 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. 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?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Abigail Jones (023 8120 5154, a.b.p.jones@soton.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of patients alive (time frame: 3 years). 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 16 Jun 2026.

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