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Chronic Heart FailureCOETAVNCT06950320

Clinical Outcome of Electrical Transcutaneous Auricular Vagal Stimulation in Patients With Stable Symptomatic Chronic Heart Failure

A study testing P-STIM (Biegler, Mauerbach, Austria) is a battery-operated micro-stimulation appliance in people with Chronic Heart Failure, run by Medical University of Vienna at 1 site in Austria.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study aims to investigate whether electrical vagus nerve stimulation in the auricle has an impact on the clinical presentation of heart failure. The device used, P-STIM, is already successfully applied in pain therapy and angiology (peripheral arterial disease, PAD) and will also be tested against a placebo in… Read more about this study

Who is it for?
Ages 18 to 85 years
Conditions the study is for
Chronic Heart Failure
What is being tested?
P-STIM (Biegler, Mauerbach, Austria) is a battery-operated micro-stimulation appliance
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
13 participants
Where
1 siteAustria
Study dates
1 Jan 2014to 31 Jan 2016
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 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Chronic heart failure
  • NYHA Classification II-III
  • Stable medication since at least 1 months
  • LVEF <40%
  • Patients must be able to understand study conditions
  • No exclusion criteria
Show all 13Show fewer
  • Signed informed consent 6.1.3 Exclusion criteria
  • Any electrical auricular vagal stimulation treatment within 6 months prior to base line visit
  • Participation in another clinical trial within 3 months prior to base line visit
  • Ventricular tachyarrhythmia within 1 month prior to base line visit
  • Psoriasis vulgaris
  • Hemophilia
  • Cardiac pace makers

Who cannot join

None listed.

Trial locations and contacts

1 site in 1 country.

Austria1 site
  • Medical University of Vienna

    Vienna, 1090

Other trials in Austria

About this study

Official title: Clinical Outcome of Electrical Auricular Vagal Stimulation in Patients With Stable Symptomatic Chronic Heart Failure

This study aims to investigate whether electrical vagus nerve stimulation in the auricle has an impact on the clinical presentation of heart failure. The device used, P-STIM, is already successfully applied in pain therapy and angiology (peripheral arterial disease, PAD) and will also be tested against a placebo in this study.

In preliminary studies, acupuncture was shown to improve the 6-minute walking distance in heart failure patients (Kristen et al., 2010). The investigators assume that acupuncture and P-STIM have similar effects, and this study also aims to improve the 6-minute walking distance as its primary endpoint. Additional endpoints include LVEF (left ventricular ejection fraction), NYHA classification, inflammatory markers (e.g., CRP, pro-BNP), and patients' quality of life.

Read more

Study Design:

Patients will be randomly assigned to either the placebo or the verum group. They will receive treatment for five weeks (with the device being replaced weekly) and undergo a follow-up examination after four weeks.

At the beginning and during follow-up, Left ventricular ejection fraction (measured by cardiac ultrasound), inflammatory markers in the blood, NYHA classification, and quality of life (assessed by questionnaire) will be recorded. The primary endpoint, the 6-minute walking distance, will be measured at baseline, two weeks after the start of treatment, and at the follow-up examination.

Being tested
P-STIM (Biegler, Mauerbach, Austria) is a battery-operated micro-stimulation appliance, Placebo
Keywords
auricular vagal stimulation, chronic heart failure, 6-minute walking test

What participants receive

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

  • P-STIM (Biegler, Mauerbach, Austria) is a battery-operated micro-stimulation applianceDevice

    P-STIM (Biegler, Mauerbach, Austria) is a battery-operated micro-stimulation appliance weighing 5 grams, designed as a disposable product for a single use. P-STIM is placed behind the patient's ear and connected to stimulation needles (usually 3 needles) on the auricle. For the study, only one stimulation needle was needed. P-STIMTM offers regular therapy over several days. The appliance transmits low frequency electric pulses to exposed nerve endings. The built-in microchip creates periods of stimulation and rest, each lasting approximately 3 hours. Stimulation was performed with a frequency of 1Hz for 40min followed by a break of 20 min.

  • PlaceboDevice

    The placebo device is a look-a-like, that stimulates only for 1h hour and then stops.

Study groups in NCT06950320
Study groupRoleWhat they receive
PlaceboPlacebo comparatorPatients received a placebo device which was a look-a-like, that stimulated only for 1h hour and then stopped. Patients in both groups were told that they will not feel the stimulation after a while, which might contribute to a better blinding between the groups.
Receives: Device: Placebo
treatment groupActive comparatorP-STIM (Biegler, Mauerbach, Austria) is a battery-operated micro-stimulation appliance weighing 5 grams, designed as a disposable product for a single use. P-STIM is placed behind the patient's ear and connected to stimulation needles (usually 3 needles) on the auricle. For the study, only one stimulation needle was needed. P-STIM offers regular therapy over several days. The appliance transmits low frequency electric pulses to exposed nerve endings. The built-in microchip creates periods of stimulation and rest, each lasting approximately 3 hours. Stimulation was performed with a frequency of 1Hz for 40min followed by a break of 20 min. After some time, the patient may feel as if the intensity of stimulation is decreasing. A decrease in the perceived intensity of stimulation may however be subjective and have no bearing on the effectiveness of the therapy.
Receives: Device: P-STIM (Biegler, Mauerbach, Austria) is a battery-operated micro-stimulation appliance

What is being measured

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

  1. 6-minutes walking distance test

    patients were asked to walk at comfortable speed for 6min in one of our hospital corridors (30m long), distance was assessed by a physician

    Measured: before treatment randomization, study day 21, 35 days after randomization

Secondary outcomes (10)
  1. SF 36, quality of life

    The 36-Item Short Form Health Survey (SF-36) is a set of generic, coherent, and easily administered quality-of-life measures.

    The possible score ranges from 0 to 100 points whereby 0 points represent the greatest possible limitation of health, while 100 points represent the absence of health restrictions.

    Measured: before treatment randomization, 35 days after treatment randomization

  2. adverse events

    An AE/ADE is any adverse change from the subject's baseline condition, i.e. any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease which is considered to be clinically relevant be the physician that occurs during the course of the, whether or not considered related to the medical device.

    Adverse event /ADE include:

    • Exacerbation of a pre-existing disease.
    • Increase in frequency or intensity of a pre-existing episodic disease or medical condition.
    • Disease or medical condition detected or diagnosed after treatment with the medical device even though it may have been present prior to the start of the clinical investigation.
    • Continuous persistent disease or symptoms present at baseline that worsen following the start of the clinical investigation.
    • Lack of efficacy in the acute treatment of a life-threatening disease.
    • Events considered by the investigator to be related to clinical investigation-mandated procedures.

    Measured: before treatment randomization, study day 21, 35 days after randomization

  3. blood concentration of TNF alpha

    blood samples will be collected before treatment randomization and at end of study, measurement will be in picogram/millilitre

    Measured: before treatment randomization, 35 days after treatment randomization

  4. blood concentration of Interleucin 6 (IL6)

    blood samples will be collected, measurement will be in nanogram/litre

    Measured: before treatment randomization, 35 days after treatment randomization

  5. blood concentration of C-reactive protein (CRP)

    blood samples will be collected, measurement will be in milligram/decilitre

    Measured: before treatment randomization, 35 days after treatment randomization

  6. blood concentration of NT-proBNP

    blood samples will be collected, measurement will be in picogram/mililitre

    Measured: before treatment randomization, 35 days after treatment randomization

  7. left ventricular ejection fraction

    left ventricular ejection fraction will be assessed by an experienced cardiologist via echocardiography and will be expressed as percentage of a normal value

    Measured: before treatment randomization, 35 days after treatment randomization

  8. NYHA

    New York Heart Association Classification, will be expressed in 4 stages Class I (Mild) No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, or dyspnea (shortness of breath). Class II (Mild) Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in fatigue, palpitation, or dyspnea. Class III (Moderate) Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity causes fatigue, palpitation, or dyspnea. Class IV (Severe) Unable to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency at rest. If any physical activity is undertaken, discomfort is increased.

    Measured: before treatment randomization, 35 days after treatment randomization

  9. blood pressure

    blood pressure will be assessed non-invasively by a cardiologist and will be expressed as millimeter mercury

    Measured: before treatment randomization, 35 days after treatment randomization

  10. ST-elevation

    will be detected via electrocardiogram which was performed by a cardiologist

    Measured: before treatment randomization, 35 days after treatment randomization

Timeline

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

  1. First posted30 Apr 2025
  2. Study start1 Jan 2014
  3. Primary completion31 Jan 2016
  4. Study completion31 Jan 2016

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
Double blind
Who is masked
Participant, Care provider
Enrolment
13 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06950320
Sponsor's protocol ID
EK-No: 2033/2012
Other IDs
2033/2012
Acronym
COETAV
Status last verified
Apr 2025
First submitted
27 Feb 2025
Last updated
30 Apr 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Zijlstra FJ, van den Berg-de Lange I, Huygen FJ, Klein J. Anti-inflammatory actions of acupuncture. Mediators Inflamm. 2003 Apr;12(2):59-69. doi: 10.1080/0962935031000114943.

    PubMed 12775355
  • Schneider A, Streitberger K, Joos S. Acupuncture treatment in gastrointestinal diseases: a systematic review. World J Gastroenterol. 2007 Jul 7;13(25):3417-24. doi: 10.3748/wjg.v13.i25.3417.

    PubMed 17659687
  • Schwartz PJ, De Ferrari GM, Sanzo A, Landolina M, Rordorf R, Raineri C, Campana C, Revera M, Ajmone-Marsan N, Tavazzi L, Odero A. Long term vagal stimulation in patients with advanced heart failure: first experience in man. Eur J Heart Fail. 2008 Sep;10(9):884-91. doi: 10.1016/j.ejheart.2008.07.016. Epub 2008 Aug 28.

    PubMed 18760668
  • Kristen AV, Schuhmacher B, Strych K, Lossnitzer D, Friederich HC, Hilbel T, Haass M, Katus HA, Schneider A, Streitberger KM, Backs J. Acupuncture improves exercise tolerance of patients with heart failure: a placebo-controlled pilot study. Heart. 2010 Sep;96(17):1396-400. doi: 10.1136/hrt.2009.187930. Epub 2010 Jun 15.

    PubMed 20554511
  • Coats AJ. The "muscle hypothesis" of chronic heart failure. J Mol Cell Cardiol. 1996 Nov;28(11):2255-62. doi: 10.1006/jmcc.1996.0218.

    PubMed 8938579
  • Anand IS, Latini R, Florea VG, Kuskowski MA, Rector T, Masson S, Signorini S, Mocarelli P, Hester A, Glazer R, Cohn JN; Val-HeFT Investigators. C-reactive protein in heart failure: prognostic value and the effect of valsartan. Circulation. 2005 Sep 6;112(10):1428-34. doi: 10.1161/CIRCULATIONAHA.104.508465. Epub 2005 Aug 29.

    PubMed 16129801
  • Lainchbury JG, Troughton RW, Strangman KM, Frampton CM, Pilbrow A, Yandle TG, Hamid AK, Nicholls MG, Richards AM. N-terminal pro-B-type natriuretic peptide-guided treatment for chronic heart failure: results from the BATTLESCARRED (NT-proBNP-Assisted Treatment To Lessen Serial Cardiac Readmissions and Death) trial. J Am Coll Cardiol. 2009 Dec 29;55(1):53-60. doi: 10.1016/j.jacc.2009.02.095.

    PubMed 20117364
  • Mann DL. Inflammatory mediators and the failing heart: past, present, and the foreseeable future. Circ Res. 2002 Nov 29;91(11):988-98. doi: 10.1161/01.res.0000043825.01705.1b.

    PubMed 12456484
  • Lecour S, James RW. When are pro-inflammatory cytokines SAFE in heart failure? Eur Heart J. 2011 Mar;32(6):680-5. doi: 10.1093/eurheartj/ehq484. Epub 2011 Feb 7.

    PubMed 21303780
  • Gullestad L, Ueland T, Vinge LE, Finsen A, Yndestad A, Aukrust P. Inflammatory cytokines in heart failure: mediators and markers. Cardiology. 2012;122(1):23-35. doi: 10.1159/000338166. Epub 2012 Jun 12.

    PubMed 22699305
  • Pomerantz BJ, Reznikov LL, Harken AH, Dinarello CA. Inhibition of caspase 1 reduces human myocardial ischemic dysfunction via inhibition of IL-18 and IL-1beta. Proc Natl Acad Sci U S A. 2001 Feb 27;98(5):2871-6. doi: 10.1073/pnas.041611398.

    PubMed 11226333
  • Kapadia SR. Cytokines and heart failure. Cardiol Rev. 1999 Jul-Aug;7(4):196-206. doi: 10.1097/00045415-199907000-00011.

    PubMed 10423671
  • Damas JK, Gullestad L, Ueland T, Solum NO, Simonsen S, Froland SS, Aukrust P. CXC-chemokines, a new group of cytokines in congestive heart failure--possible role of platelets and monocytes. Cardiovasc Res. 2000 Jan 14;45(2):428-36. doi: 10.1016/s0008-6363(99)00262-x.

    PubMed 10728363
  • Aukrust P, Ueland T, Muller F, Andreassen AK, Nordoy I, Aas H, Kjekshus J, Simonsen S, Froland SS, Gullestad L. Elevated circulating levels of C-C chemokines in patients with congestive heart failure. Circulation. 1998 Mar 31;97(12):1136-43. doi: 10.1161/01.cir.97.12.1136.

    PubMed 9537339
  • Torre-Amione G, Kapadia S, Benedict C, Oral H, Young JB, Mann DL. Proinflammatory cytokine levels in patients with depressed left ventricular ejection fraction: a report from the Studies of Left Ventricular Dysfunction (SOLVD). J Am Coll Cardiol. 1996 Apr;27(5):1201-6. doi: 10.1016/0735-1097(95)00589-7.

    PubMed 8609343

Questions about this trial

What is this clinical trial studying?

A study testing P-STIM (Biegler, Mauerbach, Austria) is a battery-operated micro-stimulation appliance in people with Chronic Heart Failure, run by Medical University of Vienna at 1 site in Austria.

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 13 inclusion and 0 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: finished, as of the sponsor's last update on 30 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Austria. 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 is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

6-minutes walking distance test (time frame: before treatment randomization, study day 21, 35 days after randomization). 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 NCT06950320, which also lists 18 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 30 Apr 2025.

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