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Investigational Device Exemption (IDE) Study for the Approval of Closed Loop Stimulation (CLS) and Cardiac Resyncronization Pacing Therapies (CRT) for the Treatment of Atrial Fibrillation (AF) With Ablate and Pace (AVAIL)

This study has been terminated.
(Slow enrollment.)
Sponsor:
ClinicalTrials.gov Identifier:
NCT00356057
First Posted: July 25, 2006
Last Update Posted: May 8, 2012
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by (Responsible Party):
Biotronik, Inc.
  Purpose
The purpose of this study is to demonstrate the safety and effectiveness of biventricular pacing over conventional right ventricular pacing in patients with persistent or permanent, symptomatic atrial fibrillation undergoing atrioventricular (AV) node ablation and permanent pacing therapy.

Condition Intervention
Atrial Fibrillation Congestive Heart Failure Device: Protos DR/CLS and Stratos LV CRT pacemakers

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: AVAIL CLS/CRT: AV-node Ablation With CLS and CRT Pacing Therapies for the Treatment of AF

Resource links provided by NLM:


Further study details as provided by Biotronik, Inc.:

Primary Outcome Measures:
  • Average Percentage Improvement From Baseline of the 6-minute Walk Test Distance and Minnesota Living With Heart Failure Quality of Life Score at 6-months [ Time Frame: Change from baseline to six months post-procedure ]
    Combined, average percentage improvement in 6-minute walk test distance and Minnessota Living With Heart Failure Quality of Life score from baseline to 6-month follow-up for the Protos DR/CLS (Group 1) and Stratos LV (Group 2) compared with the active control (Group 3). The 6-minute walk test is a test that measure how far a patient can walk in 6 minutes in a standardized walking course. Percent Change (0% (worst)-100% (best))

  • System-related Complication-free Rate [ Time Frame: at six months post-procedure ]

Secondary Outcome Measures:
  • Improvement in 6-minute Walk Test [ Time Frame: at six months post-procedure ]
  • Improvement in QOL Score [ Time Frame: at six months post-procedure ]
  • Cardiac Remodeling Assessments by Echocardiography [ Time Frame: at six months post-procedure ]
  • Changes in NYHA Classification [ Time Frame: at six months post-procedure ]
  • Rate of CHF Hospitalizations and Total Mortality [ Time Frame: at six months post-procedure ]

Enrollment: 153
Study Start Date: December 2004
Study Completion Date: June 2008
Primary Completion Date: May 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: 1
Biventricular pacing group with Closed Loop Stimulation rate adaptation (Protos CLS device)
Device: Protos DR/CLS and Stratos LV CRT pacemakers
Protos DR/CLS is a dual chamber pacemaker with CLS rate adaption, Stratos LV is a biventricular pacemaker with accelerometer based rate adaption
Other Name: Protos DR/CLS dual chamber pacemaker
Active Comparator: 2
Biventricular pacing group with accelerometer based rate adaption (Stratos LV device)
Device: Protos DR/CLS and Stratos LV CRT pacemakers
Protos DR/CLS is a dual chamber pacemaker with CLS rate adaption, Stratos LV is a biventricular pacemaker with accelerometer based rate adaption
Other Name: Protos DR/CLS dual chamber pacemaker
Active Comparator: 3
Right Ventricular pacing group with accelerometer based rate adaption (Stratos LV device)
Device: Protos DR/CLS and Stratos LV CRT pacemakers
Protos DR/CLS is a dual chamber pacemaker with CLS rate adaption, Stratos LV is a biventricular pacemaker with accelerometer based rate adaption
Other Name: Protos DR/CLS dual chamber pacemaker

Detailed Description:
This study is a multi-center, prospective, randomized, blinded trial. The study will consist of approximately 265 patients who require treatment of persistent or permanent, symptomatic atrial fibrillation by atrioventricular (AV) node ablation and permanent pacing therapy i.e. "Ablate and Pace" therapy. All patients enrolled into the clinical study will be randomly assigned to one of three groups using a randomization ratio of 2:2:1. Patients will be assigned to receive either biventricular (biV) pacing with CLS-based rate adaptive pacing using the legally marketed Protos DR/CLS (Group 1), or biventricular pacing with accelerometer-based rate adaptive pacing using the Stratos LV (Group 2), or right ventricular (RV) pacing with accelerometer-based rate adaptive pacing using the Stratos LV (Group 3). Patients in all three groups will be implanted with legally marketed right and left ventricular pacing leads. The patients, the core lab used to interpret the echocardiographic data and the Clinical Events Committee adjudicating crossover, patient death and congestive heart failure (CHF) hospitalizations will be blinded to the randomization assignment.
  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Meet the indications for therapy
  • Persistent, symptomatic AF with poorly controlled rapid ventricular rates or permanent, symptomatic AF with poorly controlled rapid ventricular rates.
  • Eligible for AV nodal ablation and permanent pacemaker implantation
  • NYHA Class II or III heart failure
  • Age ≥ 18 years
  • Understand the nature of the procedure
  • Ability to tolerate the surgical procedure required for implantation
  • Give informed consent
  • Able to complete all testing required by the clinical protocol
  • Available for follow-up visits on a regular basis at the investigational site

Exclusion Criteria:

  • Meet one or more of the contraindications
  • Have a life expectancy of less than six months
  • Expected to receive heart transplantation within six months
  • Enrolled in another cardiovascular or pharmacological clinical investigation
  • Patients with an ICD, or being considered for an ICD
  • Patients with previously implanted biventricular pacing systems
  • Patients with previously implanted single or dual chamber pacing system with > 50% documented ventricular pacing
  • Patients with previous AV node ablation
  • Six-minute walk test distance greater than 450 meters
  • Any condition preventing the patient from being able to perform required testing
  • Presence of another life-threatening, underlying illness separate from their cardiac disorder
  • Conditions that prohibit placement of any of the lead systems
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00356057


Locations
United States, Alabama
University of Alabama
Birmingham, Alabama, United States
United States, Louisiana
Lake Charles Memorial
Lake Charles, Louisiana, United States
United States, Massachusetts
Caritas St. Elizabeth's Medical Center
Boston, Massachusetts, United States
United States, Michigan
St. Joseph Mercy
Ann Arbor, Michigan, United States
McLaren Heart Foundation
LaPeer, Michigan, United States
United States, New York
NYU Medical Center
New York, New York, United States
United States, Ohio
Aultman Hospital
Canton, Ohio, United States
Ohio State University
Columbus, Ohio, United States
United States, South Carolina
Spartanburg Regional
Spartanburg, South Carolina, United States
United States, Texas
Lone Star Arrhythmia
Amarillo, Texas, United States
Sponsors and Collaborators
Biotronik, Inc.
Investigators
Principal Investigator: Michael Orlov, MD Caritas Elizabeth, Boston, MA
  More Information

Responsible Party: Biotronik, Inc.
ClinicalTrials.gov Identifier: NCT00356057     History of Changes
Other Study ID Numbers: G040150
First Submitted: July 21, 2006
First Posted: July 25, 2006
Results First Submitted: December 2, 2008
Results First Posted: July 8, 2011
Last Update Posted: May 8, 2012
Last Verified: May 2012

Keywords provided by Biotronik, Inc.:
atrial fibrillation
AV node ablation
pacemaker
congestive heart failure

Additional relevant MeSH terms:
Heart Failure
Atrial Fibrillation
Heart Diseases
Cardiovascular Diseases
Arrhythmias, Cardiac
Pathologic Processes