RecruitingNot ApplicableNCT06543446

Comparative Effectiveness of Prophylactic ICD Versus Non-ICD Therapy

Comparative Effectiveness of Prophylactic ICD Versus Non-ICD Therapy in Contemporary Heart Failure Patients With a Low Risk for Arrhythmic Death


Sponsor

University of Rochester

Enrollment

3,290 participants

Start Date

Mar 4, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

The investigators aim to compare the risk of mortality of Non-implantable carioverter defibrillator (ICD) vs. ICD management in patients with heart failure with reduced ejection fraction (HFrEF).


Eligibility

Min Age: 18 Years

Inclusion Criteria6

  • Age ≥ 18 years (no upper limit)
  • Class I or IIa indication for a primary prevention ICD15: Ischemic or non-ischemic cardiomyopathy and NYHA Class ≥ II if most recent LVEF is ≤ 35% OR ischemic cardiomyopathy with NYHA Class I if most recent LVEF is ≤ 30%
  • Most recent LVEF (%) obtained per cardiac imaging obtained at any time prior to enrollment after being stable on optimal GDMT\*\* for at least one month
  • Stable optimal GDMT at least one calendar month prior to last cardiac imaging test, prespecified as one of the following for at least 1 calendar month prior to study randomization:
  • receiving all 4 therapy classes (beta-blockers, ARNI/ARB/ACE, MRA and SGLT2i) OR GDMT Score ≥ 6 (per Figure 7)
  • • MADIT-ICD Benefit Score \< 50 (per Figure 4)

Exclusion Criteria10

  • Existing ICD/CRT-D
  • • Planned CRT-P or CRT-D implant for any indications including Class I or IIa indication for CRT: Presence of left bundle branch block (LBBB) with QRS ≥ 120 msec OR QRS duration ≥ 150 msec regardless of QRS morphology OR decision for CRT implant by EP provider for other indications
  • Acute MI within the past 3 calendar months
  • Chronic renal failure requiring hemodialysis
  • Coronary revascularization within the past 3 calendar months
  • History of sustained VT or VF
  • Known genetic cause of cardiomyopathy
  • Life expectancy \< 1 year
  • Unable or unwilling to follow study protocol
  • Inability to consent

Interventions

PROCEDUREICD implantation

Surgical implant of ICD device


Locations(15)

MaineHealth

Portland, Maine, United States

Johns Hopkins University

Baltimore, Maryland, United States

Tufts Medical Center

Boston, Massachusetts, United States

Corewell Health

Grand Rapids, Michigan, United States

Minneapolis Heart Institute Foundation

Minneapolis, Minnesota, United States

Rutgers

New Brunswick, New Jersey, United States

The Valley Hospital

Paramus, New Jersey, United States

Northwell Health

New York, New York, United States

Nuvance Health Hudson Valley Cardiovascular Practice, PC

Poughkeepsie, New York, United States

University of Rochester

Rochester, New York, United States

Intermountain Health Care, Inc.

Salt Lake City, Utah, United States

University of Virginia Health System

Charlottesville, Virginia, United States

West Virginia University

Morgantown, West Virginia, United States

University of Calgary

Calgary, Alberta, Canada

University of Alberta

Edmonton, Alberta, Canada

View Full Details on ClinicalTrials.gov

For the most up-to-date information, visit the official listing.

Visit

NCT06543446


Related Trials