CCM and Implementation of Guideline-Directed Medical Therapy in Patients With Heart Failure (Fix-GDMT-HF)

Last updated: April 2, 2025
Sponsor: Impulse Dynamics
Overall Status: Active - Recruiting

Phase

N/A

Condition

Heart Failure

Hyponatremia

Chest Pain

Treatment

N/A

Clinical Study ID

NCT06580392
ID_CA_PRO_2105
  • Ages > 18
  • All Genders

Study Summary

The primary objective of this study is to evaluate the impact of Cardiac Contractility Modulation (CCM) therapy on the initiation and up-titration of Guideline-Directed Medical Therapy (GDMT) in patients with heart failure (HF). This will be assessed by the change in Quad Medication Score (QMS) from baseline (pre-CCM) to 6-month following post-CCM device implant.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Adults (≥18 years) diagnosed with symptomatic heart failure

  2. Patients with Heart failure with reduced Ejection Fraction (HFrEF) where theEjection Fraction (EF) is ≤40%

  • Historical LVEF assessed up to 6 months prior to consent by any modality can beused if available
  1. Patients can have an active concomitant CRM device already - implanted provided thefollowing criteria:

  • CRM device has been implanted >1 year

  • Patients are functional class NYHA III

Exclusion

Exclusion Criteria:

  1. Patients that are unlikely to adhere to medical therapy for reasons other thanintolerance or contraindications.

  2. Patients with a QMS score >5

  3. eGFR <15

  4. Patients with a concomitant CRT device that has already been implanted and deemed tobe a responder

  5. Patients with class NYHA I indication for a concomitant CRT device

  6. Patients with significant comorbidities or conditions that may interfere with thestudy assessments

  7. Patients with contraindications to CCM therapy or unable to undergo implantation

  8. Severe stenotic valve disease

Study Design

Total Participants: 100
Study Start date:
February 01, 2025
Estimated Completion Date:
December 31, 2027

Study Description

Design Prospective, non-randomized, comparison analysis of medication use and dosing at pre/post CCM therapy. The Fix-GDMT-HF study aims to enroll 100 subjects to complete the study with 12- month of follow-up in the investigational arm. Subjects identified not eligible to participate in the investigational arm can participate in the registry arm.

Method

  • Subjects with QMS ≤ 5, eGFR ≥15, diagnosed symptomatic heart failure and LVEF ≤40% will be enrolled after review and approval by a member of the steering committee. Eligible subjects will receive CCM therapy and be enrolled in the investigational arm of the study. Medication optimization(Med op#2) will be assessed after implantation(approx. 3month post implant), followed by evaluation of QMS and other endpoints at 6 and 12 months. A target of 100 patients will be enrolled in the investigational arm.

  • After medical optimalization (Med op# 1), if the patient has QMS > 5 or identified during SC review as not eligible to participate in investigational arm can participate in the registry arm. They will continue treatment guided by local practice (including potential CCM implant) with QMS assessment (and other data collection as patients in investigational arm) at 6- and 12-month visit. The registry arm will be restricted to 100 patients.

Endpoints

Primary Endpoint:

• Change in the Quad Medication Score (QMS) from baseline (pre-CCM) to 6-month follow-up (post-CCM) of the Optimizer device implant.

Secondary Endpoints:

  • Change in loop diuretic dose from baseline to 6-month follow-up.

  • Change in eGFR from baseline to 6-month follow-up.

  • Change in SBP from baseline to 6-month follow-up.

  • Adverse events (AEs) associated with CCM therapy.

  • Change in HR among patients with concomitant cardiac rhythm management (CRM) devices.

  • Percentage of patients achieving maximal/optimal GDMT following CCM therapy.

  • GDMT adherence as measured by change in QMS score from 6 months (post-CCM) to 12 months (post-CCM).

Patients

Investigational arm - 100 subjects complete the study with 12- month of follow-up.

Registry arm - restricted to 100 subjects

Sites

10 sites in Germany & Italy.

Duration

The entire study is expected to take approximately 24 months or (until the target number of subjects has been reached), including the enrolment and follow-up periods.

Connect with a study center

  • Gemelli University Hospital

    Rome,
    Italy

    Active - Recruiting

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