CALM Study: Cardiomems Assisted Lvad Management

Baylor Scott and White Health (BSWH)

Status: Begins enrollment this month

Conditions: Heart Failure

Treatments: Device: CardioMEMS Device

Study type: Interventional

Funder types: Other

Identifiers

NCT07096544

025-422

Details and patient eligibility

About

This prospective, open label, randomized, single-center pilot clinical trial will determine if the rate of heart failure related (HFR) hospitalizations is less in LVAD patients whose PAP is monitored with the CardioMEMS device vs the control patients receiving standard of care treatment.

Full description

This prospective, open label, randomized, single-center pilot clinical trial will determine if the rate of heart failure related (HFR) hospitalizations is less in LVAD patients whose PAP is monitored with the CardioMEMS device vs the control patients receiving standard of care treatment.

Secondary objectives:

• Number of emergency department visits
• Days alive outside the hospital
• Rate of all cause rehospitalizations
• Change in NYHA functional class
• Impact on quality of life as determined by utilizing the Kansas City Cardiomyopathy Questionnaire (KCCQ).
• Impact on functional status as determined by a six-minute walk test
• Rate of LVAD and CardioMEMS device malfunctions
• Change in baseline pulmonary pressures
• Rate and method of mortality

Enrollment: 40 estimated patients

Sex: All

Ages: 21 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 21-85
• Status post HeartMate III Left Ventricular Assist Device Implantation
• Normally functioning left ventricular assist device as determined by device parameters
• Stable and ready to be discharged home
• 18 years of age or older at the time of left ventricular device implantation
• The patient provides written informed consent before starting any component of this clinical investigation

Exclusion criteria

• Current/ongoing fevers or constitutional symptoms
• Bilirubin greater than 2.5µmol/L, shock liver, or biopsy-proven liver cirrhosis
• Requiring dialysis or declared end stage renal disease
• Inability to complete written informed consent or a quality-of-life questionnaire
• Known active malignancy
• History of recurrent (> 1) pulmonary embolism or deep vein thrombosis
• Unable to tolerate a right heart catheterization
• Major cardiovascular event (e.g., myocardial infarction, stroke) within 2 months of CardioMEMS implant
• Glomerular Filtration Rate (GFR) <25 ml/min who are non-responsive to diuretic therapy
• Patients likely to undergo heart transplantation within 6 months of Screening Visit
• Congenital heart disease or mechanical right heart valve(s)
• Known coagulation disorders
• Hypersensitivity or allergy to aspirin, and/or clopidogrel
• Pregnant or considering pregnancy
• Required RV assist device and has severe right heart failure post LVAD implantation

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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40 participants in 2 patient groups

Intervention Group: CardioMEMS Device

Experimental group

Description:

For patients randomized to the intervention group, the CardioMEMS device will be implanted during a right heart catheterization procedure. The device will be positioned in the pulmonary artery and calibrated using a Swan-Ganz catheter. After implantation, PAP measurements will be taken daily using the home monitoring system provided to the patient. These readings will be transmitted wirelessly to the clinical team, who will review the data at least once per week. Adjustments to the patient's medical therapy and LVAD speed settings will be made based on the hemodynamic data provided by the CardioMEMS device.

Treatment:

Device: CardioMEMS Device

Control Group: Standard of Care Monitoring

No Intervention group

Description:

Patients in the control group will be monitored according to standard of care, which includes periodic evaluations of echocardiographic parameters (e.g., left ventricular size and function, aortic and mitral valve function, and right ventricular function), clinical assessments (e.g., NYHA classification, medication review, and physical examination), quality of life assessments using the Kansas City Cardiomyopathy Questionnaire (KCCQ), functional status evaluations with a six-minute walk test, and monitoring for adverse events such as heart failure-related hospitalizations, reoperations, and device-related complications.