Hemodynamic Monitoring to Prevent Adverse Events foLlowing cardiOgenic Shock Trial (HALO-Shock)

I

Inova Health Care Services

Status

Enrolling

Conditions

Ambulatory Hemodynamic Monitoring
Heart Failure
Cardiogenic Shock

Treatments

Device: CardioMEMS implantation with routine ambulatory pulmonary artery pressure monitoring and medication optimization

Study type

Interventional

Funder types

Other
Industry

Identifiers

NCT04419480
U19-05-3608

Details and patient eligibility

About

Pilot Prospective Randomized Unblinded Pragmatic Trial of Pulmonary Artery Hemodynamic Monitoring Following Hospitalization for Cardiogenic Shock

Enrollment

40 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Subject or legal representative has signed Informed Consent Form (ICF) and the patient has the capacity to participate in the study and complete the study questionnaires, in the estimation of the study investigator.
  • Age ≥ 18 years
  • NYHA Class III with dyspnea upon mild physical activity, regardless of left ventricular ejection fraction (LVEF).
  • Survive to discharge during a current hospital admission with cardiogenic shock (CS) as defined by clinical criteria previously used in cardiogenic shock trials: systolic blood pressure < 90 mmHg for > 30 minutes or requiring infusion of catecholamines to maintain the systolic blood pressure above 90 mmHg, with evidence of end-organ dysfunction such as pulmonary edema or impaired end-organ perfusion including altered mentation, oliguria with urine output < 30 mL/h, or serum lactate > 2 mmol/L (5). Hemodynamic criteria include cardiac index ≤ 1.8 L/min/m2 without vasoactive pharmacologic agents, or cardiac index ≤ 2.2 L/min/m2 and pulmonary artery occlusion pressure ≥ 15 mmHg with vasoactive agents.
  • Patients must have internet and phone access (to allow communication of the implanted device with the researchers).

Exclusion criteria

  • Technical obstacles which pose an inordinately high procedural risk, in the judgment of the investigator.
  • Treatment with ongoing mechanical circulatory support (MCS) such as a durable left ventricular assist device (LVAD) or recipient of a heart transplantation for the treatment of cardiogenic shock during the index hospitalization for CS.
  • If of childbearing potential with a positive pregnancy test.
  • Transition to hospice care.
  • Intolerance to or inability to adhere to antiplatelet therapy for 1 year after device implantation.
  • Presence of an active, uncontrolled infection.
  • Any condition other than heart failure that could limit survival to less than 6 months
  • Discharge to facility other than acute rehabilitation or to the ambulatory setting.
  • No access to internet or phone.

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

40 participants in 2 patient groups

CardioMEMS Implant Group
Experimental group
Description:
Following enrollment, patients randomized 1:1 to post-discharge implantation of the CardioMEMS device will receive that device ≤14 days following discharge from the index hospitalization for Cardiogenic Shock, in addition to local standard of care medical therapy.
Treatment:
Device: CardioMEMS implantation with routine ambulatory pulmonary artery pressure monitoring and medication optimization
Non-CardioMEMS Implant Group
No Intervention group
Description:
Following enrollment, patients randomized 1:1 to post-discharge standard of care will be treated according to local standard of care medical therapy following their index hospitalization for Cardiogenic Shock.

Trial contacts and locations

1

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Central trial contact

Bhruga Shah, MPH; Shashank Sinha, MD MSc

Data sourced from clinicaltrials.gov

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