Ignite Creation Date:
2024-05-05 @ 9:37 PM
Last Modification Date:
2024-10-26 @ 10:07 AM
Study NCT ID:
NCT00926159
Status:
COMPLETED
Last Update Posted:
2011-08-04
First Post:
2009-06-22
Brief Title:
Assessment of Appropriate ICD Implantation for Primary Prevention of Sudden Cardiac Death
Sponsor:
University of Minnesota Physicians Heart at Fairview
Organization:
University of Minnesota Physicians Heart at Fairview
Study Overview
Official Title:
Assessment of Appropriate ICD Implantation for Primary Prevention of Sudden Cardiac Death
Status:
COMPLETED
Status Verified Date:
2011-01
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Prophylactic implant of an ICD implantable cardioverter defibrillator for prevention of sudden cardiac death from a life-threatening heart rhythm abnormality is a standard recommendation for patients with ejection fractions EFs of 35 or less The main purpose of the trial is to determine why patients who are receiving care at a community-based cardiology program and are known to have a low ejection fraction EF measurement of 35 or less per echocardiogram andor cardiac nuclear scan testing are not being approached for ICD implantable cardioverter defibrillator implant Additionally other secondary purposes of the trial are 1 to determine if these patients are or are not receiving recommendation from their provider to undergo prophylactic ICD implant 2 identify the reasons providers are not recommending ICD implant for their patients with reduced EFs 3 determine reasons patients recommended for ICD implant by their provider elect not to have the implant
Detailed Description:
The implantable cardioverter defibrillator ICD for patients at high risk of sudden cardiac death primary prevention has become an accepted therapy after multiple randomized trials demonstrated the benefit consistently After years of extensive evaluation of the trial data Center for Medicare and Medicaid ServicesCMS has approved the national registry that is endorsed by the American College of Cardiology and Heart Rhythm Society Thus ICD implantation for primary prevention of sudden cardiac death is one of the most intensively evaluated strictly regulated and closely monitored therapies
Since the approval of expanded coverage for primary prevention by CMS along with the requirement for registry participation in early 2005 the ICD implant volume did not show an apparent increase as expected by many Instead a flat growth of ICD sales has been observed over the last 2 years Several explanations have been offered by various sources Some attribute the slow growth to the loss of confidence among the referring physicians patients and family members as the result of the multiple industry recalls Others claim that only a small portion of the eligible candidates receive ICD therapy because of poor awareness of the ICD benefit among the referring physicians and the public the Cambridge Heart Commercial However the Medtronic campaign to promote public awareness has had little impact on the volume of ICD implants Another group of people suspect that the cardiologists have not paid enough attention to the patients candidacy for ICD therapy because they tend to focus on the patients ongoing symptoms not proactive prevention Thusan active screening program may identify a significant number of patients who will benefit from ICD therapy However there has been no comprehensive study that has evaluated the impact of active screening on the ICD implant volume the percentage of eligible ICD patients without ICDs and the reasons for not receiving ICDs
Majority of ICD implants in the United States are currently performed in the community-based cardiology programs Thus a proactive program to identify ICD candidates in a community-based program may provide a good assessment on the unrealized potential benefit of ICDs for primary prevention of sudden cardiac death
Since the approval of expanded coverage for primary prevention by CMS along with the requirement for registry participation in early 2005 the ICD implant volume did not show an apparent increase as expected by many Instead a flat growth of ICD sales has been observed over the last 2 years Several explanations have been offered by various sources Some attribute the slow growth to the loss of confidence among the referring physicians patients and family members as the result of the multiple industry recalls Others claim that only a small portion of the eligible candidates receive ICD therapy because of poor awareness of the ICD benefit among the referring physicians and the public the Cambridge Heart Commercial However the Medtronic campaign to promote public awareness has had little impact on the volume of ICD implants Another group of people suspect that the cardiologists have not paid enough attention to the patients candidacy for ICD therapy because they tend to focus on the patients ongoing symptoms not proactive prevention Thusan active screening program may identify a significant number of patients who will benefit from ICD therapy However there has been no comprehensive study that has evaluated the impact of active screening on the ICD implant volume the percentage of eligible ICD patients without ICDs and the reasons for not receiving ICDs
Majority of ICD implants in the United States are currently performed in the community-based cardiology programs Thus a proactive program to identify ICD candidates in a community-based program may provide a good assessment on the unrealized potential benefit of ICDs for primary prevention of sudden cardiac death
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None