NCT00395447

REPLACE: Implantable Cardiac Pulse Generator Replacement Registry

Prospective Assessment of the Complication Rate After Device Replacement Due to ERI, Advisory or Upgrade

• Status: Completed
• Phase: —
• Study type: Observational
• Enrollment: 1,744 (actual)
• Sponsor: Biotronik, Inc. · Industry
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

The objective of this study is to prospectively estimate the all-cause complication rates at 6-months for patients undergoing generator replacement due to elective replacement indicator (ERI), advisory, or upgrade without a planned system modification or with a planned system modification. Secondarily, this study aims to compare the influence of baseline variables contributing to the all-cause complication rates for subjects undergoing generator replacement.

Detailed description

Device replacements occur for many reasons, including elective replacement indication (ERI), manufacturer advisory, and upgrade. Recently pacemaker and implantable cardioverter (ICD) advisories have created a dilemma for both physicians and patients. While the risk of device malfunction is low, replacement rates following an advisory are usually high and complication rates following device replacement are not widely known. One retrospective analysis of ICD advisories in Canada reported an 18.3% replacement rate, and subsequent 8.1% complication rate directly related to the replacement. Device replacements also occur in order to upgrade an existing system. Clinical studies have shown that cardiac resynchronization therapy (CRT) significantly reduces all-cause mortality and hospitalization in patients with advanced heart failure (HF). As a result of expanding indications for this therapy, many standard ICD patients are being upgraded to CRT-D systems. Complication rates related to upgrades of these systems are also not widely known. To our knowledge, the risk of complications following a device replacement has not been studied prospectively in any patient population. Limited data are available to guide physicians when weighing the risks and benefits of device replacement. This is a prospective multi-center study. 1750 patients at 100 clinical sites will be enrolled prior to generator replacement. Patients will be implanted and followed for 6 months to assess any complications related to the replacement procedure. Patients with any legally marketed device for explant can be enrolled. The replacement device can be from any manufacturer.

Conditions

• Device Replacement
• Elective Replacement (ERI)
• Device Advisory
• Device Upgrade
• Postoperative Complications

Interventions

Type	Name	Description
PROCEDURE	Straight-forward Device Replacement
PROCEDURE	Device Replacement with Upgrade

Timeline

• Start date: 2007-07-01
• Primary completion: 2009-06-01
• Completion: 2009-06-01
• First posted: 2006-11-03
• Last updated: 2015-04-14
• Results posted: 2010-11-30

Locations

71 sites across 1 country: United States