Global LEADR clinical trial meets safety and
effectiveness objectives; results presented at Heart Rhythm 2024
and simultaneously published in Heart Rhythm
DUBLIN and BOSTON, May 17, 2024
/PRNewswire/ -- Medtronic plc (NYSE: MDT), a global leader in
healthcare technology, announced that its investigational
OmniaSecure™ defibrillation lead met its primary safety and
effectiveness endpoints, exceeding prespecified performance goals,
in the global Lead Evaluation for Defibrillation and Reliability
(LEADR) Pivotal Trial. Late breaking results were presented at
Heart Rhythm 2024 and simultaneously published in the journal
Heart Rhythm. Worldwide, the OmniaSecure
defibrillation lead is investigational and not yet approved for
sale or distribution.
Implantable cardioverter defibrillators (ICDs) are the gold
standard for preventing sudden cardiac death. Yet transvenous
defibrillator leads, which are thin wires connected to the ICD and
threaded through the veins into the heart muscle, remain the
weakest point of the system,1 given the harsh
environment inside the human body where the lead must remain
attached and yet flex with millions of heart contractions over a
patient's lifetime. Existing defibrillation leads have a large
diameter (7-8 French), which can contribute to venous occlusion or
tricuspid valve complications. For patients where an
extravascular defibrillator may not be appropriate, Medtronic
engineers designed the OmniaSecure defibrillation lead based on the
Medtronic SelectSecure™ Model 3830 pacing lead, which has offered
safe and effective treatment to patients for more than 20 years. By
beginning with this highly reliable pacing lead and building a
larger lead suitable for defibrillation therapy, the Medtronic
OmniaSecure lead is the world's smallest transvenous defibrillation
lead (4.7 French, equivalent to the diameter of graphite in a
wooden pencil).
LEADR Primary Results: Effectiveness
Defibrillation testing conducted at device implantation in 119
patients was successful in 97.5% of cases. The study exceeded the
prespecified efficacy goal of 88%.
LEADR Primary Results: Safety
At six months, 97.1% (Kaplan-Meier estimate) of 657 patients with
an implant attempt were free from lead-related major complications
such as hospitalization, lead fracture, system revision, or death.
The study exceeded the prespecified safety performance goal of 90%.
There were no lead-related major complications observed between six
and 12 months (average follow up of 12.7±4.8 months).
"The positive results from the LEADR Pivotal trial are a
significant advancement for patients at risk of sudden cardiac
death who rely on ICDs to deliver life-saving therapy in the event
of a dangerous heart rhythm," said George
H. Crossley, M.D., Director of the Electrophysiology Lab and
Cardiac Research Enterprise, Vanderbilt
University Medical Center, Nashville, Tenn., and LEADR Pivotal trial
steering committee chair. "Patients with defibrillators are living
longer today, and we need to strive for reliable therapy for the
lifetime of the patient. This innovative, low-profile
defibrillation lead leverages a highly reliable pacing lead design
to help achieve this goal, and the unique catheter-based method of
implantation helps the physician place the lead in the optimal
position for the patient."
The LEADR Pivotal trial is a prospective, multicenter,
single-arm, non-randomized, global clinical study that assessed the
safety and effectiveness of the Medtronic OmniaSecure
defibrillation lead when placed at traditional locations in the
right ventricle to achieve defibrillation, sensing, pacing and
cardioversion in patients at risk of sudden cardiac death. The
study enrolled 675 patients at 45 sites in 17 countries
in North America, Europe,
Asia, and Australia.
Secondary and Ancillary Results: Reliability
The lead
demonstrated reliable performance with zero (0) study lead
fractures through an average follow up of 12.7±4.8 months.
Medtronic developed and validated an in-vitro model that accurately
predicts lead reliability out to 10 years,2 and then
applied that model within the study to predict a fracture-free
survival of 99.9% at two years for the investigational OmniaSecure
lead. The lead also demonstrated a 97.9% implant success rate, and
stable electricals (R-wave, pacing capture threshold, and pacing
impedance) through 12 months.
Nearly 12% of patients in the study received appropriate therapy
(shock, or anti-tachycardia pacing [ATP]) for dangerously fast
ventricular arrhythmias by 14.0±5.0 months. ATP terminated 74.9% of
episodes, preventing a shock in 49 patients.
Medtronic plans to present additional reliability model results
from the LEADR study in the coming months.
"For 75 years, Medtronic has innovated to bring better
life-saving technologies to the patients who need them,"
said Alan Cheng, M.D., chief medical officer of the Cardiac
Rhythm Management business, which is part of the Cardiovascular
Portfolio at Medtronic. "Given our history in working with health
care providers to design technology for patients with arrhythmias,
we applied learnings from our deep experience with both transvenous
defibrillation and pacing leads to create the novel OmniaSecure
lead, a catheter-delivered lead that can be placed in the desired
location. The LEADR study results are an encouraging step forward
in achieving the goal of an even more reliable defibrillation lead
for patients."
In addition to the LEADR results presented at Heart Rhythm 2024,
Medtronic recently initiated the LEADR LBBAP study (Lead Evaluation
for Defibrillation and Reliability in Left Bundle Branch Area
Pacing), which is assessing the safety and efficacy of the
investigational OmniaSecure defibrillation lead when placed at the
Left Bundle Branch Area in patients eligible for an ICD or Left
Bundle Branch-Optimized Cardiac Resynchronization Therapy
(LOT-CRT). Placing the defibrillation lead in the left bundle
branch area is being evaluated as an alternative to right
ventricular stimulation for sensing, pacing, cardioversion and
defibrillation. First implants were recently conducted by
Muhammad Afzal, M.D., MBBS,
principal investigator at The Ohio State Medical Center Wexner
Medical Center, and John Zakaib,
M.D., principal investigator at Minneapolis Heart Institute
Foundation.
About Medtronic
Bold thinking. Bolder actions. We are
Medtronic. Medtronic plc, headquartered
in Dublin, Ireland, is the leading global healthcare
technology company that boldly attacks the most challenging health
problems facing humanity by searching out and finding solutions.
Our Mission — to alleviate pain, restore health, and extend life —
unites a global team of 95,000+ passionate people across 150
countries. Our technologies and therapies treat 70 health
conditions and include cardiac devices, surgical robotics, insulin
pumps, surgical tools, patient monitoring systems, and more.
Powered by our diverse knowledge, insatiable curiosity, and desire
to help all those who need it, we deliver innovative technologies
that transform the lives of two people every second, every hour,
every day. Expect more from us as we empower insight-driven care,
experiences that put people first, and better outcomes for our
world. In everything we do, we are engineering the extraordinary.
For more information on Medtronic (NYSE:MDT), visit
www.Medtronic.com and follow Medtronic on LinkedIn.
Any forward-looking statements are subject to risks and
uncertainties such as those described in Medtronic's periodic
reports on file with the Securities and Exchange Commission. Actual
results may differ materially from anticipated results.
1
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Swerdlow CD, Kalahasty
G, Ellenbogen KA. Implantable Cardiac Defibrillator Lead Failure
and Management. J Am Coll Cardiol 2016;67:1358-1368
|
2
|
Wilkoff, Bruce
L., et al. In vitro modeling accurately predicts cardiac lead
fracture at 10 years. Heart Rhythm 18.9 (2021):
1605-1612.
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SOURCE Medtronic plc