Reducing Fluid Overload in Heart Failure Patients Using a Non-invasive, Renal Independent System

Purpose

The REFORM-HF study aims to test a new technology, AQUAPASS, designed to assist patients experiencing symptoms of fluid overload due to Heart Failure. Patients will wear a lightweight suit that helps remove excess fluids through their sweat. The investigators want to see if the AQUAPASS system can remove an additional 500mL of fluids during treatment, alongside patients' regular medications like diuretics. Participants will be treated in the hospital or in the outpatient clinic.

Conditions

  • Chronic Heart Failure
  • CKD Stage 3

Eligibility

Eligible Ages
Between 21 Years and 79 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  1. Age ≥21 years and < 80 years 2. Subject, with known decompensated heart failure NYHA Class II, III (as evaluated by an independent observer who is not on the study team) presenting with fluid overload, defined by a congestion score of ≥3, who are not responding adequately or are resistant to current medical treatment as evidenced by persistent or worsening congestion, despite a daily dose of 80 mg furosemide or greater or the equivalent dose of another loop diuretic . 3. No change in diuretic dosage in the past 5 days 4. Subjects with eGFR between 15-89 mL/min/1.73m2 5. Baseline NT-proBNP ≥600 pg/mL 6. Baseline systolic blood pressure ≥100 mmHg 7. Subject is able and willing to provide written informed consent, inclusive of the release of medical information, and Health Insurance Portability and Accountability Act (HIPAA) documentation 8. Subject is not participating in any clinical investigation that may interfere with the data collection or the results of this study

Exclusion Criteria

  1. Subject considered to be in the acute worsening of heart failure: Requiring invasive or non-invasive mechanical ventilation, mechanical circulatory support or is clinically unstable requiring pressors, inotropes, deterioration triggered by arrhythmia, infection, or other medical condition unrelated to fluid overload . 2. Subject has any known or visible lower body (non-facial) skin condition (open wounds, ulcers, infections) that can potentially prevent using the wearable for the duration of the procedure 3. Known allergy to Polyester or Thermoplastic polyurethane (TPU) 4. Subject with severe peripheral arterial disease 5. Subject is pregnant or planning to become pregnant within the study period, or a lactating woman. 6. Subject with known hypothalamic disorders 7. Subject with known hypohidrosis disorders 8. Subjects with external medical technology dependency (gastric (G) tubes, ventilators, peripherally inserted central venous catheters, etc.) 9. Subject with cystic fibrosis 10. Subject with active infections 11. Inability or unwillingness to comply with the study requirements 12. Subjects with unstable electrolytes or acid-base balance (as per investigator's discretion) 13. Known Severe aortic valve or mitral valve stenosis 14. History of a heart transplant or actively listed for a heart transplant 15. Implanted left ventricular assist device (LVAD) or implant anticipated in <3 months 16. Subject with a life expectancy of less than 6 months, per investigator's discretion, due to malignant or non-cardiac comorbidities

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Non-Randomized
Intervention Model
Crossover Assignment
Intervention Model Description
A prospective, multicenter, single-arm, within-subject-controlled, pivotal trial, enrolling subjects with decompensated heart failure inadequately responding to current medical treatment, indicated by persistent or worsening congestion despite a daily dose of ≥80 mg furosemide or equivalent loop diuretics.
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
AquaPass
An AquaPass treatment session (up to 5-Hrs.) will be administered and supervised by certified study staff
  • Device: AquaPass System
    a treatment session of up to 5 hours with the AquaPass system, evaluating net fluid removal for efficacy analysis and effect on vital signs for safety analysis
No Intervention
Control
An observation visit, during which data will be collected on fluid intake, fluid output, congestion score, and body weight. These data will serve as a control for the efficacy primary endpoint comparison.

Recruiting Locations

UC San Diego Health-Sulpizio Cardiovascular Center
La Jolla, California 92037
Contact:
Ori Ben-Yehuda, MD
858-246-2413
obenyehuda@health.ucsd.edu

UC San Francisco
San Francisco, California 94143
Contact:
Liviu Klein, MD
619-972-4251
liviu.klein@ucsf.edu

University of Minnesota
Minneapolis, Minnesota 55455
Contact:
Tamas Alexy, MD
612-626-1240
alexy001@umn.edu

Northwell Health- Lenox Hill Hospital
New York, New York 10075
Contact:
Gerin Stevens, MD
516-562-1428
gstevens1@northwell.edu

Rochester Regional Health
Rochester, New York 14621
Contact:
Scott C Feitell, DO
(585) 442 5320
Scott.Feitell@rochesterregional.org

Mission Hospital
Asheville, North Carolina 28801
Contact:
Vinay Thohan, MD
828-412-9149
vinay.thohan@hcahealthcare.com

Cone Health Advanced Heart Failure Clinic at Moses Cone
Greensboro, North Carolina 27401
Contact:
Benjamin Stoner, MD
benjamin.stoner@conehealth.com

Austin Heart Hospital
Austin, Texas 78705
Contact:
Kunjan Bhatt, MD
512-206-3600
kbhatt@austinheart.com

More Details

Status
Recruiting
Sponsor
AquaPass Medical Ltd.

Study Contact

Scott C Feitell, DO
(585) 442 5320
scott.feitell@rochesterregional.org

Detailed Description

This study is being conducted to demonstrate the safety and effectiveness of the AquaPass System in reducing fluid overload in patients with decompensated heart failure and chronic kidney disease stage 2-3 who are not responding adequately or resistant to current medical treatment. The study checks if patients' fluid loss as a result of taking diuretics medications is improved when using AQUAPASS in parallel to this treatment. The evaluation of success is done by comparing participants' weight before and after the use of the AQUAPASS system, to evaluate if the system effectively removes excess fluids. Patients will also have blood and urine tests every morning to check how well their kidneys and heart are functioning. The first visit will be observation only, without using AQUAPASS. This will serve as the baseline data. The investigators will compare the data of the AQUAPASS treatments with this baseline to measure the effectiveness of the system in removing excess fluids.