An interventional study of aCRT ON and aCRT OFF in Heart Failure, Left Bundle-Branch Block and Heart Failure With Reduced Ejection Fraction (HFrEF), sponsored by Medtronic Cardiac Rhythm and Heart Failure. Completed at 61 sites in 10 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-07-09.
Sponsored by Medtronic Cardiac Rhythm and Heart Failure (part of Medtronic) · Not applicable, Interventional, and Treatment
The Mid-Q Response study is a prospective, multi-center, randomized controlled, interventional, single-blinded, post-market study.
The purpose of the Mid-Q Response study is to test the hypothesis that the AdaptivCRT (aCRT) algorithm is superior to standard CRT therapy regarding patient outcomes in CRT indicated patients with moderate QRS duration, preserved atrioventricular (AV) conduction and left bundle branch block (LBBB).
The study will be executed at approximately 60 centers in Asia. The subjects will be randomly assigned in a 1:1 ratio to the aCRT ON (Adaptive Bi-V and LV) group or the aCRT OFF (Nonadaptive CRT) group.
The primary objective is to test the hypothesis that aCRT ON increases the proportion of patients that improve on the Clinical Composite Score (CCS) compared to aCRT OFF at 6 months of follow-up.
6,331 studies on the registry are indexed under Heart Failure; 1,396 are open to participants now.
This study's enrollment of 177 is above the median of 76 across 4,049 interventional studies indexed under Heart Failure.
Browse Heart Failure studies →Medtronic Cardiac Rhythm and Heart Failure is the lead sponsor of 240 studies on the registry; 4 are open to participants now.
Of its 19 completed or terminated interventional studies of FDA-regulated products, 18 (95%) have results posted.
Counted across the registry records on this site, refreshed daily.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.
The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.
The New York Heart Association’s four classes of how much heart failure limits physical activity.
Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.
The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.
Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).
Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
ECG (electrocardiogram)
A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
LVEF (left ventricular ejection fraction)
The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
NYHA class (heart failure)
The New York Heart Association’s four classes of how much heart failure limits physical activity.
Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Life expectancy
The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Childbearing potential
Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).
Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
AdaptivCRT programmed to "Adaptive Bi-V and LV The aCRT algorithm has been developed to provide RV-synchronized LV pacing when intrinsic AV conduction is normal or BiV pacing otherwise.
Device: aCRT ON
AdaptivCRT programmed to "Nonadaptive CRT" (standard CRT). Control group subjects will be optimized per physician's discretion. The method of AV and VV optimization in the control group will be collected.
Device: aCRT OFF
CRT device with AdaptivCRT enabled
CRT device with AdaptivCRT disabled
Clinical Composite Score
The Clinical Composite Score (CCS) classifies patients according their clinical status at 6 months post-randomization into categories Improved, Unchanged, and Worsened. A patient is classified Worsened in case of death, hospitalization for worsening heart failure, worsened New York Heart Association (NYHA) class (using last observation carried forward), or worsened status on the Global Assessment Score. Also, patients that exit the study or cross over because of worsening heart failure are classified Worsened. A patient is classified Improved when not Worsened and there is an improvement in NYHA class or Global Assessment Score. Patients that are not Worsened or Improved are Unchanged including all patients that miss NYHA class and Global Assessment Score data and are not classified Worsened because of death, HF hospitalization, exit or crossover.
Time frame: 6 months post-randomization
Change in New York Heart Association (NYHA) Class
NYHA class is an ordinal variable with higher classes indicating a worse degree of heart failure: Class I - No symptoms and no limitation in ordinary physical activity, e.g. shortness of breath when walking, climbing stairs etc. Class II - Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity. Class III - Marked limitation in activity due to symptoms, even during less-than-ordinary activity, e.g. walking short distances (20-100 m).Comfortable only at rest. Class IV - Severe limitations. Experiences symptoms even while at rest. Mostly bedbound patients.
Time frame: Baseline to 6 and 12 months post-randomization
Occurrence of Hospitalizations for Worsening Heart Failure
Defined as an event requiring inpatient hospitalization or invasive intervention
Time frame: 12 months post-randomization
All-cause Mortality
All-cause mortality in the aCRT ON group vs the aCRT OFF group
Time frame: 12 months post-randomization
Cardiovascular-related Mortality
Defined as all cardiac deaths as well as any cardiovascular deaths that are not directly a result of mechanical or electrical heart dysfunction.
Time frame: 12 months post-randomization
The study was multicentric and in a hospital setting, patients selected were heart failure patients in Asian countries indicated for CRT per local guidelines with moderately wide QRS (duration ≥120ms and \<150ms), preserved AV conduction (PR interval ≤ 200 ms), along with a Left bundle branch block (LBBB).
| Milestone | AdaptivCRT ON (aCRT ON, Treatment Group) | AdaptivCRT OFF (aCRT OFF, Control Group) |
|---|---|---|
| Started | 86 | 85 |
| Completed | 80 | 78 |
| Not completed | 6 | 7 |
| Withdrew: Death | 5 | 6 |
| Withdrew: Lost to follow-up | 1 | 0 |
| Withdrew: Withdrawal by subject | 0 | 1 |
The Clinical Composite Score (CCS) classifies patients according their clinical status at 6 months post-randomization into categories Improved, Unchanged, and Worsened. A patient is classified Worsened in case of death, hospitalization for worsening heart failure, worsened New York Heart Association (NYHA) class (using last observation carried forward), or worsened status on the Global Assessment Score. Also, patients that exit the study or cross over because of worsening heart failure are classified Worsened. A patient is classified Improved when not Worsened and there is an improvement in NYHA class or Global Assessment Score. Patients that are not Worsened or Improved are Unchanged including all patients that miss NYHA class and Global Assessment Score data and are not classified Worsened because of death, HF hospitalization, exit or crossover.
| Participants | AdaptivCRT ON (aCRT ON, Treatment Group) | AdaptivCRT OFF (aCRT OFF, Control Group) |
|---|---|---|
| Improved | 66 | 68 |
| Unchanged | 10 | 11 |
| Worsened | 10 | 6 |
NYHA class is an ordinal variable with higher classes indicating a worse degree of heart failure: Class I - No symptoms and no limitation in ordinary physical activity, e.g. shortness of breath when walking, climbing stairs etc. Class II - Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity. Class III - Marked limitation in activity due to symptoms, even during less-than-ordinary activity, e.g. walking short distances (20-100 m).Comfortable only at rest. Class IV - Severe limitations. Experiences symptoms even while at rest. Mostly bedbound patients.
| Participants | AdaptivCRT ON (aCRT ON, Treatment Group) | AdaptivCRT OFF (aCRT OFF, Control Group) |
|---|---|---|
| Baseline — Class I | 1 | 1 |
| Baseline — Class II | 30 | 31 |
| Baseline — Class III/IV | 55 | 53 |
| Baseline — Not reported | 0 | 0 |
| 3 Month — Class I | 24 | 22 |
| 3 Month — Class II | 49 | 53 |
| 3 Month — Class III/IV | 11 | 4 |
| 3 Month — Not reported | 2 | 6 |
| 6 Month — Class I | 23 | 27 |
| 6 Month — Class II | 50 | 52 |
| 6 Month — Class III/IV | 11 | 3 |
| 6 Month — Not reported | 2 | 3 |
| 12 Month — Class I | 35 | 32 |
| 12 Month — Class II | 41 | 42 |
| 12 Month — Class III/IV | 8 | 9 |
| 12 Month — Not reported | 2 | 2 |
Defined as an event requiring inpatient hospitalization or invasive intervention
| Participants | AdaptivCRT ON (aCRT ON, Treatment Group) | AdaptivCRT OFF (aCRT OFF, Control Group) |
|---|---|---|
| Occurrence of Hospitalizations for Worsening Heart Failure | 10 | 8 |
All-cause mortality in the aCRT ON group vs the aCRT OFF group
| Participants | AdaptivCRT ON (aCRT ON, Treatment Group) | AdaptivCRT OFF (aCRT OFF, Control Group) |
|---|---|---|
| All-cause Mortality | 5 | 6 |
Defined as all cardiac deaths as well as any cardiovascular deaths that are not directly a result of mechanical or electrical heart dysfunction.
| Participants | AdaptivCRT ON (aCRT ON, Treatment Group) | AdaptivCRT OFF (aCRT OFF, Control Group) |
|---|---|---|
| Cardiovascular-related Mortality | 3 | 3 |
Collected over The data were collected from the time the subject signed informed consent until they completed the study, 12 months post-randomization.. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| AdaptivCRT ON (aCRT ON, Treatment Group) | 5/86 (5.8%) | 27/86 (31.4%) | 8/86 (9.3%) |
| AdaptivCRT OFF (aCRT OFF, Control Group) | 6/85 (7.1%) | 24/85 (28.2%) | 14/85 (16.5%) |
| Event | AdaptivCRT ON (aCRT ON, Treatment Group) | AdaptivCRT OFF (aCRT OFF, Control Group) |
|---|---|---|
| Cardiac failureCardiac disorders | 7/86 | 7/85 |
| Lead dislodgementProduct Issues | 3/86 | 0/85 |
| Ventricular tachycardiaCardiac disorders | 1/86 | 2/85 |
| COVID-19Infections and infestations | 0/86 | 2/85 |
| PneumoniaInfections and infestations | 0/86 | 2/85 |
| Atrial fibrillationCardiac disorders | 2/86 | 1/85 |
| Mitral valve incompetenceCardiac disorders | 2/86 | 0/85 |
| AppendicitisInfections and infestations | 2/86 | 0/85 |
| AnaemiaBlood and lymphatic system disorders | 0/86 | 1/85 |
| Cardiac arrestCardiac disorders | 0/86 | 1/85 |
| Event | AdaptivCRT ON (aCRT ON, Treatment Group) | AdaptivCRT OFF (aCRT OFF, Control Group) |
|---|---|---|
| Device stimulation issueProduct Issues | 3/86 | 7/85 |
| Cardiac failureCardiac disorders | 1/86 | 3/85 |
| Atrial fibrillationCardiac disorders | 3/86 | 1/85 |
| Ventricular extrasystolesCardiac disorders | 0/86 | 1/85 |
| Ventricular tachycardiaCardiac disorders | 1/86 | 1/85 |
| Implant site painGeneral disorders | 0/86 | 1/85 |
| Medical device site painGeneral disorders | 0/86 | 1/85 |
| PneumothoraxRespiratory, thoracic and mediastinal disorders | 0/86 | 1/85 |
| Tricuspid valve incompetenceCardiac disorders | 1/86 | 0/85 |
| Implant site infectionInfections and infestations | 1/86 | 0/85 |
Number of subjects randomized following successful implant
| Age, Continuous(years) | AdaptivCRT ON (aCRT ON, Treatment Group) | AdaptivCRT OFF (aCRT OFF, Control Group) | Total |
|---|---|---|---|
| Mean | 67.0 ± 11.3 | 65.8 ± 13.7 | 66.4 ± 12.5 |
| Sex: Female, Male(Participants) | AdaptivCRT ON (aCRT ON, Treatment Group) | AdaptivCRT OFF (aCRT OFF, Control Group) | Total |
|---|---|---|---|
| Female | 29 | 25 | 54 |
| Male | 57 | 60 | 117 |
| Race and Ethnicity Not Collected(Participants) | AdaptivCRT ON (aCRT ON, Treatment Group) | AdaptivCRT OFF (aCRT OFF, Control Group) | Total |
|---|---|---|---|
| Count of participants | — | — | 0 |
| NYHA class(Participants) | AdaptivCRT ON (aCRT ON, Treatment Group) | AdaptivCRT OFF (aCRT OFF, Control Group) | Total |
|---|---|---|---|
| NYHA class I | 1 | 1 | 2 |
| NYHA class II | 30 | 31 | 61 |
| NYHA class IIII | 52 | 47 | 99 |
| NYHA class IV | 3 | 6 | 9 |
| LVEF(percent) | AdaptivCRT ON (aCRT ON, Treatment Group) | AdaptivCRT OFF (aCRT OFF, Control Group) | Total |
|---|---|---|---|
| Mean | 27.0 ± 6.6 | 25.2 ± 6.5 | 26.1 ± 6.6 |
| QRS duration(ms) | AdaptivCRT ON (aCRT ON, Treatment Group) | AdaptivCRT OFF (aCRT OFF, Control Group) | Total |
|---|---|---|---|
| Mean | 136.9 ± 9.4 | 136.1 ± 9.0 | 136.5 ± 9.2 |
| PR interval(ms) | AdaptivCRT ON (aCRT ON, Treatment Group) | AdaptivCRT OFF (aCRT OFF, Control Group) | Total |
|---|---|---|---|
| Mean | 173.2 ± 21.0 | 174.3 ± 21.4 | 173.7 ± 21.1 |
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: No
Ran from Jan 2020 to primary completion in Mar 2024, 50 months.
Results were first posted in May 2025, 1 year 2 months after primary completion.
Of 236 industry-sponsored interventional studies with no phase under Heart Failure, half reached primary completion within 34 months of starting (the median), counting those still running; a quarter within 18 and three quarters within 62. This study's 50 months is above that.
Counting every sponsor, half of 1,354 studies reached it within 31 months; a quarter within 16 and three quarters within 52.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in Apr 2025. You cannot join it, but the record below documents what was studied.
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