ClinicalTrials.gg
RecruitingNCT05568069BRITISHUpdated Jun 16, 2026

RCT of Implantable Defibrillators in Patients With Non Ischemic Cardiomyopathy, Scar and Severe Systolic Heart Failure

An interventional study of Implantable Cardioverter-Defibrillator (ICD) or Cardiac Resynchronisation Therapy Defibrillator (CRTD) in Heart Failure, sponsored by University Hospital Southampton NHS Foundation Trust. Recruiting at 47 sites in United Kingdom. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-06-16.

Sponsored by University Hospital Southampton NHS Foundation Trust · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Apr 2023; still recruiting 3 years 6 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
2,504
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

BRITISH is a UK multicentre trial of patients who have been diagnosed with heart failure due to Non-Ischemic Cardiomyopathy (NICM, or heart failure that is not caused by blocked heart arteries. Participants will be randomised into two groups. Half the participants will receive an Implantable Cardioverter-Defibrillator (ICD) and the other half will not. The aim of the study will be to compare all-cause mortality (death from any cause) between these two groups at 36 months, and longer-term to 10 years. The study has the potential to change international heart failure treatment guidelines and to improve how patients with this condition are managed.

Read the detailed description

Patients with Non-Ischemic Cardiomyopathy (NICM) have a higher risk of experiencing serious abnormal heart rhythms that might be life-threatening. Current guidelines recommend fitting a device that can correct these serious heart rhythms (Implantable Cardioverter-Defibrillator (ICD)). However, research studies have shown that 90% of patients who have an ICD will never use it because they won't experience any serious heart rhythms. A recent large trial (DANISH) of over one thousand patients with severe Non-Ischemic Cardiomyopathy has called the current guidelines into question. The trial concluded that for patients who received an ICD, there was no difference in the likelihood of dying when compared to patients that didn't have an ICD fitted. As a result, many doctors are choosing not to implant an ICD in patients with this type of heart failure, as they believe there is no overall survival benefit. However, there are clues that some patients with NICM may still benefit from an ICD, even though the headline results suggest they are not necessary. It's likely that it's the patients who are at increased risk of having a serious abnormal heart rhythm that stand to benefit from ICDs. But having an ICD fitted carries with it a significant risk of problems developing e.g. bleeding, infection, lead problems, and inappropriate shocks. These risks may not outweigh the benefits and it is this question which BRITISH will address. The study will randomly assign (like the toss of a coin), half the study participants to receive an ICD and the other half to no ICD.

Both groups will be followed up to decide whether having an ICD fitted reduces the chances of dying.

02

Conditions studied

  • Heart Failure

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Keywords

  • Cardiac Magnetic Resonance Imaging (CMR)
  • Implantable Cardioverter Device
  • Implantable Loop Recorder
  • Left ventricular ejection fraction (LVEF)
  • Myocardial scar
03

In context

Heart Failure

6,331 studies on the registry are indexed under Heart Failure; 1,396 are open to participants now.

This study's planned enrollment of 2,504 is above the median of 76 across 4,049 interventional studies indexed under Heart Failure.

Browse Heart Failure studies →

Lead sponsor

University Hospital Southampton NHS Foundation Trust is the lead sponsor of 150 studies on the registry; 35 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

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.

Inclusion criteria

  1. A diagnosis of NICM on contrast-enhanced cardiovascular magnetic resonance imaging
  2. LV scar on routine CMR (patient without scar can enter the registry)
  3. (NYHA) Heart Failure (HF) functional class I-III and severely impaired left ventricular function ( ≤ 35% on any imaging modality) after a minimum of 3 months of treatment with optimal medical therapy (OMT) as recommended by National Institute for Health and Care Excellence (NICE)
  4. Able and willing to provide

Exclusion criteria

Exclusion Criteria:

  1. (NYHA) HF functional class IV after 3 months of optimal medical therapy (OMT)
  2. Acute decompensated heart failure
  3. Previous implantable device in situ (PPM, Cardiac Resynchronisation Therapy (CRT) or ICD)
  4. Ischemic cardiomyopathy (ICM) is defined as segmental wall motion abnormalities or wall thinning in a particular coronary territory with subendocardial or transmural late gadolinium enhancement (LGE). Patients with an ≤35% and a small amount of ischemic LGE (i.e. an infarct out of keeping with the amount of LV dysfunction) will not be excluded (so-called dual pathology patients)
  5. Known diagnosis of amyloidosis, sarcoidosis, arrhythmogenic right ventricular cardiomyopathy, or hypertrophic cardiomyopathy (diseases in which there are specific guidelines regarding defibrillator therapy)
  6. Known Lamin gene mutation or a positive family history of a Lamin gene mutation
  7. Valve disease is considered likely to require surgery during the 3 years follow-up period
  8. Complex congenital heart disease
  9. Any secondary prevention ICD indication
  10. Heart transplant recipient or admitted for cardiac transplantation/ left ventricular assist device
  11. Clinically apparent myocardial ischemia which requires revascularization
  12. Intracardiac mass which requires surgery
  13. Active endocarditis
  14. Active Septicaemia
  15. Pregnancy
  16. \<2 years secondary to any other cause (i.e. )
  17. Active treatment with chemotherapy
  18. Severe renal failure ( \<30)
  19. Actively participating in another study without prior agreement between both Chief Investigators
Terms in these criteria, in plain language(6)

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.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

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.

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.

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.

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.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
2,504 participants (estimated)

Study arms

  • Experimental
    Intervention

    ICD or CRTD fitted

    Device: Implantable Cardioverter-Defibrillator (ICD) or Cardiac Resynchronisation Therapy Defibrillator (CRTD)

  • No intervention
    Control

    No ICD fitted (with Implantable Loop Recorder) or Cardiac Resynchronisation Therapy Pacemaker (CRTP)

  • No intervention
    Registry

    Usual medical care

Interventions

  • DeviceImplantable Cardioverter-Defibrillator (ICD) or Cardiac Resynchronisation Therapy Defibrillator (CRTD)

    An ICD is a device that is implanted under the skin under a local anesthetic. It has a battery/generator component and leads which are fixed into the heart chambers. It has the ability to detect dangerous heart rhythms if they occur, and deliver a shock to treat this to help prevent sudden cardiac death. A CRTD is a pacemaker with a defibrillator function.

06

What researchers measure

Primary outcomes

  1. Percentage of patients alive

    All-cause mortality

    Time frame: 3 years

Secondary outcomes

  1. Change in health-related quality of life measured using KCCQ-12

    Short questionnaire including questions related to heart failure symptoms and how they affect daily activities

    Time frame: 3 years

  2. Change in health-related quality of life measured using EQ-5D-5L

    Questionnaire consisting of 5 questions to evaluate a patients quality of life

    Time frame: 3 years

  3. Cardiovascular Death

    Percentage of patients that have cardiovascular death

    Time frame: 3 years

  4. Sudden cardiac death

    Percentage of patients that have sudden cardiac death

    Time frame: 3 years

  5. Aborted sudden cardiac death

    Percentage of patients that have aborted sudden cardiac death

    Time frame: 3 years

  6. Appropriate ICD Therapy

    Percentage of patients that have appropriate ICD therapy

    Time frame: 3 years

  7. Inappropriate ICD Therapy

    Percentage of patients that have inappropriate ICD therapy

    Time frame: 3 years

  8. Significant ventricular arrhythmias

    Percentage of patients that have significant ventricular arrhythmias

    Time frame: 3 years

  9. NYHA Status

    Percentage of patients in each category

    Time frame: 3 years

  10. Heart failure hospitalisations

    Number of events

    Time frame: 3 years

  11. Cardiac hospitalisations

    Number of events

    Time frame: 3 years

  12. Procedures related to implanted device

    Number of events

    Time frame: 3 years

  13. Percentage of patients alive

    Mortality

    Time frame: At 5 and 10 years

07

Study locations

44 of 47 sites recruiting
  • Wycombe Hospital
    High Wycombe, Buckinghamshire HP11 2TT, United Kingdom
    Recruiting
    • Nadine Ali, Dr · Contact01494 425958
  • Derriford Hospital
    Plymouth, Devon PL6 8DH, United Kingdom
    Recruiting
    • Ben Sieniewicz, Dr · Contact01752 202082
  • Royal Bournemouth Hospital
    Bournemouth, Dorset BH7 7DW, United Kingdom
    Recruiting
    • Chris Critoph · Contact01202 303626
  • Durham & Darlington NHS Foundation Trust
    Darlington, Durham DL3 6HX, United Kingdom
    Recruiting
    • Darragh Twomey, MD · Contact01325380100
  • Royal Sussex County Hospital
    Brighton, East Sussex BN2 5BE, United Kingdom
    Recruiting
    • Steve Coombs · Contact01273 696955
  • Essex Cardiothoracic Centre
    Basildon, Essex SS16 5NL, United Kingdom
    Recruiting
    • Jason Dungu · Contact01268 524900
  • James Paget University Hospitals NHS FT
    Gorleston-on-Sea, Great Yarmouth NR31 6LA, United Kingdom
    Recruiting
    • Sunil Nair, Dr · Contact01493 452452
  • Portsmouth Hospitals University NHS Trust
    Portsmouth, Hampshire PO6 3LY, United Kingdom
    Recruiting
    • Geraint Morton · Contact02392286000
  • Southampton Clinical Trials Unit
    Southampton, Hampshire SO16 6YD, United Kingdom
    Not yet recruiting
    • Jacqui Nuttall · ContactJ.Nuttall@soton.ac.uk · 023 8120 3866
    • Zina Eminton · ContactZ.B.Eminton@soton.ac.uk · 023 8026 8125
    • Andrew Flett, BSc, MBBS, FRCP, MD(Res) · Principal investigator
    • Nick Curzen, BM(Hons) PhD FRCP · Principal investigator
  • University Hospital Southampton NHS Foundation Trust
    Southampton, Hampshire SO16 6YD, United Kingdom
    Recruiting
  • Kent & Canterbury Hospital
    Canterbury, Kent CT1 3NG, United Kingdom
    Recruiting
    • Steven White · Contact01227 766877
  • Maidstone Hospital, Maidstone & Tunbridge Wells NHS Trust
    Maidstone, Kent ME16 9QQ, United Kingdom
    Recruiting
    • Laurence Nunn · Contact01622 729000
  • Blackpool Victoria Hospiatal
    Blackpool, Lancashire FY3 8NR, United Kingdom
    Recruiting
    • Alison Seed, Dr · Contact01253 300000
  • Liverpool Heart & Chest
    Liverpool, Lancashire L14 3PE, United Kingdom
    Recruiting
    • Archie Rao · Contact0151 600 1616
  • Glenfield Hospital
    Leicester, Leicestershire LE3 9QP, United Kingdom
    Recruiting
    • Ian Loke · Contact01268 524900
  • St Bartholomew's Hospital
    London, London EC1A 7BE, United Kingdom
    Recruiting
    • Kostas Savvatis · Contact0207 3777 000
  • Royal Free Hospital
    London, London NW3 2QG, United Kingdom
    Recruiting
    • Gabriella Captur · Contact020 7794 0500
  • Guy's Hospital
    London, London SE1 9RT, United Kingdom
    Recruiting
    • Anoop Shetty · Contact020 7188 7188
  • King's College Hospital
    London, London SE5 9RS, United Kingdom
    Recruiting
    • Daniel Sado, Dr · Contact020 3299 9000
  • Royal Brompton Hospital
    London, London SW3 6NP, United Kingdom
    Recruiting
    • Sanjay Prasad, MD · Contact02073528121
  • Hammersmith Hospital, Imperial College Healthcare NHS Trust
    London, London Wq12 0HS, United Kingdom
    Recruiting
    • Graham Cole · Contact020 3313 1000
  • St George's Hospital
    Tooting, London SW17 0QT, United Kingdom
    Recruiting
    • Fadi Jouhra, Dr · Contact02086721255
  • Fairfield General Hospital, Northern Care Alliance NHS FT
    Manchester, Manchester BL9 7TD, United Kingdom
    Recruiting
    • Yuran Zheng · Contact0161 624 0420
  • Newcastle Freeman Hospital
    Newcastle, Newcastle Upon Tyne NE7 7DN, United Kingdom
    Recruiting
    • Hanney Gonna, MD · Contact01912336161
  • The James Cook University Hospital
    Middlesbrough, North Yorkshire TS4 3BW, United Kingdom
    Recruiting
    • Michael Chapman, Dr · Contact01642 850850
  • Wansbeck General Hospital
    Ashington, Northumbria NE63 9JJ, United Kingdom
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Scarborough Hospital
    Scarborough, Nortrh Yorkshire YO12 6QL, United Kingdom
    Recruiting
    • Daniel Swarbrick, Dr · Contact01723 368111
  • Nottingham City Hospital
    Nottingham, Nottinghamshire NG5 1PB, United Kingdom
    Recruiting
    • Jenny Chuen, Dr · Contact0115 969 1169
  • The John Radcliffe Hospital
    Oxford, Oxfordshire OX3 9DU, United Kingdom
    Recruiting
    • Julian Ormerod, Dr · Contact0300 304 7777
  • Aberdeen Royal Infirmary
    Aberdeen, Scotland AB25 2ZN, United Kingdom
    Recruiting
    • Dana Dawson · Contact03454566000
  • Royal Infirmary of Edinburgh
    Edinburgh, Scotland EH16 4SA, United Kingdom
    Recruiting
    • Marc Dweck · Contact0131 536 1000
  • Musgrove Park Hospital
    Taunton, Somerset TA1 5DA, United Kingdom
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Northern General Hospital
    Sheffield, South Yorkshire S5 7AU, United Kingdom
    Recruiting
    • Dominic Rogers, Dr · Contact0114 243 4343
  • University Hospital of North Tees
    Hardwick, Stockton-on-Tees TS19 8PE, United Kingdom
    Recruiting
    • Matthew Dewhurst, Dr · Contact01642 617617
  • Frimley Park Hospital
    Camberley, Surrey GU16 7UJ, United Kingdom
    Recruiting
    • Lydia Sturridge, Dr · Contact0300 614 5000
  • Surrey & Sussex Healthcare NHS Trust
    Redhill, Surrey RH1 5RH, United Kingdom
    Recruiting
    • Cheuk Chan, Dr · Contact01737 768511
  • University Hospital of Wales
    Cardiff, Wales CF14 4XW, United Kingdom
    Recruiting
    • Abbas Zaidi · Contact029 2074 7747
  • University Hospital Coventry
    Coventry, Warwickshire CV2 2DX, United Kingdom
    Recruiting
    • Michael Kuehl · Contact024 7696 4000
  • New Cross Hospital
    Wolverhampton, West Midlands WV10 0QP, United Kingdom
    Recruiting
    • Anita Arya · Contact01902 307999
  • St Richards Hospital
    Chichester, West Sussex PO19 6SE, United Kingdom
    Recruiting
    • Nick Child · Contact01243 788122
  • Leeds General Infirmary
    Leeds, West Yorkshire LS1 3EX, United Kingdom
    Recruiting
    • John Greenwood · Contact01132432799
  • Pinderfields Hospital
    Wakefield, West Yorkshire WF1 4DG, United Kingdom
    Recruiting
    • Peter Swaboda · Contact01924 541000
  • Worcestershire Royal Hospital
    Worcester, Worcestershire WR5 1DD, United Kingdom
    Recruiting
    • David Wilson, Dr · Contact01905 763333
  • Wythenshaw Hospital
    Manchester, Wythenshaw M23 9LT, United Kingdom
    Recruiting
    • Niall Campbell · Contact0161 998 7070
  • Castle Hill Hospital
    Hull, Yorkshire HU16 5JQ, United Kingdom
    Recruiting
    • Antony Renjith · Contact01482 875875
  • Royal Devon & Exeter Hospital
    Exeter, EX2 5DW, United Kingdom
    Recruiting
    • Andrew Ludman, Dr · Contact01392 411611
  • Morriston Hospital
    Swansea, SA6 6NL, United Kingdom
    Recruiting
    • Geraint Jenkins · Contact01792 702222
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 16, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05568069
Collaborators
British Heart Foundation, University of Southampton
Responsible party
Sponsor
First posted
Oct 5, 2022
Start date
Apr 12, 2023
Primary completion
Feb 28, 2029 (estimated)
Completion
Feb 28, 2032 (estimated)
Last update
Jun 16, 2026

Study contacts

Abigail Jones
Contact
a.b.p.jones@soton.ac.uk
023 8120 5154
Pedro Rodrigues
Contact
p.rodrigues@soton.ac.uk
023 8120 5154
Andrew Flett
study chair · University Hospital Southampton NHS Foundation Trust

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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