CClinicalTrials.gg
RecruitingNCT06059638BACKBEATUpdated Sep 24, 2026

BradycArdia paCemaKer With AV Interval Modulation for Blood prEssure treAtmenT

An interventional study of Medtronic Astra/Azure DR MRI IPG with AVIM therapy Activated and Medtronic Astra/Azure DR MRI IPG with AVIM therapy Deactivated in Hypertension, Hypertension, Systolic and Hypertension, Essential, sponsored by Orchestra BioMed, Inc. Recruiting at 131 sites in 15 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-24.

Sponsored by Orchestra BioMed, Inc · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
316
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

A prospective, multinational, randomized, double-blind, clinical trial evaluating the safety and effectiveness of a novel atrioventricular interval modulation (AVIM) algorithm downloaded into a dual-chamber Medtronic Astra/Azure pacemaker.

Read the detailed description

The study will be conducted in three phases: 1) Screening Phase, 2) Double-blind Randomized Phase (1 year), and 3) Unblinded Phase (2 years). Patients scheduled for implantation of an Astra/Azure pacemaker, or those who already have one implanted, who also have hypertension, may be screened for inclusion into this study. Subjects meeting randomization eligibility criteria will have the investigational AVIM Therapy RAMware downloaded into the Astra/Azure pacemaker and be randomized 1:1 to either have AVIM therapy turned ON or turned OFF. All subjects will continue to receive antihypertensive drug therapy.

02

Conditions studied

  • Hypertension
  • Hypertension, Systolic
  • Hypertension, Essential
03

Who can participate

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

Inclusion criteria

  1. Patient has or is indicated for a dual-chamber pacemaker. Visit 1 can be performed within 30 days prior to a planned implant of a Medtronic Astra/Azure dual-chamber pacemaker system or at any time thereafter
  2. On a stable antihypertension treatment regimen with at least 1 class of antihypertensive drug
  3. Office SBP ≥135 mmHg and \<180 mmHg
  4. Average 24-Hour aSBP ≥130 mmHg and \<170 mmHg

Exclusion criteria

Exclusion Criteria:

  1. LVEF \<50%
  2. NYHA Class III-IV
  3. History of cerebrovascular accident (CVA) or transient ischemic attack (TIA) within 6 months
  4. Myocardial infarction (MI) within 3 months
  5. Prior percutaneous or surgical coronary, carotid, or endovascular intervention within 3 months
  6. Permanent atrial fibrillation
  7. Mitral valve regurgitation greater than or equal to grade 3
  8. Aortic stenosis with a valve area less than 1.5 cm2
  9. Has an active or prior device-based anti-hypertensive treatment (e.g., renal denervation procedure, baroreflex activation therapy)
  10. Has an existing active cardiac device or neurostimulator other than the recent Astra/Azure pacemaker implant
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
316 participants (estimated)

Study arms

  • Experimental
    Treatment Group

    AVIM therapy activated with continued stable antihypertensive drug therapy

    Device: Medtronic Astra/Azure DR MRI IPG with AVIM therapy Activated

  • Sham comparator
    Control Group

    AVIM therapy deactivated with continued stable antihypertensive drug therapy

    Device: Medtronic Astra/Azure DR MRI IPG with AVIM therapy Deactivated

Interventions

  • DeviceMedtronic Astra/Azure DR MRI IPG with AVIM therapy Activated

    Antihypertensive therapy utilizing atrioventricular interval modulation.

    Also known as: BackBeat CNT

  • DeviceMedtronic Astra/Azure DR MRI IPG with AVIM therapy Deactivated

    AVIM therapy is deactivated

05

What researchers measure

Primary outcomes

  1. Change from Baseline in the Mean 24-hour ambulatory systolic blood pressure (aSBP) at 3 Months

    Between group difference in the change of mean 24-hour ambulatory systolic blood pressure (aSBP) from baseline to 3 months post randomization

    Time frame: Baseline and 3 months post randomization

  2. Freedom from Unanticipated Serious Adverse Device Effects (USADE)

    Freedom from Unanticipated Serious Adverse Device Effects (USADE) in the treatment group at 3 months.

    Time frame: 3 months post randomization

06

Study locations

104 of 131 sites recruiting
  • HonorHealth
    Scottsdale, Arizona 85258, United States
    Recruiting
  • Adventist Health Glendale
    Glendale, California 91206, United States
    Recruiting
  • Hoag Memorial Hospital Presbyterian
    Newport Beach, California 92633, United States
    Recruiting
  • Stanford
    Redwood City, California 94063, United States
    Recruiting
  • Scripps Clinic
    San Diego, California 92121, United States
    Withdrawn
  • Sutter Valley Hospitals
    San Francisco, California 94109, United States
    Recruiting
  • South Denver Cardiology
    Denver, Colorado 80210, United States
    Recruiting
  • Colorado Heart and Vascular
    Golden, Colorado 80401, United States
    Recruiting
  • Intermountain Health Lutheran Hospital
    Golden, Colorado 80401, United States
    Recruiting
  • UCHealth Medical Center of the Rockies
    Loveland, Colorado 80538, United States
    Recruiting
  • MedStar Washington Hospital Center
    Washington D.C., District of Columbia 20010, United States
    Recruiting
  • HCA Florida JFK Hospital
    Atlantis, Florida 33462, United States
    Recruiting
  • Cardiovascular Research Solutions (MyCardiologist)
    Celebration, Florida 34747, United States
    Recruiting
  • Clearwater Cardiovascular Consultants
    Clearwater, Florida 33756, United States
    Recruiting
  • Citrus Cardiology Consultants
    Crystal River, Florida 34429, United States
    Recruiting
  • The Cardiac and Vascular Institute
    Gainesville, Florida 32605, United States
    Recruiting
  • Memorial Healthcare System
    Hollywood, Florida 33021, United States
    Recruiting
  • Baptist Health Jacksonville
    Jacksonville, Florida 32207, United States
    Withdrawn
  • Baptist Health South Florida
    Miami, Florida 33176, United States
    Withdrawn
  • Mount Sinai Medical Center of Florida
    Miami Beach, Florida 33140, United States
    Withdrawn
  • Sarasota Memorial Hospital
    Sarasota, Florida 34239, United States
    Recruiting
  • Piedmont Healthcare, Inc.
    Atlanta, Georgia 30309, United States
    Recruiting
  • Wellstar Research Institute
    Marietta, Georgia 30060, United States
    Recruiting
  • St. Luke's Idaho Cardiology
    Boise, Idaho 83712, United States
    Recruiting
  • University of Chicago
    Chicago, Illinois 60637, United States
    Recruiting
  • University of Kansas Medical Center
    Kansas City, Kansas 66160, United States
    Recruiting
  • Cardiovascular Research Institute of Kansas
    Wichita, Kansas 67226, United States
    Recruiting
  • West Houston Area Clinical Trial Consultants (Wichita, KS)
    Wichita, Kansas 67226, United States
    Recruiting
  • Baptist Health Lexington
    Lexington, Kentucky 40503, United States
    Recruiting
  • Ochsner Medical Center
    New Orleans, Louisiana 70121, United States
    Recruiting
  • The Johns Hopkins University
    Baltimore, Maryland 21205, United States
    Recruiting
  • Medstar Union Memorial Hospital
    Baltimore, Maryland 21218, United States
    Recruiting
  • The Brigham and Women's Hospital
    Boston, Massachusetts 02115, United States
    Withdrawn
  • St. Elizabeth's Medical Center
    Boston, Massachusetts 02135, United States
    Recruiting
  • Beth Israel Deaconess Medical Center
    Boston, Massachusetts 02215, United States
    Withdrawn
  • Henry Ford Health
    Detroit, Michigan 48202-2689, United States
    Recruiting
  • UMH-Sparrow Clinical Research
    Lansing, Michigan 48912, United States
    Recruiting
  • Michigan Heart
    Ypsilanti, Michigan 48197, United States
    Recruiting
  • Health Partners Institute (Methodist Heart and Vascular Center)
    Bloomington, Minnesota 55425, United States
    Recruiting
  • Minneapolis Heart Institute
    Minneapolis, Minnesota 55407, United States
    Recruiting
  • Mayo Clinic
    Rochester, Minnesota 55905, United States
    Withdrawn
  • Washington University St. Louis
    St Louis, Missouri 63130, United States
    Recruiting
  • The Cooper Health System
    Camden, New Jersey 08103, United States
    Recruiting
  • Hackensack University Medical Center
    Hackensack, New Jersey 07601, United States
    Recruiting
  • Virtua Medical Group, P.A.
    Marlton, New Jersey 08053, United States
    Recruiting
  • Jersey Shore University Medical Center
    Neptune City, New Jersey 07753, United States
    Withdrawn
  • The Valley Hospital
    Ridgewood, New Jersey 07450, United States
    Withdrawn
  • Lovelace Medical Center (New Mexico Heart Institute)
    Albuquerque, New Mexico 87110, United States
    Recruiting
  • Northwell Health, Inc.
    New Hyde Park, New York 11042, United States
    Withdrawn
  • Icahn School of Medicine at Mount Sinai
    New York, New York 10029, United States
    Recruiting
  • University of Rochester - Cardiology CCTU
    Rochester, New York 14642, United States
    Recruiting
  • HCA Asheville Cardiology Associates
    Asheville, North Carolina 28801, United States
    Recruiting
  • Atrium Health - Sanger Heart
    Charlotte, North Carolina 28210, United States
    Recruiting
  • WakeMed
    Raleigh, North Carolina 27610, United States
    Recruiting
  • The Lindner Research Center
    Cincinnati, Ohio 45219, United States
    Withdrawn
  • The Ohio State University
    Columbus, Ohio 43210, United States
    Withdrawn
  • OhioHealth Corporation
    Columbus, Ohio 43214, United States
    Withdrawn
  • University of Oklahoma
    Oklahoma City, Oklahoma 73019, United States
    Withdrawn
  • Hightower Clinical Trials
    Oklahoma City, Oklahoma 73102, United States
    Recruiting
  • South Oklahoma Heart Research
    Oklahoma City, Oklahoma 73135, United States
    Recruiting
  • Penn Medicine at Doylestown Health Cardiology
    Doylestown, Pennsylvania 18901, United States
    Recruiting
  • Penn Medicine Lancaster General Health
    Lancaster, Pennsylvania 17602, United States
    Withdrawn
  • Hospital of the University of Pennsylvania
    Philadelphia, Pennsylvania 19104, United States
    Recruiting
  • Penn Presbyterian Medical Center
    Philadelphia, Pennsylvania 19104, United States
    Withdrawn
  • Medical University of South Carolina
    Charleston, South Carolina 29425, United States
    Recruiting
  • Stern Cardiovascular Foundation, Inc.
    Germantown, Tennessee 38138, United States
    Recruiting
  • Ascension St. Thomas Hospital
    Nashville, Tennessee 37203, United States
    Recruiting
  • Ascension Seton
    Austin, Texas 78723, United States
    Recruiting
  • Baylor Scott & White Research Institute
    Dallas, Texas 75204, United States
    Recruiting
  • Centra Health dba Stroobants Cardiovascular Center
    Lynchburg, Virginia 24501, United States
    Recruiting
  • West Virginia University
    Morgantown, West Virginia 26506, United States
    Recruiting
  • Advocate Aurora Research Institute, LLC
    Milwaukee, Wisconsin 53233, United States
    Recruiting
  • Lyell McEwin Hospital
    Elizabeth Vale, South Australia 5112, Australia
    Recruiting
  • OLV Ziekenhuis
    Aalst, Belgium
    Withdrawn
  • Middelheim Ziekenhuis
    Antwerp, Belgium
    Recruiting
  • Universite Libre de Bruxelles-Erasme Hospital
    Brussels, Belgium
    Recruiting
  • UZ Brussel
    Brussels, Belgium
    Withdrawn
  • UZ Leuven
    Leuven, Belgium
    Recruiting
  • Nanjing Drum Tower Hospital
    Nanjing, Jiangsu 210008, China
    Recruiting
  • Jiangsu Province Hospital
    Nanjing, China
    Recruiting
  • Fakultní nemocnice Královské Vinohrady (FNKV)
    Prague, Czechia
    Recruiting
  • Institute for Clinical and Experimental Medicine (IKEM)
    Prague, Czechia
    Recruiting
  • Na Homolce Hospital
    Prague, Czechia
    Recruiting
  • CHU Grenoble
    Grenoble, France
    Recruiting
  • Hospices Civils de Lyon (HCL)
    Lyon, France
    Recruiting
  • CHU de Nantes
    Nantes, France
    Recruiting
  • AP-HP Hôpital Pitié Salpêtrière
    Paris, France
    Recruiting
  • CHRU Tours
    Tours, France
    Recruiting
  • Universitätsmedizin Berlin, Deutsches Herzzentrum der Charité (DHZC)
    Berlin, Germany
    Recruiting
  • Herzzentrum Bonn am Universitätsklinikum Bonn
    Bonn, Germany
    Withdrawn
  • Cardioangiologisches Centrum Bethanien (CCB) am AGAPLESION Markus Krankenhaus
    Frankfurt, Germany
    Recruiting
  • Universitätsklinikum Hamburg-Eppendorf
    Hamburg, Germany
    Withdrawn
  • Herzzentrum Leipzig
    Leipzig, Germany
    Recruiting
  • University Hospital Luebeck
    Lübeck, Germany
    Recruiting
  • University Medical Centre Mannheim
    Mannheim, Germany
    Recruiting
  • Saarland University Hospital
    Saarbrücken, Germany
    Recruiting
  • Krankenhaus der Barmherzigen Brüder Trier
    Trier, Germany
    Withdrawn
  • Central Hospital of Northern Pest - Military Hospital
    Budapest, Hungary
    Withdrawn
  • Semmelweis University
    Budapest, Hungary
    Recruiting
  • University of Debrecen
    Debrecen, Hungary
    Recruiting

Showing the first 100 of 131 sites across 15 countries.

07

References and documents

Publications

  • Kalarus Z, Merkely B, Neuzil P, Grabowski M, Mitkowski P, Marinskis G, Erglis A, Kazmierczak J, Sturmberger T, Sokal A, Pluta S, Geller L, Osztheimer I, Malek F, Kolodzinska A, Mika Y, Evans SJ, Hastings HM, Burkhoff D, Kuck KH. Pacemaker-Based Cardiac Neuromodulation Therapy in Patients With Hypertension: A Pilot Study. J Am Heart Assoc. 2021 Aug 17;10(16):e020492. doi: 10.1161/JAHA.120.020492. Epub 2021 Aug 13. PubMed 34387126 ↗
  • Neuzil P, Merkely B, Erglis A, Marinskis G, de Groot JR, Schmidinger H, Rodriguez Venegas M, Voskuil M, Sturmberger T, Petru J, Jongejan N, Aichinger J, Kamzola G, Aidietis A, Geller L, Mraz T, Osztheimer I, Mika Y, Evans S, Burkhoff D, Kuck KH; BackBeat Study Investigators. Pacemaker-Mediated Programmable Hypertension Control Therapy. J Am Heart Assoc. 2017 Dec 23;6(12):e006974. doi: 10.1161/JAHA.117.006974. PubMed 29275370 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT06059638
Lead sponsor
Orchestra BioMed, Inc
Collaborators
Medtronic
Responsible party
Sponsor
First posted
Sep 28, 2023
Start date
Dec 27, 2023
Primary completion
Dec 2026 (estimated)
Completion
Aug 2029 (estimated)
Last update
Sep 24, 2026

Study contacts

Steven J. Evans, MD
Contact
sevans@orchestrabiomed.com
917-670-5933
Angela Stagg
Contact
astagg@orchestrabiomed.com
David Kandzari, MD
principal investigator · Piedmont Heart Institute
Andrea Russo, MD
principal investigator · Cooper University

Oversight

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

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