ClinicalTrials.gg
Not yet recruitingNCT07696975RELIEVE-HFrEFUpdated Nov 6, 2026

RELIEVE-HFrEF TRIAL: REducing Lung congestIon Symptoms Using the v-wavE Shunt in adVancEd Heart Failure With Reduced EF

An interventional study of Implantation of the V-Wave Interatrial shunt and Sham (no implant) in Heart Failure and Reduced Ejection Fraction, Heart Failure Chronic and Heart Failure New York Heart Association Class III, sponsored by V-Wave Ltd. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-06.

Sponsored by V-Wave Ltd (part of Johnson & Johnson) · Not applicable, Interventional, and Treatment

Updated Nov 6, 2026Start date movedPrimary completion moved+1 moreGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
250
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study will evaluate the V-Wave Ventura Interatrial shunt. The Shunt is a small, hourglass-shaped device implanted in the dividing wall (septum) between the right and left atria (top chambers) of the heart placed during a minimally invasive cardiac catheterization procedure. The hourglass shape of the device holds the Shunt in place. The small opening in the center allows a small amount of blood to flow (to be shunted) from the top left chamber to the top right chamber of the heart. By "shunting" this small amount of blood, the increased pressure in the left side of the heart is reduced, which is expected to reduce congestion in the lungs and improve your symptoms of heart failure.

A previous study, the REducing Lung congestIon symptoms using the v-wavE shunt in adVancEd Heart Failure (RELIEVE-HF) trial showed that implantation of an interatrial shunt device was safe. In that study, patients whose heart pumping function (left ventricular ejection fraction, or LVEF) was >40% did not have better HF outcomes, such as hospitalization or even death after getting the device. However, the study looked separately at the LVEF ≤40% group and found that patients with an LVEF ≤40% showed improvements in these HF outcomes, as well as fewer episodes of worsening HF requiring an artificial heart pump. This suggests the shunt may help people whose heart pump is reduced, but more information is needed. The purpose of this study is to add to the data on the safety and whether the shunt works in preventing worsening heart failure for patients with reduced pumping strength or LVEF ≤40% .

This study is a multi-center, randomized, patient and observer blinded trial, with three (3) patients randomized to received the shunt (Treatment arm) for every two (2) non-implant Placebo-Procedure (Control patients). A total of approximately 250 patients will be randomized. Patients and research staff managing patients after randomization will be blinded during follow-up for a minimum of 12 months to a maximum of 24 months. All patients (Randomized to Treatment and Control) will be followed for a total of 3 years from the time of the randomization for comparison. Follow-up visits will be performed for the study will be conducted in clinic with the research doctors and staff and will include some telephone/remote visits. Patients randomized to the Control group who still meet inclusion/without exclusion criteria and consent will have an opportunity to receive the shunt if the effectiveness endpoint is met at primary study results.

Read the detailed description

The Study Device, the V-Wave Interatrial Shunt System, includes a permanent implant-the Shunt, placed during a minimally invasive cardiac catheterization procedure using its dedicated Delivery Catheter. By transferring blood from the left to the right atrium, the Shunt is intended to reduce excessive left-sided cardiac filling pressures in patients with advanced Heart Failure with reduced Ejection Fraction (HFrEF). The anticipated outcome is a reduction in heart failure events (all-cause mortality, cardiac transplantation or LVAD implantation (HT/LV), and all heart failure hospitalizations).

The study is a prospective, multi-center, 3:2 randomized, patient and observer blinded trial, with three (3) patients randomized to the Shunt Treatment arm for every two (2) non-implant Placebo-Procedure Control patients. The primary analysis will be performed when the last enrolled patient has been followed for a minimum of 12 months from randomization. The duration of follow-up evaluated by the primary effectiveness endpoint will range from a minimum of 12 to a maximum of 24 months. All patients (Randomized to Treatment and Control) will be followed for a total of 3 years from the time of the randomization. Patients randomized to the Control group who still meet inclusion/without exclusion criteria will have an opportunity to crossover and receive the shunt if the primary effectiveness endpoint is met at primary study analysis.

The REducing Lung congestIon symptoms using the v-wavE shunt in adVancEd Heart Failure (RELIEVE-HF) trial demonstrated that transcatheter implantation of an interatrial shunt device was safe but did not improve outcomes in HF patients across the full range of left ventricular ejection fraction (LVEF). However, results from a prespecified exploratory analysis in stratified randomized LVEF subgroups (LVEF ≤40% versus >40%) suggests that shunt implantation was beneficial in patients with reduced LVEF ≤40%. The RELIEVE- HFrEF trial is designed to provide additional data supporting this finding from the RELIEVE-HF trial.

02

Conditions studied

  • Heart Failure and Reduced Ejection Fraction
  • Heart Failure Chronic
  • Heart Failure New York Heart Association Class III
  • Heart Failure Congestive

Keywords

  • Heart Failure
  • Chronic heart failure
  • Reduced LVEF
  • Heart failure with low EF
  • interatrial shunt
03

In context

Heart Failure, Systolic

230 studies on the registry are indexed under Heart Failure, Systolic; 51 are open to participants now.

This study's planned enrollment of 250 is above the median of 60 across 165 interventional studies indexed under Heart Failure, Systolic.

Browse Heart Failure, Systolic studies →

Lead sponsor

V-Wave Ltd is the lead sponsor of 5 studies on the registry; 1 is open to participants now.

First submitted after V-Wave Ltd became part of Johnson & Johnson.

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

Eligibility criteria

Inclusion Criteria:

  1. Heart failure with a reduced LV (≤40%) and documented heart failure for at least 6 months from Baseline Visit.
  2. Class III symptoms
  3. Receiving guideline directed medical therapy (GDMT) for heart failure which refers to those HF drugs carrying a Class I indication:

    1. An inhibitor of the renin-angiotensin system (RAS inhibitor), including an angiotensin receptor-neprilysin inhibitor (ARNI), angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) and an evidence-based beta-blocker (BB) for at least 3 months prior to the Baseline Visit
    2. An SGLT2I Inhibitor for at least 1 month prior to the Baseline Visit
    3. Other medications recommended for selected populations, e.g., on diuretics as required for volume control. Mineralocorticoid receptor antagonist (MRA) or nitrates/hydralazine should be used in appropriate patients, according to the published guidelines.
    4. All patients are on stable HF medications as determined by the investigator, for at least 1 month, with the exception of diuretic therapy. Stable is defined as no more than a 100% increase or 50% decrease in dose within these periods.
  4. Receiving Class I recommended cardiac rhythm management device therapy. Specifically: if indicated by class I guidelines, cardiac resynchronization therapy (CRT), implanted cardioverter-defibrillator (ICD) or a pacemaker should be implanted at least 3 months prior to Baseline Visit.
  5. Must meet 5a OR 5b.

    1. One (1) prior Heart Failure Hospitalization with duration >24 hours or Emergency Room Heart Failure Visit with duration ≥6 hours, or Heart Failure Clinic ADHF Visit with duration ≥6 hours, within 12 months from Baseline Visit.
    2. Alternatively, if patients have not had a HF hospitalization or ER HF Visit within the prior 12 months, they must have a corrected elevated Brain Natriuretic Peptide (BNP) level of at least 300 pg/ml or an N-terminal pro-BNP (NT-proBNP) level of at least 1,500 pg/ml, according to local measurement, within 3 months of the Baseline Visit.
  6. Able to perform the 6-minute walk test with a distance ≥100 meters and ≤450 meters.
  7. Provide written for study participation and be willing and able to comply with the required tests, treatment instructions and follow-up visits.

Main Exclusion Criteria:

  • Resting systolic blood pressure \<90 or >160 mmHg
  • Baseline echocardiographic evidence of intracardiac blood clot, significant right ventricular dysfunction or severe left sided dilation.
  • Diagnosis of severe pulmonary hypertension.
  • Congenital Atrial septal defect, patent foramen ovale, with known shunting on echo
  • Untreated moderately severe or severe aortic or mitral stenosis.
  • Mitral valve repair device (e.g. MitraClip) implanted within 3 months prior to Baseline Visit.
  • Acute MI, acute coronary syndrome (ACS), percutaneous coronary intervention (PCI), rhythm management system revision (not including generator change), lead extraction, or cardiac or other major surgery within 3 months of Baseline Visit.
  • Stroke, (TIA), systemic or pulmonary thromboembolism, or deep vein thrombosis (DVT) within 6 months.
  • Intractable HF with any of the following:

Treatment with IV vasoactive medications (e.g., IV inotropes, IV vasodilators) within the last 30 days.

Treated with a ventricular assist device (VAD). Listed for cardiac transplantation.

  • Prior cardiac transplantation.
  • \<1 year due to non-cardiovascular illness.
  • Kidney failure or is receiving dialysis.
  • Active infection requiring parenteral or oral antibiotics.
  • Known allergy to nickel.
  • Hemodynamic, heart rhythm or respiratory instability at the time of Final Exclusion Criteria.
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.

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.

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.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

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.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

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.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
250 participants (estimated)

Study arms

  • Experimental
    Treatment arm

    Treatment arm patients will undergo a diagnostic right heart catheterization and invasive echocardiography to determine study eligibility followed by a transseptal catheterization and V-Wave Ventura interatrial shunt implantation and continue taking guideline recommended medical therapy .

    Device: Implantation of the V-Wave Interatrial shunt

  • Sham comparator
    Control

    Control arm patients will undergo a diagnostic right heart catheterization and invasive echocardiography to determine study eligibility, but will not have a transseptal catheterization and V-Wave Ventura interatrial shunt implantation and will continue guideline recommended medical therapy.

    Device: Sham (no implant)

Interventions

  • DeviceImplantation of the V-Wave Interatrial shunt

    Implantation of the Ventura Shunt should be performed only by physicians experienced in transseptal cardiac catheterization procedures and trained in the proper use of the Shunt and Delivery System. Perform a standard right heart catheterization and (TEE) or (ICE) echo imaging to assess adequacy of vascular access, cardiovascular anatomy and to rule out potential contraindications. Perform a transseptal puncture, attempting to cross near the center of the fossa ovalis or where anatomy is most suitable. Advance the Delivery System and verify the tip is in the mid left atrium. Deploy the left portion of the Shunt which will be visible on echo or fluoroscopy. Slowly retract the Introducer and the Delivery System as a unit, until the left atrial cone of the Shunt contacts the left side of the fossa ovalis. Release the shunt from the delivery system, and retract until the Shunt is deployed across the fossa ovalis. Shunt placement is verified by fluoroscopic and echo observations.

    Also known as: V-Wave Ventura interatrial shunt, V-Wave shunt, Interatrial shunt implant, transseptal shunt

  • DeviceSham (no implant)

    Study procedures should be performed only by physicians experienced in the RELIEVE-HFrEF study protocol and manual of operations. Perform a standard right heart catheterization and transesophogeal (TEE) or intracardiac (ICE) echo imaging to assess adequacy of vascular access, cardiovascular anatomy and to rule out potential contraindications. If eligible and randomized to control, the transseptal and shunt implantation will not be performed but the Interventionalist will simulate the procedure to maintain participant blinding.

    Also known as: Sham Control, No implant

06

What researchers measure

Primary outcomes

  1. Primary Safety

    The percentage of Treatment Group patients experiencing device-related Major Adverse Cardiovascular and Neurological Events (MACNE) during the first 30 days after randomization, compared to a pre-specified Performance Goal.

    Time frame: From enrollment at the intervention procedure through 30 days.

  2. Primary Effectiveness

    A composite of time to all-cause mortality or Heart Transplantation/LVAD implantation (HT/LV) and recurrent heart failure hospitalizations. This endpoint will be evaluated utilizing a Bayesian joint frailty model with two components: 1) time to all- cause mortality or HT/LV; and 2) rate of recurrent heart failure hospitalization. A shared parameter for the risk ratio will quantify the treatment benefit of Treatment versus Control across both components. The primary analysis model will also incorporate Bayesian borrowing on the shared treatment effect from the corresponding subgroup in the RELIEVE-HF trial (≤40%). The prior information will be down weighted using Bayesian power prior methodology, and simulations will be used to calibrate the decision criteria and weighting of the prior information to be pre-specified in the Statistical Analysis Plan. This includes a comprehensive evaluation of statistical power and Type I error of the primary analysis with Bayesian borrowing.

    Time frame: The Primary analysis will be conducted after the final enrolled participant completes the 12-month visit. Data for the primary analysis will be collected from a minimum of 12- months to a maximum of 24-months of follow-up.

Secondary outcomes

  1. Secondary Effectiveness

    Heart failure hospitalizations adjusted for all-cause mortality and HT/LV by joint frailty

    Time frame: Baseline to the time of primary (unblinded) follow-up. Follow-up duration at outcome analysis ranges from a minimum of 12 months to a maximum of 24 months.

  2. Secondary Effectiveness

    Primary endpoint inclusive of worsening HF treated as an outpatient (WHF)

    Time frame: Baseline to the time of primary (unblinded) follow-up. Follow-up duration at outcome analysis ranges from a minimum of 12 months to a maximum of 24 months.

  3. Secondary Effectiveness

    Primary endpoint replacing HFH with All-cause hospitalization (non-elective)

    Time frame: Baseline to the time of primary (unblinded) follow-up. Follow-up duration at outcome analysis ranges from a minimum of 12 months to a maximum of 24 months.

  4. Secondary Effectiveness

    Time to all-cause death or HT/LV

    Time frame: Baseline to the time of primary (unblinded) follow-up. Follow-up duration at outcome analysis ranges from a minimum of 12 months to a maximum of 24 months.

  5. Secondary Effectiveness

    Change in NYHA Class

    Time frame: Baseline to 12 months

  6. Secondary Effectiveness

    Change in NYHA Class

    Time frame: Baseline to 24 months

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Pfeiffer M, Boehmer J, Gorcsan J, Eguchi S, Orihara Y, Perl ML, Eigler N, Abraham WT, Villota JN, Lee E, Bayes-Genis A, Moravsky G, Kar S, Zile MR, Holcomb R, Anker SD, Stone GW, Rodes-Cabau J, Lindenfeld J, Bax JJ. In vivo fluid dynamics of the Ventura interatrial shunt device in patients with heart failure. ESC Heart Fail. 2024 Oct;11(5):2499-2509. doi: 10.1002/ehf2.14859. Epub 2024 May 22. PubMed 38773938 ↗
  • Rodes-Cabau J, Lindenfeld J, Abraham WT, Zile MR, Kar S, Bayes-Genis A, Eigler N, Holcomb R, Nunez J, Lee E, Perl ML, Moravsky G, Pfeiffer M, Boehmer J, Gorcsan J, Bax JJ, Anker S, Stone GW. Interatrial shunt therapy in advanced heart failure: Outcomes from the open-label cohort of the RELIEVE-HF trial. Eur J Heart Fail. 2024 Apr;26(4):1078-1089. doi: 10.1002/ejhf.3215. Epub 2024 Apr 1. PubMed 38561314 ↗
  • Zile MR, Abraham WT, Lindenfeld J, Anker SD, Rodes-Cabau J, Pfeiffer MP, Boehmer JP, Litwin S, Baicu CF, Villota JN, Lee EC, Holcomb R, O'Keefe P, Eigler NL, Stone GW; RELIEVE-HF Investigators. Mechanistic Basis for Differential Effects of Interatrial Shunt Treatment in HFrEF vs HFpEF: The RELIEVE-HF Trial. JACC Cardiovasc Imaging. 2026 Jan;19(1):1-15. doi: 10.1016/j.jcmg.2025.08.005. Epub 2025 Sep 15. PubMed 40892630 ↗
  • Stone GW, Lindenfeld J, Rodes-Cabau J, Anker SD, Zile MR, Kar S, Holcomb R, Pfeiffer MP, Bayes-Genis A, Bax JJ, Bank AJ, Costanzo MR, Verheye S, Roguin A, Filippatos G, Nunez J, Lee EC, Laufer-Perl M, Moravsky G, Litwin SE, Prihadi E, Gada H, Chung ES, Price MJ, Thohan V, Schewel D, Kumar S, Kische S, Shah KS, Donovan DJ, Zhang Y, Eigler NL, Abraham WT; RELIEVE-HF Investigators. Interatrial Shunt Treatment for Heart Failure: The Randomized RELIEVE-HF Trial. Circulation. 2024 Dec 10;150(24):1931-1943. doi: 10.1161/CIRCULATIONAHA.124.070870. Epub 2024 Sep 23. PubMed 39308371 ↗

Individual participant data

Plan to share: Undecided — This decision balances participant privacy, ethical commitments in the consent process, legal/regulatory constraints, and the need to ensure scientific integrity. Aggregate results and study metadata will be made available; limited, controlled access to de-identified data may be provided under strict governance when appropriate.

09

Updates

1 registry update since Sep 25, 2026
Start date
Sep 30, 2026→Jul 1, 2027
Nov 6, 2026
Primary completion
Mar 31, 2029→Jul 31, 2030
Nov 6, 2026
Study completion
Sep 30, 2031→Jul 31, 2032
Nov 6, 2026
Show all 1 update
  1. Nov 6, 2026
    Start date Sep 30, 2026→Jul 1, 2027
    Primary completion Mar 31, 2029→Jul 31, 2030
    Study completion Sep 30, 2031→Jul 31, 2032
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07696975
Lead sponsor
V-Wave Ltd
Collaborators
Johnson & Johnson
Responsible party
Sponsor
First posted
Jul 10, 2026
Start date
Jul 1, 2027 (estimated)
Primary completion
Jul 31, 2030 (estimated)
Completion
Jul 31, 2032 (estimated)
Last update
Nov 6, 2026

Study contacts

Deborah Deutsch, VP of Clinical Affairs
Contact
ddeutsch@its.jnj.com
818-629-2164
Cheryl Calhoun RN, MS, Clinical Trial Manager
Contact
ccalhou4@its.jnj.com
603-493-3435
Gregg W. Stone, MD
principal investigator · Icahn School of Medicine at Mount Sinai
Joann Lindenfeld, MD
principal investigator · Vanderbilt University
Michael Zile, MD
principal investigator · Medical University of South Carolina
William T Abraham, MD
study director · Ohio State University

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in Nov 2026. You cannot join it, but the record below documents what was studied.

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