Research

Remote Alert Pathway To Optimize Care of Cardiac Implantable Electrical Devices: RAPTOR-CIED                        July 2024 - January 2031

          PCORI
          Principal Investigator: Daniel B. Kramer

This study explores the effectiveness of alert-driven care   compared to guideline-based care for patients with pacemakers and ICDs. Traditionally, patients follow scheduled in-office and remote transmissions, but routine evaluations often provide little benefit. Alert-driven care, using wireless technology to monitor devices for critical changes, aims to reduce unnecessary appointments and free up clinical resources. This randomized controlled trial will assess outcomes such as major adverse cardiac events and patient-provider experiences, with input from diverse stakeholders, including clinicians, telemedicine experts, and patient advocates. 

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Study of Response to Injury in Vascular Endothelium: The STRIVE Study                                                             February 2024 - February 2025 

          BIDMC                                                                                                                                                          
          Principal Investigator: Daniel B. Kramer

The STRIVE Study investigates the vascular response to injury by analyzing plasma biomarkers during cardiac implantable electrical device (CIED) implantation. This controlled setting allows researchers to measure changes in specific biomarkers before and after the procedure, offering insights into endothelial disruption and its role in thrombosis. The study will collect blood samples to evaluate the feasibility of using CIED procedures as a model for understanding vascular injury. The findings aim to identify biomarkers that could inform future studies and improve patient outcomes related to vascular health.

Prospective Investigation of Palliative and End-of-Life Experiences with ICDs (PIPER-ICD) Study                             July 2022 - June 2026 

          NIH; R01
          Principal Investigator: Daniel B. Kramer 

The PIPER-ICD Study aims to improve care for older patients living with ICDs by examining their long-term and end-of-life experiences. Around 50,000 ICDs are implanted in patients 65 and older annually, but current guidelines lack robust data on this population. This study will follow patients to assess their clinical and functional trajectories and explore when to replace or deactivate ICDs. With a focus on patient-centered care, the study will also examine ICD shocks at the end of life to identify potential interventions, providing critical data to guide decisions for this group.       

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The Trajectories and Clinical Experiences of ICD Therapy (TRACER-ICD) Study                                                                  April 2021 - March 2026

          NIH; R01
          Principal Investigator: Daniel B. Kramer 

The TRACER-ICD Study aims to enhance shared decision-making (SDM) for older adults considering ICD implantation. Despite over 50,000 ICDs being implanted annually in patients aged 65 and older, little is known about their long-term health and quality of life. This multi-center study will follow patients and assess their clinical and functional trajectories using data from geriatric conditions and remote monitoring. By refining predictive models of patient outcomes, the study seeks to provide personalized data that can improve SDM and guide better care for millions of older ICD recipients.

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