{"id":208,"date":"2025-01-27T13:17:25","date_gmt":"2025-01-27T13:17:25","guid":{"rendered":"https:\/\/carvtop.org\/?page_id=208"},"modified":"2026-02-25T03:45:42","modified_gmt":"2026-02-25T03:45:42","slug":"clinicians","status":"publish","type":"page","link":"https:\/\/carvtop.org\/index.php\/clinicians\/","title":{"rendered":"Clinicians"},"content":{"rendered":"<div id=\"cs-content\" class=\"cs-content\"><div class=\"x-section e208-e1 m5s-0 m5s-1\"><div class=\"x-div e208-e2 m5s-6 m5s-7 m5s-8 m5s-9 m5s-a\"><div class=\"x-text x-content e208-e3 m5s-f m5s-g m5s-h\"><span class=\"clinicians-tag\">FOR INVESTIGATORS &amp; SITE STAFF<\/span><span><\/span><\/div><div class=\"x-text x-text-headline e208-e4 m5s-k m5s-l m5s-m\"><div class=\"x-text-content\"><div class=\"x-text-content-text\">\n<h2 class=\"x-text-content-text-primary\">Scientific Rationale<\/h2><\/div><\/div><\/div><div class=\"x-text x-content e208-e5 m5s-g m5s-h m5s-i\"><p>The CARVTOP-ICD trial addresses a key evidence gap in the management of patients with heart failure with reduced ejection fraction (HFrEF) who have an implanted cardioverter-defibrillator (ICD). Both metoprolol succinate and carvedilol are Guideline-recommended beta-blockers in HFrEF that improve survival and reduce cardiovascular events. However, there is clinical equipoise regarding their comparative effects on arrhythmic outcomes, cardiovascular hospitalization and survival. Prior observational studies have suggested possible differences in arrhythmia burden and clinical outcomes between these agents, but these findings are not definitive and were not derived from prospective randomized studies.<\/p>\n<p>The CARVTOP-ICD trial is a prospective, multicenter, open-label, randomized comparative effectiveness study designed to rigorously compare carvedilol versus metoprolol succinate in patients with HFrEF and an ICD. The trial will enroll 2,000 participants, randomized 1:1 to either continue metoprolol succinate or switch to carvedilol, with titration to maximally tolerated doses. The primary composite endpoint includes first ICD therapy (appropriate or inappropriate), cardiovascular hospitalization, or cardiovascular death. Secondary outcomes include shock burden, healthcare utilization, and patient-reported quality of life measures.<\/p>\n<p>This trial will generate high-quality comparative effectiveness data to inform beta-blocker selection in a real-world HFrEF population with ICDs, addressing an important gap in evidence that may influence personalized treatment strategies and improve arrhythmic and clinical outcomes.<\/p>\n<p class=\"clinicians-subtitle\">Additional information on the clinicaltrials.gov website.<\/p><\/div><div class=\"x-row e208-e6 m5s-p m5s-q m5s-s\"><div class=\"x-row-inner\"><div class=\"x-col e208-e7 m5s-u m5s-v\"><a class=\"x-anchor x-anchor-button e208-e8 m5s-x m5s-y m5s-z m5s-10 m5s-4\" tabindex=\"0\" href=\"https:\/\/clinicaltrials.gov\/study\/NCT06964464\" data-x-effect=\"{&quot;durationBase&quot;:&quot;300ms&quot;}\"><div class=\"x-anchor-content\"><div class=\"x-anchor-text\"><span class=\"x-anchor-text-primary\">ClinicalTrials.gov ID NCT06964464<\/span><\/div><\/div><\/a><\/div><\/div><\/div><\/div><\/div><div class=\"x-section e208-e9 m5s-0 m5s-2\"><div class=\"x-div x-container max width e208-e10 m5s-7 m5s-8 m5s-9\"><div class=\"x-text x-text-headline e208-e11 m5s-l m5s-n\"><div class=\"x-text-content\"><div class=\"x-text-content-text\"><h2 class=\"x-text-content-text-primary\">Video Resources<\/h2>\n<\/div><\/div><\/div><div class=\"x-row e208-e12 m5s-p m5s-r m5s-t\"><div class=\"x-row-inner\"><div class=\"x-col e208-e13 m5s-u m5s-w\"><div class=\"x-div e208-e14 m5s-7 m5s-9 m5s-b\"><figure class=\"x-div e208-e15 m5s-7 m5s-8 m5s-c m5s-d\"><span class=\"x-image e208-e16 m5s-14\"><img decoding=\"async\" src=\"https:\/\/carvtop.org\/wp-content\/uploads\/2025\/09\/Anekwe-Onwuanyi-MD-5.png\" width=\"960\" height=\"540\" alt=\"Placeholder Image\" loading=\"lazy\"><\/span><div class=\"x-div e208-e17 m5s-6 m5s-7 m5s-8 m5s-9 m5s-d m5s-e m5s-5\"><div class=\"x-anchor x-anchor-toggle has-graphic e208-e18 m5s-x m5s-z m5s-11 m5s-12 m5s-4\" tabindex=\"0\" role=\"button\" data-x-toggle=\"1\" data-x-toggleable=\"e208-e18\" data-x-toggle-overlay=\"1\" data-x-effect=\"{&quot;durationBase&quot;:&quot;300ms&quot;}\" aria-controls=\"e208-e18-modal\" aria-expanded=\"false\" aria-haspopup=\"true\" aria-label=\"Toggle Modal Content\"><div class=\"x-anchor-content\"><span class=\"x-graphic\" aria-hidden=\"true\"><i class=\"x-icon x-graphic-child x-graphic-icon x-graphic-primary\" aria-hidden=\"true\" data-x-icon-s=\"&#xf04b;\"><\/i><\/span><\/div><\/div><\/div><\/figure><\/div><div class=\"x-text x-content e208-e20 m5s-h m5s-j\">Background and Rationale\u00a0 for the CARVTOP-ICD Trial.<\/div><\/div><div class=\"x-col e208-e21 m5s-u m5s-w\"><div class=\"x-div e208-e22 m5s-7 m5s-9 m5s-b\"><figure class=\"x-div e208-e23 m5s-7 m5s-8 m5s-c m5s-d\"><span class=\"x-image e208-e24 m5s-14\"><img decoding=\"async\" src=\"https:\/\/carvtop.org\/wp-content\/uploads\/2025\/09\/Anekwe-Onwuanyi-MD-2.png\" width=\"960\" height=\"540\" alt=\"Placeholder Image\" loading=\"lazy\"><\/span><div class=\"x-div e208-e25 m5s-6 m5s-7 m5s-8 m5s-9 m5s-d m5s-e m5s-5\"><div class=\"x-anchor x-anchor-toggle has-graphic e208-e26 m5s-x m5s-z m5s-11 m5s-12 m5s-4\" tabindex=\"0\" role=\"button\" data-x-toggle=\"1\" data-x-toggleable=\"e208-e26\" data-x-toggle-overlay=\"1\" data-x-effect=\"{&quot;durationBase&quot;:&quot;300ms&quot;}\" aria-controls=\"e208-e26-modal\" aria-expanded=\"false\" aria-haspopup=\"true\" aria-label=\"Toggle Modal Content\"><div class=\"x-anchor-content\"><span class=\"x-graphic\" aria-hidden=\"true\"><i class=\"x-icon x-graphic-child x-graphic-icon x-graphic-primary\" aria-hidden=\"true\" data-x-icon-s=\"&#xf04b;\"><\/i><\/span><\/div><\/div><\/div><\/figure><\/div><div class=\"x-text x-content e208-e28 m5s-h m5s-j\"><p>History of Beta-blocker Therapy. Sex and Racial Differences.<\/p><\/div><\/div><div class=\"x-col e208-e29 m5s-u m5s-w\"><div class=\"x-div e208-e30 m5s-7 m5s-9 m5s-b\"><figure class=\"x-div e208-e31 m5s-7 m5s-8 m5s-c m5s-d\"><span class=\"x-image e208-e32 m5s-14\"><img decoding=\"async\" src=\"https:\/\/carvtop.org\/wp-content\/uploads\/2025\/09\/Anekwe-Onwuanyi-MD-3.png\" width=\"960\" height=\"540\" alt=\"Placeholder Image\" loading=\"lazy\"><\/span><div class=\"x-div e208-e33 m5s-6 m5s-7 m5s-8 m5s-9 m5s-d m5s-e m5s-5\"><div class=\"x-anchor x-anchor-toggle has-graphic e208-e34 m5s-x m5s-z m5s-11 m5s-12 m5s-4\" tabindex=\"0\" role=\"button\" data-x-toggle=\"1\" data-x-toggleable=\"e208-e34\" data-x-toggle-overlay=\"1\" data-x-effect=\"{&quot;durationBase&quot;:&quot;300ms&quot;}\" aria-controls=\"e208-e34-modal\" aria-expanded=\"false\" aria-haspopup=\"true\" aria-label=\"Toggle Modal Content\"><div class=\"x-anchor-content\"><span class=\"x-graphic\" aria-hidden=\"true\"><i class=\"x-icon x-graphic-child x-graphic-icon x-graphic-primary\" aria-hidden=\"true\" data-x-icon-s=\"&#xf04b;\"><\/i><\/span><\/div><\/div><\/div><\/figure><\/div><div class=\"x-text x-content e208-e36 m5s-h m5s-j\"><p>The Need for Data to Determine which Beta-Blocker is Best for Patients.<\/p><\/div><\/div><div class=\"x-col e208-e37 m5s-u m5s-w\"><div class=\"x-div e208-e38 m5s-7 m5s-9 m5s-b\"><figure class=\"x-div e208-e39 m5s-7 m5s-8 m5s-c m5s-d\"><span class=\"x-image e208-e40 m5s-14\"><img decoding=\"async\" src=\"https:\/\/carvtop.org\/wp-content\/uploads\/2025\/09\/Anekwe-Onwuanyi-MD-4.png\" width=\"960\" height=\"540\" alt=\"Placeholder Image\" loading=\"lazy\"><\/span><div class=\"x-div e208-e41 m5s-6 m5s-7 m5s-8 m5s-9 m5s-d m5s-e m5s-5\"><div class=\"x-anchor x-anchor-toggle has-graphic e208-e42 m5s-x m5s-z m5s-11 m5s-12 m5s-4\" tabindex=\"0\" role=\"button\" data-x-toggle=\"1\" data-x-toggleable=\"e208-e42\" data-x-toggle-overlay=\"1\" data-x-effect=\"{&quot;durationBase&quot;:&quot;300ms&quot;}\" aria-controls=\"e208-e42-modal\" aria-expanded=\"false\" aria-haspopup=\"true\" aria-label=\"Toggle Modal Content\"><div class=\"x-anchor-content\"><span class=\"x-graphic\" aria-hidden=\"true\"><i class=\"x-icon x-graphic-child x-graphic-icon x-graphic-primary\" aria-hidden=\"true\" data-x-icon-s=\"&#xf04b;\"><\/i><\/span><\/div><\/div><\/div><\/figure><div class=\"x-text x-content e208-e44 m5s-h m5s-j\"><p>CARVTOP-ICD Trial Study Design.<\/p><\/div><\/div><\/div><div class=\"x-col e208-e45 m5s-u m5s-w\"><div class=\"x-div e208-e46 m5s-7 m5s-9 m5s-b\"><figure class=\"x-div e208-e47 m5s-7 m5s-8 m5s-c m5s-d\"><span class=\"x-image e208-e48 m5s-14\"><img decoding=\"async\" src=\"https:\/\/carvtop.org\/wp-content\/uploads\/2026\/02\/deborah-1.png\" width=\"960\" height=\"540\" alt=\"Placeholder Image\" loading=\"lazy\"><\/span><div class=\"x-div e208-e49 m5s-6 m5s-7 m5s-8 m5s-9 m5s-d m5s-e m5s-5\"><div class=\"x-anchor x-anchor-toggle has-graphic e208-e50 m5s-x m5s-z m5s-11 m5s-12 m5s-4\" tabindex=\"0\" role=\"button\" data-x-toggle=\"1\" data-x-toggleable=\"e208-e50\" data-x-toggle-overlay=\"1\" data-x-effect=\"{&quot;durationBase&quot;:&quot;300ms&quot;}\" aria-controls=\"e208-e50-modal\" aria-expanded=\"false\" aria-haspopup=\"true\" aria-label=\"Toggle Modal Content\"><div class=\"x-anchor-content\"><span class=\"x-graphic\" aria-hidden=\"true\"><i class=\"x-icon x-graphic-child x-graphic-icon x-graphic-primary\" aria-hidden=\"true\" data-x-icon-s=\"&#xf04b;\"><\/i><\/span><\/div><\/div><\/div><\/figure><\/div><div class=\"x-text x-content e208-e52 m5s-h m5s-j\"><p>History of Beta-blocker Therapy. Sex and Racial Differences.<\/p><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"x-section e208-e53 m5s-0 m5s-3\"><div class=\"x-div x-container max width e208-e54 m5s-6 m5s-7 m5s-8 m5s-9 m5s-a\"><div class=\"x-text x-text-headline e208-e55 m5s-l m5s-m m5s-o\"><div class=\"x-text-content\"><div class=\"x-text-content-text\">\n<h2 class=\"x-text-content-text-primary\">We are looking for US collaborators <\/h2><\/div><\/div><\/div><a class=\"x-anchor x-anchor-button has-graphic e208-e56 m5s-z m5s-10 m5s-12 m5s-13\" tabindex=\"0\" href=\"https:\/\/carvtop.org\/index.php\/form-2\/\"><div class=\"x-anchor-content\"><span class=\"x-graphic\" aria-hidden=\"true\"><i class=\"x-icon x-graphic-child x-graphic-icon x-graphic-primary\" aria-hidden=\"true\" data-x-icon-s=\"&#xf105;\"><\/i><\/span><div class=\"x-anchor-text\"><span class=\"x-anchor-text-primary\">Interested in Collaborating as an Enrolling SiTe<\/span><\/div><\/div><\/a><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p> &#8230; <\/p>\n<div><a href=\"https:\/\/carvtop.org\/index.php\/clinicians\/\" class=\"more-link\">Read More<\/a><\/div>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template-blank-4.php","meta":{"footnotes":""},"class_list":["post-208","page","type-page","status-publish","hentry","no-post-thumbnail"],"_links":{"self":[{"href":"https:\/\/carvtop.org\/index.php\/wp-json\/wp\/v2\/pages\/208","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/carvtop.org\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/carvtop.org\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/carvtop.org\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/carvtop.org\/index.php\/wp-json\/wp\/v2\/comments?post=208"}],"version-history":[{"count":19,"href":"https:\/\/carvtop.org\/index.php\/wp-json\/wp\/v2\/pages\/208\/revisions"}],"predecessor-version":[{"id":561,"href":"https:\/\/carvtop.org\/index.php\/wp-json\/wp\/v2\/pages\/208\/revisions\/561"}],"wp:attachment":[{"href":"https:\/\/carvtop.org\/index.php\/wp-json\/wp\/v2\/media?parent=208"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}