Effect of His-Ventricular (HV) Interval Optimisation in Cardiac Resynchronisation Therapy
A Randomised Cross-over Pilot Study of the Effect of His-Ventricular (HV) Interval Optimisation in Cardiac Resynchronisation Therapy
Cardiac resynchronisation therapy (CRT) is a specialised type of pacemaker used in patients with severe heart failure to improve symptoms and survival. Approximately one third of patients treated with CRT do not notice significant improvement in their symptoms and this may be due to inadequate co-ordination between the upper and lower chambers of the heart (atrioventricular dyssynchrony).
The investigators propose a new method to achieve atrioventricular synchrony in CRT based on measurements of electrical conduction from within the heart. Patients referred for CRT implantation at Castle Hill Hospital are eligible to participate. During CRT implantation, additional measurements, will be recorded from within the heart. After implantation, device settings will be adjusted to either standard or electrophysiologically-optimised settings with cross-over at 4 months.
The investigators hypothesis is that patients with optimised settings will derive additional benefit compared to patients with standard pacemaker-determined settings.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Hull, United Kingdom
- Castle Hill Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Clinical diagnosis of heart failure
- Referred for cardiac resynchronisation therapy (CRT) with or without defibrillator
- In sinus rhythm
- Patients must have a telephone
- Ability to give informed consent
- Ability to complete the study
Exclusion Criteria:
- Severe valve disease or previous valve replacement
- Previous atrial flutter ablation
- Chronic kidney disease Stage 3 or above
- Recent myocardial infarction
- Ongoing cardiac ischaemia
- Infiltrative cardiomyopathy
- Wolff-Parkinson White syndrome
- Presence of second or third degree heart block
- <90% biventricular pacing at 3 months
- Hypertrophic cardiomyopathy
- Pregnancy or breastfeeding
- On treatment for hypothyroidism or hyperthyroidism
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: CROSSOVER
- Masking: DOUBLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: His-Ventricular (HV)-optimised
His-Ventricular (HV) optimised atrioventricular delay
|
Optimisation of atrioventricular pacing interval
|
|
NO_INTERVENTION: Non-optimised
Standard atrioventricular delay
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Change in amino-terminal pro-B-type natriuretic peptide (NT-proBNP)
Time Frame: 7 months and 11 months
|
7 months and 11 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Increase in 6-min walk test distance by ≥25 m
Time Frame: 7 months and 11 months
|
7 months and 11 months
|
|
≥5points improvement in the short Kansas City Cardiomyopathy Questionnaire score
Time Frame: 7 months and 11 months
|
7 months and 11 months
|
|
Reduction of left ventricular end-diastolic volume.
Time Frame: 7 months and 11 months
|
7 months and 11 months
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (ACTUAL)
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 113 (Other Identifier: Shenzhen Universisty general hospital)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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