- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00655213
Spontaneous Atrio Ventricular Conduction Preservation (SAVER)
In case of sinus node dysfunction, it is often necessary to choose the safer option provided by a DDD pacemaker even though the most appropriate mode of pacing is AAI mode.
In addition to saving energy, the latter mode allows spontaneous ventricular activation, the haemodynamic consequences of which are, in most cases, better than those obtained with dual chamber pacing.
Recent studies as the MOST study suggest also that ventricular desynchronization imposed by right ventricular apical pacing even when AV synchrony is preserved increases the risk of atrial fibrillation in patients with SND. Similar results were already given by anterior studies (PIPAF) which, taking into account the percentage of ventricular pacing, suggested that AF prevention algorithm in combination with a preserved native conduction are efficient in reducing AF burden.
However, current practice is to implant a dual chamber pacemaker to prevent the risk of atrioventricular block (AVB) even if DDDR pacing with a fixed long AV delay was found inefficient in reducing ventricular pacing and was associated with a high risk of arrhythmias.
The Symphony 2550 cardiac pacemaker offers pacing modes that automatically switch from AAI(R) mode to DDD(R) or DDI(R) in event of severe atrioventricular conduction disorder, irrespective of whether or not these are accompanied by an atrial arrhythmia, returning spontaneously to AAI(R) mode as soon as the spontaneous AV conduction has resumed. These 2 particular modes are called the AAI SafeR and DDD/AMC (R) mode.
The main differences between both modes are that (i) AAI SafeR does not trigger any AV Delay after a sensed or paced atrial event which allows long PR intervals or even limited ventricular pauses with no switch to DDD(R), while (ii) DDD/AMC (R) is able to optimize AV Delay after switching to DDD(R) according to measured spontaneous conduction times and to provide an acceleration in case of vaso-vagal syndrome. This pacing mode has previously been assessed in clinical studies.
This study intends to demonstrate that the automatic modes switching significantly reduce the percentage of ventricular pacing in patients implanted with a spontaneous AV conduction and reduce the occurrence of atrial arrhythmias, on a mid-term follow-up period, in comparison to standard DDD pacing with long AVDelay.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
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Aalst, Belgium
- Onze Lieve Vrouw Ziekenhuis
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Baudour, Belgium
- Clinique Louis Caty
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Bruxelles, Belgium
- Hopital Universitaire Brugmann
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Campus st. Elisabeth Uccle, Belgium
- Europa ziekenhuis
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Moen, Belgium
- Heiling Hart van Jezus
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Montigny Le Tilleul, Belgium
- Hôpital Vésale (univ.)
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Tivoli, Belgium
- CHU - Tivoli
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Aix-en-Provence, France
- Centre Hospitalier
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Albi, France
- CH Albi
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Angers, France
- CHU d'Angers
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Besancon, France
- CHU Jean Minjoz
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Castres-mazamet, France
- CH de Castres
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Clermont-Ferrand, France
- Hospice St-Jacques-Hôspital G.Montpied
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Grenoble, France, 38043
- CHU - Hopital Michallon
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Lille, France
- CHRU de Lille - Hopital Cardiologique
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Limoges, France
- chu de Limoges
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Montpellier, France
- CH Montpellier
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Mulhouse, France
- CH Emile Muller
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Nantes, France
- CHU de Nantes
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Nantes, France
- Nouvelles Cliniques Nantaises
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Nice, France
- Chu de Nice
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Paris cedex 16, France, 75116
- Clinique BIZET
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Rennes, France
- CHU Pontchaillou
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Rouen, France, 76035
- CHU Hopital C. Nicolle
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St Cloud, France
- InParys Cardiology
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Vandoeuvre les Nancy, France, 54511
- Chu de Nancy
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Bonn, Germany
- Marien Hospital
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Bonn, Germany
- Universitatskliniken Bonn
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Bremen, Germany
- St.Josef-Stift Bremen
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Halberstadt, Germany
- St. Salvator Krankenhaus Halberstadt
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Holzminden, Germany
- Holzminden Praxis Bub
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Hürth, Germany
- Hürth Sana
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Kassel, Germany
- Herzzentrum Kassel
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Koln, Germany
- KH Holweide
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Luedenscheid, Germany
- Klinikum Lüdenscheid
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Lübeck, Germany
- Universitätsklinikum Schleswig-Holstein
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Lüneburg, Germany
- Städt. Kh. Lüneburg
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Mainz, Germany
- Univ. Mainz
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Marburg, Germany
- Univ. Marburg
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Memmingen, Germany
- Klinkum Memmingen
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Munchen, Germany
- Augustinum
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Munchen, Germany
- Klinikum Bogenhausen
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Munchen, Germany
- Rot-Kreuz Krankenhaus
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Peine, Germany
- Praxis Bitar
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Regensburg, Germany
- Uni Regensburg
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Starnberg, Germany
- Prof. Frey Praxis Starnberg
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Ulm, Germany
- Uni Ulm
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Waren, Germany
- Waren-Müritzklinikum
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Wolgast, Germany
- Klinikum Wolgast
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Avellino, Italy
- Ospedale Moscati
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Chiari (BS), Italy
- Ospedale Mellini
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Conegliano (TV), Italy
- Ospedale Civile
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Foligno (PG), Italy
- Ospedale S. G. Battista
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Mestre (VE), Italy
- Ospedale Umberto I
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Portogruaro (VE), Italy
- Ospedale Civile
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San Donato, Italy
- Istituto Policlinico
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Sesto S. Giovanni (MI), Italy
- Ospedale Civile
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Trento, Italy
- Ospedale Civile
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Venezia, Italy
- Ospedale Civili Reuniti
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Voghera, Italy
- Ospedale Civile
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Birmingham, United Kingdom
- Queen Elizabeth Hospital
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Bristol, United Kingdom
- Bristol Royal Infirmary
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Burton on Trent, United Kingdom
- Queens Hospital
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Hull, United Kingdom
- Castle Hill Hospital
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Leeds, United Kingdom
- Leeds General Infirmary
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London, United Kingdom
- Barts and the London NHS Trust
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London, United Kingdom
- St Thomas' Hospital,
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patient has been primo-implanted with a Symphony™ 2550 or 2450 devices for less than 3 months
- Patient with a normal spontaneous AV conduction at rest (PR < 250 ms)
- Patient implanted for Sinus Node Dysfunction, Braycardia-Tachycardia Syndrome, carotid sinus syndrome/ vaso vagal syndrome or paroxistic AV Block
- Patient implanted with a bipolar right-atrial lead and ventricular lead available in the local market
- Patient has signed a consent form after having received the appropriate information
Exclusion Criteria:
- Permanent 1st, 2nd or 3rd AV block
- Patient having a medical status complying with one of the following cases
- patient suffering from sustained ventricular arrhythmias
- patient having sustained a myocardial infarction within the last month
- patient having undergone cardiac surgery within the last month
- patient suffering from severe aortic stenosis
- patient suffering from unstable angina pectoris
- patient presents with permanent atrial arrhythmias
- Patient is not able to understand the study objectives and protocol or refuses to co-operate
- Patient is not available for scheduled follow-up
- Patient has a life expectancy less than one year
- Patient is included into another clinical study
- Patient is minor or a pregnant woman
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: 1
AAISafeR mode programming
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Active Comparator: 2
DDD with long AV Delay programming
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Active Comparator: 3
DDDAMC mode programming
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Other: 4
AAISafer mode programming in non randomized patients
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
mean percentage of ventricular pacing between the randomized branches on a two-months period (M3 visit)
Time Frame: 2 months
|
2 months
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mean percentage of ventricular pacing between the studied groups during the whole study (up to 1 year).
Time Frame: 12 months
|
12 months
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Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
percentage of ventricular pacing two month after randomization versus the percentage reported at the end of the first month follow-up in AAIsafeR mode.
Time Frame: 12 months
|
12 months
|
AF burden relatively to the branch of the protocol
Time Frame: 12 months
|
12 months
|
evolution of conduction disturbances by documentings nature, number and duration of ario-ventricular blocks.
Time Frame: 12 months
|
12 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jean Marc DAVY, PhD, CH Montpellier
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IGXD02 - SAVER
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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