A Pilot Study Comparing the Programmed Delay Between the Atrial and Ventricle Interval (BRAVO-CRT)

June 22, 2012 updated by: University of Minnesota

A Pilot Study of theRelationship Between Atrio-Ventricular Delay and Changes in Biochemical Markers of Chronic Heart Failure During Cardiac Resynchronization Therapy (BRAVO-CRT)

The idea of this study is to compare different ways of setting up a pacemaker, using blood tests to give us information about how well it's working. We hope to learn if we can use this approach to figure out the best pacemaker setup ("programming") for each individual patient.

The setting we propose to adjust is the timing between the impulse sent between top and bottom chambers.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

There are different kinds of pacemakers and different ways they can be set up to try to make the heart beat regularly. A normal heart has four chambers; these four chambers pump in a co-ordinated way to move blood effectively. When pacemakers were first invented, they told the heart when to pump, but didn't make the four chambers work well together. Newer pacemakers can give more detailed instructions, so the chambers work together more effectively. We already know that the newer (bi-ventricular) pacemakers work better for some patients with heart failure.

There are blood tests (often referred to as "markers") that give us information about how well your heart is working and about how your body is responding to heart failure. The idea of this study is to compare different ways of setting up a pacemaker, using these blood tests to give us information about how well it's working. We hope to learn if we can use this approach to figure out the best pacemaker setup ("programming") for each individual patient.

Usually pacemakers have two wires or leads, one is in the top right chamber and the other in the bottom right chamber of the heart. The newer pacemakers, which are given to patients with heart failure, have an additional lead or wire, which goes to the left side of the heart. So when heart contracts the lead from top chamber sends impulses to bottom chambers and the leads in right and left sides of bottom chamber responds by sending impulses in a co-ordinated way enabling heart to contract efficiently.

Currently, the standard way of treating patients with heart failure is by pacing the top and then bottom chambers, based on a timing interval determined by ultrasound, while also pacing the two bottom chambers in a coordinated manner. There are differences of opinion among experts and by previous studies regarding this method. Pacing is accomplished through pacemaker wires, which are placed in the right top chamber, the right bottom chamber and the left bottom chamber of the heart.

The setting we propose to adjust is the timing between the impulse sent between top and bottom chambers.

Study Type

Interventional

Enrollment (Actual)

25

Phase

  • Early Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Minnesota
      • Minneapolis, Minnesota, United States, 55455
        • University of Minnesota

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Diagnosis of chronic heart failure
  • patients on stable pharmacologic therapy for at least 3 months
  • EF< 35%
  • age >18 years
  • NYHA functional class III or IV
  • eligible for either CRT pacer or CRT defibrillator for heart failure
  • Ischemic or non-ischemic cardiomyopathy
  • patients that are able to tolerate VDD mode with a lower rate of 40bpm programming

Exclusion Criteria:

  • systolic blood pressure <70mmHg
  • Likely to receive a left ventricular assist device or cardiac transplant within 6 months of implant procedure
  • patients who have previously received a CRT device
  • documented atrial fibrillation
  • complete heart block

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: 1
AVD set by taking the larger of 0.50ms or A-V interval 0.30
Device: CRT device settings
Comparision of A-V delay settings
Active Comparator: 2
AVD set by taking the larger of 0.50ms or A-V interval 0.50
Device: CRT device settings
Comparision of A-V delay settings
Active Comparator: 3
AVD set by taking the larger of 0.50ms or A-V interval 0.70
Device: CRT device settings
Comparision of A-V delay settings

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
To assess the effect of CRT atrioventricular delay settings on biochemical markers in blood through 6 months
Time Frame: end of the study
end of the study

Secondary Outcome Measures

Outcome Measure
Time Frame
assess effects of echocardiogram through 6months after CRT on heart failure
Time Frame: end to study
end to study
assess the effects of minnesota Living with heart failure questionaire through 6 months after CRT on heart failure
Time Frame: end of study
end of study
assess effects of six minute hall walk through 6 months after CRt on heart failure
Time Frame: end of study
end of study
assess effects of SDANN through 6 months after CRT on heart failure
Time Frame: end of study
end of study

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Minnesota

Collaborators

Minnesota Medical Foundation

Investigators

  • Principal Investigator: David G Benditt, MD, University of Minnesota

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

June 1, 2004

Primary Completion (Actual)

May 1, 2010

Study Completion (Actual)

November 1, 2010

Study Registration Dates

First Submitted

November 18, 2008

First Submitted That Met QC Criteria

November 18, 2008

First Posted (Estimate)

November 19, 2008

Study Record Updates

Last Update Posted (Estimate)

June 26, 2012

Last Update Submitted That Met QC Criteria

June 22, 2012

Last Verified

June 1, 2012

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 0303M44604

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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