Assessment of AAIR Pacing Treatment for Heart Failure Patients With Chronotropic Incompetence
調査の概要
状態
条件
詳細な説明
CI is the inability of the heart to increase its rate in response to increased physical activity or metabolic demand, leading to exercise intolerance and poor quality of life. Studies have demonstrated that patients with CI have a high risk of cardiac morbidity and mortality. Recent studies further demonstrate a high incidence of CI in patients with heart failure, which is also confirmed by CI in Heart Failure Study Phase I. However, clinical attention is often paid to heart failure symptoms instead CI-related symptom. Thus, patients with heart failure are often not tested for CI, even though the CI incidence is high in these patients. Moreover, such patients could gain significant improvements in exercise tolerance and quality of life once they get diagnosed followed by effective therapy for CI and long-term management.
This study is designed to establish clinical evidence that AAIR pacing is beneficial to treat CI-caused symptoms in heart failure patients, which will improve the life quality of such patients and further support the expansion of Brady therapy indications to the population of HF with CI in existing markets and also potential markets.
CI is rarely seen and has different definition among various animal species. It is impossible to use animals to get wanted data for AAIR pacing treatment to CI. Thus, a human clinical study is necessary. Furthermore, exercise testings, such as 6 minutes hall walk (6MHW) and treadmill, allow objective evaluation of exercise capacity and exertional symptoms, which have been suggested as other investigations for HF in "ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012". Therefore, exercise testings will be applied upon physicians' need or judgment.
Firstly, this study is to assess the effect of AAIR pacing treatment for HF patients with CI in terms of exercise tolerance and quality of life. Specifically, the study will assess the changes in cardiac function associated with changes of physical exercise intensity and heart rate in AAIR pacing mode compared with AAI pacing mode. Secondly, the study will look at clinical outcomes in terms of NYHA class, 6MHW, blood BNP, Echo measurements following pacemaker therapy for 1 year. 6MHW and treadmill tests have been suggested as other investigations for HF in "ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012" and will be performed upon physicians' need or judgment.
The study will enroll up to 30 subjects that meet the indication for pacing therapy. Consented subjects will receive pacing therapy and two follow-ups in the following one year.
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Beijing
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Beijing、Beijing、中国、100037
- Fuwai Hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Patient is willing to give informed consent.
- Patient is between 18 and 70 years of age (including 18 and 70 years of age).
- Patients can perform treadmill exercise test for at least 8 minutes.
- Patient has been diagnosed with stable chronic HF according to HF guidance, including HFpEF (Heart Failure with preserved Ejection Fraction) and HFrEF (Heart Failure with reduced Ejection Fraction) patients.
- NYHA class I- III, with left ventricular ejection fraction less than 55% and more than 25%.
- Heart rate during treadmill test cannot reach 70% APMHR (Age Predicted Maximal Heart Rate) in (diagnostic criteria for CI, in accordance with class IA indications of pacing therapy for CI).
Exclusion Criteria:
- Patient with severe liver or kidney dysfunction.
- Patient has contraindications for pacing therapy.
- Patient has CI and is under appropriate clinical therapy.
- Patient has persistent or permanent atrial fibrillation (AF).
- Patient whose heart rate baseline at resting state is greater than 95 beats per minutes (BPM).
- Patient has contraindications for cardio-pulmonary exercise testing, including but not limited to unstable angina, decompensated heart failure, active pericarditis or myocarditis, hypertrophic cardiomyopathy, valvular heart disease and ECG ST-segment shift > 2mm at resting state.
- Less than 6 months after angina and ST dynamic changes during last 3 months.
- Patient with class I (with PR interval more than 200ms), II or III atrioventricular block, or interventricular block.
- NYHA Class IV.
- Less than 45 days after myocardial infarction.
- Less than 3 months after acute heart failure.
- Patient has uncontrolled hypertension.
- Patient is unwilling to sign the patient informed consent.
- Patient is pregnant or has pregnancy intention in the study duration.
- Patient has a medical condition that would limit study participation.
- Patient is enrolled in a concurrent study that may affect the outcome of this study.
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 観測モデル：ケースクロスオーバー
- 時間の展望：見込みのある
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
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The treadmill walk duration change
時間枠：The treadmill walk duration change from 3-6 months to 6-12 months post pacemaker implantation
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The treadmill walk duration change from 3-6 months to 6-12 months post pacemaker implantation
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二次結果の測定
結果測定 |
時間枠 |
|---|---|
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The 6 minutes hall walk distance change
時間枠：3-6 months and 6-12 months post pacemaker implantation
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3-6 months and 6-12 months post pacemaker implantation
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協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
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