Ambulatorisk elektrokardiografisk overvåking for påvisning av høygradig atrioventrikulær blokk hos pasienter med nyoppstått persistent venstre bunt grenblokk etter transkateter aortaklaffimplantasjon. "MARE"-studien (MARE)
2. november 2026 oppdatert av: Josep Rodes-Cabau, Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Quebec
The purpose of this study is to determine the incidence and predictors of high degree or complete atrioventricular block (AVB) (paroxysmal or persistent) in patients with new-onset persistent left bundle branch block (NOP-LBBB) following transcatheter aortic valve implantation (TAVI) and to evaluate the usefulness of the Reveal LINQ® insertable Cardiac Monitor (ICM) (Medtronic, Inc., Minneapolis, USA) for the detection of significant arrhythmias in patients with NOP-LBBB following TAVI.
Studieoversikt
Status
Rekruttering
Intervensjon / Behandling
Detaljert beskrivelse
This is a prospective observational study including patients undergoing TAVI with either self- or balloon-expandable valves. After the procedure, patients will be on ECG monitoring during the hospitalization period (or at least 72 hours), and an ECG will be performed daily until hospital discharge in all patients. Patients with new-onset persistent LBBB at hospital discharge (new-onset LBBB of a duration of at least 48 h which persists at hospital discharge, at least 3 days and up to 15 days after the procedure) will receive an implantable loop recorder Reveal ICM LINQ®, which will be implanted subcutaneously to record adequate QRS complexes and P waves. The patients will be followed in outpatient clinic visits at 1, 12, 24 and 36 months after TAVR, or if symptoms suggestive of cardiac origin or relevant arrhythmic events occur. The device will be manually interrogated in each visit. Phone contacts will be also carried out every three months.
Studietype
Intervensjonell
Registrering (Antatt)
80
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
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Quebec
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Québec, Quebec, Canada, G1V 4G5
- Rekruttering
- IUCPQ
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Ta kontakt med:
- Emilie Pelletier Beaumont, M.Sc.
- Telefonnummer: 3929 418-656-8711
- E-post: Emilie.Pelletier-Beaumont@criucpq.ulaval.ca
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Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
18 år og eldre (Voksen, Eldre voksen)
Tar imot friske frivillige
Ja
Kjønn som er kvalifisert for studier
Alle
Beskrivelse
Inclusion Criteria:
-Patients undergoing TAVI with either balloon or self-expandable valves who develop new-onset LBBB persistent at hospital discharge, at least 3 days after the procedure
Exclusion Criteria:
- Failure to provide informed consent
- Baseline pacemaker/defibrillator or pacemaker/defibrillator implanted during the hospitalization period following the TAVI procedure
- Pre-existing complete LBBB
- Patients with a life-expectancy of less than 2 years
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Diagnostisk
- Tildeling: N/A
- Intervensjonsmodell: Enkeltgruppeoppdrag
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
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Eksperimentell: Implanterbare sløyfeopptakere Reveal ICM LINQ®,
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
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-Rate og tidspunkt for utbruddet av høy grad eller fullstendig AVB
Tidsramme: 1 år
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1 år
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-Forekomst av arytmiske hendelser identifisert av IRL som fører til endring i behandling eller større uønsket hendelse
Tidsramme: 1 år
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1 år
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Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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-Rate av høy grad eller fullstendig AVB
Tidsramme: Innen den første måneden etter TAVI-prosedyren
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Innen den første måneden etter TAVI-prosedyren
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-Rate av høy grad eller fullstendig AVB
Tidsramme: 6 måneders oppfølging
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6 måneders oppfølging
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-Rate av høy grad eller fullstendig AVB
Tidsramme: 24 måneders oppfølging
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24 måneders oppfølging
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-Rate av høy grad eller fullstendig AVB
Tidsramme: 36 måneders oppfølging
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36 måneders oppfølging
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- Frekvens av nye atrieflimmer eller ventrikulære arytmier
Tidsramme: Innen de første 3 årene etter TAVI-prosedyren
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Innen de første 3 årene etter TAVI-prosedyren
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-Endringer i venstre ventrikkelfunksjon og mitralregurgitasjon over tid
Tidsramme: Innen de første 3 årene etter TAVI-prosedyren
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Innen de første 3 årene etter TAVI-prosedyren
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-Electrocardiographic and device-related factors predicting the occurence of high degree or complete AVB in patients with new-onset LBBB after TAVI
Tidsramme: Within the first 3 years following TAVI procedure
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Periprocedural results of TAVI of patients with NOP-LVV will be used to characterize predictors of high degree or complete AVB. Moreover, electrocardiographic characteristics at hospital discharge of patients with NOP-LVV will also be used to characterize predictors of high degree or complete AVB. |
Within the first 3 years following TAVI procedure
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Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Etterforskere
- Hovedetterforsker: Josep Rodes, MD, Fondation IUCPQ
Publikasjoner og nyttige lenker
Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.
Generelle publikasjoner
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- El-Khally Z, Thibault B, Staniloae C, Theroux P, Dubuc M, Roy D, Guerra P, Macle L, Talajic M. Prognostic significance of newly acquired bundle branch block after aortic valve replacement. Am J Cardiol. 2004 Oct 15;94(8):1008-11. doi: 10.1016/j.amjcard.2004.06.055.
- Thomas JL, Dickstein RA, Parker FB Jr, Potts JL, Poirier RA, Fruehan CT, Eich RH. Prognostic significance of the development of left bundle conduction defects following aortic valve replacement. J Thorac Cardiovasc Surg. 1982 Sep;84(3):382-6.
- Foppl M, Hoffmann A, Amann FW, Roth J, Stulz P, Hasse J, Gradel E, Burckhardt D. Sudden cardiac death after aortic valve surgery: incidence and concomitant factors. Clin Cardiol. 1989 Apr;12(4):202-7. doi: 10.1002/clc.4960120405.
- van der Boon RM, Nuis RJ, Van Mieghem NM, Jordaens L, Rodes-Cabau J, van Domburg RT, Serruys PW, Anderson RH, de Jaegere PP. New conduction abnormalities after TAVI--frequency and causes. Nat Rev Cardiol. 2012 May 1;9(8):454-63. doi: 10.1038/nrcardio.2012.58.
- Dou J, Xia L, Zhang Y, Shou G, Wei Q, Liu F, Crozier S. Mechanical analysis of congestive heart failure caused by bundle branch block based on an electromechanical canine heart model. Phys Med Biol. 2009 Jan 21;54(2):353-71. doi: 10.1088/0031-9155/54/2/012. Epub 2008 Dec 19.
- Piazza N, Nuis RJ, Tzikas A, Otten A, Onuma Y, Garcia-Garcia H, Schultz C, van Domburg R, van Es GA, van Geuns R, de Jaegere P, Serruys PW. Persistent conduction abnormalities and requirements for pacemaking six months after transcatheter aortic valve implantation. EuroIntervention. 2010 Sep;6(4):475-84. doi: 10.4244/EIJ30V6I4A80.
- Houthuizen P, Van Garsse LA, Poels TT, de Jaegere P, van der Boon RM, Swinkels BM, Ten Berg JM, van der Kley F, Schalij MJ, Baan J Jr, Cocchieri R, Brueren GR, van Straten AH, den Heijer P, Bentala M, van Ommen V, Kluin J, Stella PR, Prins MH, Maessen JG, Prinzen FW. Left bundle-branch block induced by transcatheter aortic valve implantation increases risk of death. Circulation. 2012 Aug 7;126(6):720-8. doi: 10.1161/CIRCULATIONAHA.112.101055. Epub 2012 Jul 12.
- Testa L, Latib A, De Marco F, De Carlo M, Agnifili M, Latini RA, Petronio AS, Ettori F, Poli A, De Servi S, Ramondo A, Napodano M, Klugmann S, Ussia GP, Tamburino C, Brambilla N, Colombo A, Bedogni F. Clinical impact of persistent left bundle-branch block after transcatheter aortic valve implantation with CoreValve Revalving System. Circulation. 2013 Mar 26;127(12):1300-7. doi: 10.1161/CIRCULATIONAHA.112.001099. Epub 2013 Feb 26.
- Urena M, Mok M, Serra V, Dumont E, Nombela-Franco L, DeLarochelliere R, Doyle D, Igual A, Larose E, Amat-Santos I, Cote M, Cuellar H, Pibarot P, de Jaegere P, Philippon F, Garcia del Blanco B, Rodes-Cabau J. Predictive factors and long-term clinical consequences of persistent left bundle branch block following transcatheter aortic valve implantation with a balloon-expandable valve. J Am Coll Cardiol. 2012 Oct 30;60(18):1743-52. doi: 10.1016/j.jacc.2012.07.035. Epub 2012 Oct 3.
- Moya A, Garcia-Civera R, Croci F, Menozzi C, Brugada J, Ammirati F, Del Rosso A, Bellver-Navarro A, Garcia-Sacristan J, Bortnik M, Mont L, Ruiz-Granell R, Navarro X; Bradycardia detection in Bundle Branch Block (B4) study. Diagnosis, management, and outcomes of patients with syncope and bundle branch block. Eur Heart J. 2011 Jun;32(12):1535-41. doi: 10.1093/eurheartj/ehr071. Epub 2011 Mar 28.
- Furukawa T, Maggi R, Bertolone C, Fontana D, Brignole M. Additional diagnostic value of very prolonged observation by implantable loop recorder in patients with unexplained syncope. J Cardiovasc Electrophysiol. 2012 Jan;23(1):67-71. doi: 10.1111/j.1540-8167.2011.02133.x. Epub 2011 Jul 21.
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- Rodes-Cabau J, Urena M, Nombela-Franco L, Amat-Santos I, Kleiman N, Munoz-Garcia A, Atienza F, Serra V, Deyell MW, Veiga-Fernandez G, Masson JB, Canadas-Godoy V, Himbert D, Castrodeza J, Elizaga J, Francisco Pascual J, Webb JG, de la Torre JM, Asmarats L, Pelletier-Beaumont E, Philippon F. Arrhythmic Burden as Determined by Ambulatory Continuous Cardiac Monitoring in Patients With New-Onset Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Replacement: The MARE Study. JACC Cardiovasc Interv. 2018 Aug 13;11(15):1495-1505. doi: 10.1016/j.jcin.2018.04.016. Epub 2018 Jul 18.
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Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart
1. januar 2014
Primær fullføring (Faktiske)
1. mai 2020
Studiet fullført (Antatt)
1. juli 2027
Datoer for studieregistrering
Først innsendt
26. mai 2014
Først innsendt som oppfylte QC-kriteriene
29. mai 2014
Først lagt ut (Antatt)
3. juni 2014
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
4. november 2026
Siste oppdatering sendt inn som oppfylte QC-kriteriene
2. november 2026
Sist bekreftet
1. november 2026
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- MARE
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