LBBB 和正常或轻度降低的心室功能与 CRT 的再同步比较 (REINVENT-CRT) (REINVENT)
LBBB 和正常或轻度降低的心室功能与 CRT (REINVENT-CRT) 的再同步化比较,一项 I 期前瞻性随机对照试验
Primary Objective - To determine if implantation of a permanent CRT pacing device (with LB-CRT, or conventional BiV-CRT with a coronary sinus LV lead) can improve electromechanical function, HF symptoms, and natriuretic peptide levels among patients with symptomatic HF, LVEF > 35%, and LBBB.
研究概览
详细说明
This pilot study will be a multicenter randomized controlled trial involving 20 medically stable outpatients with heart failure (HF), preserved or mildly reduced LVEF (>35%), and LBBB. Patients will undergo implantation of a Medtronic Percepta CRT-P with an atrial lead, left bundle branch area pacing (LBBap) lead, and a LV lead. They will then be randomly allocated in a 1:1 fashion to usual care plus LB-CRT (DDD 60-130, LV lead turned off) (active intervention #1) or usual care plus BIV-CRT (DDD 60- 130, LV lead turned on) (active intervention #2).
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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North Carolina
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Durham、North Carolina、美国、27710
- Duke University Medical Center
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Virginia
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Falls Church、Virginia、美国、22042
- Inova Health System
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-
参与标准
资格标准
适合学习的年龄
- 孩子
- 成人
- 年长者
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Ability to understand and the willingness to sign a written informed consent form and HIPAA Authorization.
- Stated willingness to comply with all study procedures and availability for the duration of the study
- Male or female aged ≥18 years
- Strict LBBB defined as QRS duration ≥130ms in women and ≥140ms in men, a QS or rS complex in V1 and V2, as well as notching or QRS slurring in mid-QRS in ≥2 contiguous leads.
- NYHA II/III, ambulatory NYHA IV, or NYHA I HF with any prior history of HF symptom decompensation requiring hospitalization, ED visit, or outpatient visit for care with IV diuretic
- LVEF >35% by clinically obtained echocardiogram overread by the study core-lab
- Demonstration of adequate echocardiographic images to allow for assessment of endpoints
- On a stable guideline directed HF medical regimen
- For females of reproductive potential: use of a highly effective contraception for at least 1 month prior to screening and agreement to use such a method during study participation
- Ability to understand and the willingness to sign a written informed consent form and HIPAA Authorization.
Exclusion Criteria:
- Patients with anticipated addition or titration of HF medical therapies (ACE/ARB/ARNI, beta blocker, MRA, SGLT2 inhibitor) during the duration of the study
- Treatment with another investigational drug or other intervention within 3 months
- Current unrevascularized coronary artery disease, unstable angina, acute MI, CABG, or PCI within the past 3 months
- Significant non-functional mitral or aortic valvular disease (severe stenosis or regurgitation)
- Significant structural heart [including hypertrophic cardiomyopathy (septal thickness ≥15 mm) or infiltrative cardiomyopathy (eg. amyloid)]
- Current moderate to severe pulmonary hypertension (right ventricular systolic pressure of ≥40 mmHg)
- Oxygen dependent chronic lung disease
- Prolonged episodes of AF (>3 days or an AF burden >10%) within the preceding 3 months
- Presence of cardiac pacemaker or implantable cardioverter defibrillator
- Prior mechanical tricuspid valve replacement
- Pregnancy or lactation due to concerns about the effect of radiation from the pacemaker implantation procedure on the fetus
- Known allergic reactions to components of the pacemaker or leads
- Febrile illness within 3 days of trial enrollment
- Parents/guardians or participants who, in the opinion of the Investigator, may be non-compliant with study schedules or procedures.
- Control Participant Exclusion Criteria: same
学习计划
研究是如何设计的?
设计细节
- 主要用途:其他
- 分配:随机化
- 介入模型:交叉作业
- 屏蔽:双倍的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的:Sequence 1
LB-CRT - Left Bundle Cardiac Resynchronization Therapy, Participants will spend 3 months in this group |
LB-CRT (DDD 60-130, LV lead turned off) (active intervention #1) BIV-CRT (DDD 60- 130, LV lead turned on) (active intervention #2). |
|
实验性的:Sequence 2
BiV-CRT - Biventricular Pacing Cardiac Resynchronization Therapy. Participants will spend 3 months in this group |
LB-CRT (DDD 60-130, LV lead turned off) (active intervention #1) BIV-CRT (DDD 60- 130, LV lead turned on) (active intervention #2). |
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Change in myocardial performance index (MPI) as compared to Baseline
大体时间:Baseline and 3 month treatment period after each pacing mode
|
Myocardial performance index (MPI), a global measure of cardiac performance is defined using tissue Doppler imaging. |
Baseline and 3 month treatment period after each pacing mode
|
合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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