Ventricular Pacing Site Selection (V-PASS)

NCT ID: NCT00292383

Last Updated: 2011-08-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Completion Date

2008-12-31

Brief Summary

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The purpose of this study is to determine whether there is a relationship between ventricular lead position and the incidence of heart failure and atrial fibrillation in patients with indication for permanent pacemaker stimulation.

Detailed Description

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AV-Block of higher degree is the primary indication for pacing therapy for about 20% of pacemaker patients. Pacing systems with only ventricular stimulation (VVI and VDD) have a fraction of about 40% of all pacemakers in Germany. About 50% of the implanted pacemakers in Germany are dual-chamber pacemakers and one half of them is used for treatment of AV blocks.

Picture 1: Fractions of pacing indications in Germany Picture 2: Fractions of used pacing modes in Germany /1/

A lot of studies proved in the past that the pacing site influenced the development of hemodynamics, heart failure (HF) and atrial fibrillation (AF). Unfortunately, the results are not commonly applicable or statistically assured. Due to this, further examinations are required in order to get explicit statements regarding application of alternative, nonapical ventricular lead positioning.

1. Pilotphase It shall be determined whether a randomized positioning of ventricular leads at 2 defined positions (either Group A: Positioning at right ventricular apex or Group B:. Positioning at right ventricular high septum) is feasible. Included patients will already by examined and followed according to protocol. After having proved feasibility of randomized positioning, the data of these patients shall be used for evaluation of the V-PASS study.
2. Study Phase It shall be evaluated how far 2 defined different ventricular lead positions for permanent pacemaker therapy can influence the combined study endpoint mortality and clinically relevant symptoms of heart failure. Further more the development of hemodynamics and the incidence of atrial fibrillation shall be studied.

Conditions

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Atrioventricular Block

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Interventions

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Leads to be implanted according randomization on specified sites. Vitatron pacemakers to be implanted: T60 DR, T70 DR, T20 SR, C60 DR

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

Patients with an expected ventricular stimulation rate of \>60% in planned pacing therapy. This will be the following pacing indications

* Symptomatic first-degree AV block, PQ time \>250ms
* Second-degree Av block with permanent 2:1 conduction
* Permanent third-degree AV block
* Paroxysmal first-degree to third-degree Av block, with an anticipated rate of ventricular stimulation \>60%
* Symptomatic bradyarrhythmia absoluta with permanent atrial fibrillation, with an anticipated rate of ventricular stimulation \>60%

Exclusion Criteria

* heart failure acc. NYHA III or IV
* Intra-atrial conduction delay (P-wave \> 150ms)
* Myocardial infarction less then 6 months before pacemaker implant
* hypertrophic obstructive cardiomyopathy
* Cardiogenic shock
* pregnancy
* Lactation period
* Patients under 18 years of age
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Vitatron GmbH

INDUSTRY

Sponsor Role collaborator

Medtronic BRC

INDUSTRY

Sponsor Role lead

Principal Investigators

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Jochem F. Stockinger, MD

Role: PRINCIPAL_INVESTIGATOR

Herzzentrum Bad Krozingen

Locations

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Herzzentrum Bad Krozingen, Elektrophysiologie

Bad Krozingen, , Germany

Site Status RECRUITING

Universitätsklinikum Heidelberg, Innere Medizin III

Heidelberg, , Germany

Site Status NOT_YET_RECRUITING

Oberschwaben Klinik GmbH, Krankenhaus Wangen, Innere Med.

Wangen, , Germany

Site Status NOT_YET_RECRUITING

Countries

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Germany

Central Contacts

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Matthias E Reimers, Dipl. Documentalist

Role: CONTACT

0049021152930 ext. 422

Steffen Gazarek, Dr., Engineer

Role: CONTACT

004901729135662

Facility Contacts

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Jochem Stockinger, MD

Role: primary

0049 07633402 ext. 248

Alexander Bauer, MD

Role: primary

++49 0622563 ext. 8672

Jörg Maurus, MD

Role: primary

0049 00752296 ext. 1311

References

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Fachgruppe Herzschrittmacher. Bericht des Deutschen Herzschrittmacher Registers 2003 http://www.pacemaker-register.de/pdf/zentralregister_herzschrittmacher_bericht03.pdf

Reference Type BACKGROUND

DÄNISCHES HERZSCHRITTMACHERREGISTER http://www.pacemaker.dk

Reference Type BACKGROUND

SCHWEIZER HERZSCHRITTMACHERREGISTER http://www.pacemaker.ch

Reference Type BACKGROUND

Lemke B, Nowak B, Pfeiffer D; Deutschen Gesellschaft fur Kardiologie--Herz- und Kreislaufforschung e.V. Bearbeitet im Auftrag der Kommission fur Klinische Kardiologie. [Guidelines for heart pacemaker therapy]. Z Kardiol. 2005 Oct;94(10):704-20. doi: 10.1007/s00392-005-0269-3. No abstract available. German.

Reference Type BACKGROUND
PMID: 16200488 (View on PubMed)

Gregoratos G., Abrams J. Epstein AE, et al. ACC/AHA /NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (ACC/AHA/NASPE Committee on Pacemaker Implantation)(2002). http://www.acc.org/clinical/guidelines/pacemaker/pacemaker.pdf

Reference Type BACKGROUND

Lamas GA, Lee KL, Sweeney MO, Silverman R, Leon A, Yee R, Marinchak RA, Flaker G, Schron E, Orav EJ, Hellkamp AS, Greer S, McAnulty J, Ellenbogen K, Ehlert F, Freedman RA, Estes NA 3rd, Greenspon A, Goldman L; Mode Selection Trial in Sinus-Node Dysfunction. Ventricular pacing or dual-chamber pacing for sinus-node dysfunction. N Engl J Med. 2002 Jun 13;346(24):1854-62. doi: 10.1056/NEJMoa013040.

Reference Type BACKGROUND
PMID: 12063369 (View on PubMed)

Frohlig G, Schwaab B, Kindermann M. Selective site pacing: the right ventricular approach. Pacing Clin Electrophysiol. 2004 Jun;27(6 Pt 2):855-61. doi: 10.1111/j.1540-8159.2004.00547.x.

Reference Type BACKGROUND
PMID: 15189516 (View on PubMed)

Koglek W, Kranig W, Kowalski M, Kronski D, Brandl J, Oberbichler A, Suntinger A, Wutte M, Grimm G, Grove R, Ludorff G. [A simple method for AV-delay determination in dual chamber pacemakers]. Herzschrittmacherther Elektrophysiol. 2000 Dec;11(4):244-53. doi: 10.1007/s003990070023. German.

Reference Type BACKGROUND
PMID: 27515355 (View on PubMed)

Giudici MC, Thornburg GA, Buck DL, Coyne EP, Walton MC, Paul DL, Sutton J. Comparison of right ventricular outflow tract and apical lead permanent pacing on cardiac output. Am J Cardiol. 1997 Jan 15;79(2):209-12. doi: 10.1016/s0002-9149(96)00718-7.

Reference Type BACKGROUND
PMID: 9193029 (View on PubMed)

Other Identifiers

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V-PASS V.1.2.

Identifier Type: -

Identifier Source: org_study_id

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