Spontaneous Atrio Ventricular Conduction Preservation

NCT ID: NCT00655213

Last Updated: 2008-04-09

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

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

622 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-11-30

Study Completion Date

2006-12-31

Brief Summary

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In case of sinus node dysfunction, it is often necessary to choose the safer option provided by a DDD pacemaker even though the most appropriate mode of pacing is AAI mode.

In addition to saving energy, the latter mode allows spontaneous ventricular activation, the haemodynamic consequences of which are, in most cases, better than those obtained with dual chamber pacing.

Recent studies as the MOST study suggest also that ventricular desynchronization imposed by right ventricular apical pacing even when AV synchrony is preserved increases the risk of atrial fibrillation in patients with SND. Similar results were already given by anterior studies (PIPAF) which, taking into account the percentage of ventricular pacing, suggested that AF prevention algorithm in combination with a preserved native conduction are efficient in reducing AF burden.

However, current practice is to implant a dual chamber pacemaker to prevent the risk of atrioventricular block (AVB) even if DDDR pacing with a fixed long AV delay was found inefficient in reducing ventricular pacing and was associated with a high risk of arrhythmias.

The Symphony 2550 cardiac pacemaker offers pacing modes that automatically switch from AAI(R) mode to DDD(R) or DDI(R) in event of severe atrioventricular conduction disorder, irrespective of whether or not these are accompanied by an atrial arrhythmia, returning spontaneously to AAI(R) mode as soon as the spontaneous AV conduction has resumed. These 2 particular modes are called the AAI SafeR and DDD/AMC (R) mode.

The main differences between both modes are that (i) AAI SafeR does not trigger any AV Delay after a sensed or paced atrial event which allows long PR intervals or even limited ventricular pauses with no switch to DDD(R), while (ii) DDD/AMC (R) is able to optimize AV Delay after switching to DDD(R) according to measured spontaneous conduction times and to provide an acceleration in case of vaso-vagal syndrome. This pacing mode has previously been assessed in clinical studies.

This study intends to demonstrate that the automatic modes switching significantly reduce the percentage of ventricular pacing in patients implanted with a spontaneous AV conduction and reduce the occurrence of atrial arrhythmias, on a mid-term follow-up period, in comparison to standard DDD pacing with long AVDelay.

Detailed Description

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Conditions

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Sinus Node Dysfunction Bradycardia-Tachycardia Syndrome Paroxysmal Atrioventricular Block

Keywords

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Pacing, AV conduction disorders, minimized ventricular pacing, AF

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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1

AAISafeR mode programming

Group Type ACTIVE_COMPARATOR

Symphony D 2450

Intervention Type DEVICE

Symphony DR 2550

Intervention Type DEVICE

2

DDD with long AV Delay programming

Group Type ACTIVE_COMPARATOR

Symphony D 2450

Intervention Type DEVICE

Symphony DR 2550

Intervention Type DEVICE

3

DDDAMC mode programming

Group Type ACTIVE_COMPARATOR

Symphony D 2450

Intervention Type DEVICE

Symphony DR 2550

Intervention Type DEVICE

4

AAISafer mode programming in non randomized patients

Group Type OTHER

Symphony D 2450

Intervention Type DEVICE

Symphony DR 2550

Intervention Type DEVICE

Interventions

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Symphony D 2450

Intervention Type DEVICE

Symphony DR 2550

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patient has been primo-implanted with a Symphony™ 2550 or 2450 devices for less than 3 months
* Patient with a normal spontaneous AV conduction at rest (PR \< 250 ms)
* Patient implanted for Sinus Node Dysfunction, Braycardia-Tachycardia Syndrome, carotid sinus syndrome/ vaso vagal syndrome or paroxistic AV Block
* Patient implanted with a bipolar right-atrial lead and ventricular lead available in the local market
* Patient has signed a consent form after having received the appropriate information

Exclusion Criteria

* Permanent 1st, 2nd or 3rd AV block
* Patient having a medical status complying with one of the following cases
* patient suffering from sustained ventricular arrhythmias
* patient having sustained a myocardial infarction within the last month
* patient having undergone cardiac surgery within the last month
* patient suffering from severe aortic stenosis
* patient suffering from unstable angina pectoris
* patient presents with permanent atrial arrhythmias
* Patient is not able to understand the study objectives and protocol or refuses to co-operate
* Patient is not available for scheduled follow-up
* Patient has a life expectancy less than one year
* Patient is included into another clinical study
* Patient is minor or a pregnant woman
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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LivaNova

INDUSTRY

Sponsor Role lead

Responsible Party

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CH Montpellier

Principal Investigators

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Jean Marc DAVY, PhD

Role: PRINCIPAL_INVESTIGATOR

CH Montpellier

Locations

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Onze lieve Vrouw ziekenhuis

Aalst, , Belgium

Site Status

Clinique Louis Caty

Baudour, , Belgium

Site Status

Hôpital universitaire Brugmann

Brussels, , Belgium

Site Status

Europa ziekenhuis

Campus Saint Elisabeth Uccle, , Belgium

Site Status

Heiling Hart van Jezus

Moen, , Belgium

Site Status

Hôpital Vésale (univ.)

Montigny-le-Tilleul, , Belgium

Site Status

CHU - Tivoli

Tivoli, , Belgium

Site Status

Centre Hospitalier

Aix-en-Provence, , France

Site Status

CH Albi

Albi, , France

Site Status

CHU d'Angers

Angers, , France

Site Status

CHU Jean Minjoz

Besançon, , France

Site Status

CH de CASTRES

Castres-mazamet, , France

Site Status

Hospice St-Jacques-Hôspital G.Montpied

Clermont-Ferrand, , France

Site Status

CHU - Hopital Michallon

Grenoble, , France

Site Status

CHRU de Lille - Hôpital Cardiologique

Lille, , France

Site Status

CHU de Limoges

Limoges, , France

Site Status

CH Montpellier

Montpellier, , France

Site Status

CH Emile Muller

Mulhouse, , France

Site Status

CHU de Nantes

Nantes, , France

Site Status

Nouvelles Cliniques Nantaises

Nantes, , France

Site Status

CHU de Nice

Nice, , France

Site Status

Clinique Bizet

Paris, , France

Site Status

CHU Pontchaillou

Rennes, , France

Site Status

CHU Hopital C. Nicolle

Rouen, , France

Site Status

InParys Cardiology

Saint-Cloud, , France

Site Status

CHU de Nancy

Vandœuvre-lès-Nancy, , France

Site Status

Marien Hospital

Bonn, , Germany

Site Status

Universitätskliniken Bonn

Bonn, , Germany

Site Status

St.Josef-Stift Bremen

Bremen, , Germany

Site Status

KH Holweide

Cologne, , Germany

Site Status

St. Salvator Krankenhaus Halberstadt

Halberstadt, , Germany

Site Status

Holzminden Praxis Bub

Holzminden, , Germany

Site Status

Hürth Sana

Hürth, , Germany

Site Status

Herzzentrum Kassel

Kassel, , Germany

Site Status

Universitätsklinikum Schleswig-Holstein

Lübeck, , Germany

Site Status

Klinikum Lüdenscheid

Lüdenscheid, , Germany

Site Status

Städt. Kh. Lüneburg

Lüneburg, , Germany

Site Status

Univ. Mainz

Mainz, , Germany

Site Status

Univ. Marburg

Marburg, , Germany

Site Status

Klinkum Memmingen

Memmingen, , Germany

Site Status

Augustinum

München, , Germany

Site Status

Klinikum Bogenhausen

München, , Germany

Site Status

Rot-Kreuz Krankenhaus

München, , Germany

Site Status

Praxis Bitar

Peine, , Germany

Site Status

Uni Regensburg

Regensburg, , Germany

Site Status

Prof. Frey Praxis Starnberg

Starnberg, , Germany

Site Status

Uni Ulm

Ulm, , Germany

Site Status

Waren-Müritzklinikum

Waren, , Germany

Site Status

Klinikum Wolgast

Wolgast, , Germany

Site Status

Ospedale Moscati

Avellino, , Italy

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Ospedale Mellini

Chiari (BS), , Italy

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Ospedale Civile

Conegliano (TV), , Italy

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Ospedale S. G. Battista

Foligno (PG), , Italy

Site Status

Ospedale Umberto I

Mestre (VE), , Italy

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Ospedale Civile

Portogruaro (VE), , Italy

Site Status

Istituto Policlinico

San Donato, , Italy

Site Status

Ospedale Civile

Sesto S. Giovanni (MI), , Italy

Site Status

Ospedale Civile

Trento, , Italy

Site Status

Ospedale Civili Reuniti

Venezia, , Italy

Site Status

Ospedale Civile

Voghera, , Italy

Site Status

Queen Elizabeth Hospital

Birmingham, , United Kingdom

Site Status

Bristol Royal Infirmary

Bristol, , United Kingdom

Site Status

Queens Hospital

Burton-on-Trent, , United Kingdom

Site Status

Castle Hill Hospital

Hull, , United Kingdom

Site Status

Leeds General Infirmary

Leeds, , United Kingdom

Site Status

Barts and The London NHS Trust

London, , United Kingdom

Site Status

St Thomas' Hospital,

London, , United Kingdom

Site Status

Countries

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Belgium France Germany Italy United Kingdom

Other Identifiers

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IGXD02 - SAVER

Identifier Type: -

Identifier Source: org_study_id