Temporary Epicardial Cardiac Resynchronisation.

NCT ID: NCT01027299

Last Updated: 2020-01-29

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

NA

Total Enrollment

31 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-12-31

Study Completion Date

2012-01-31

Brief Summary

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This trial will investigate the clinical and haemodynamic effects of temporary biventricular pacing after cardiac surgery. Subjects with poor left ventricular systolic function will receive either temporary biventricular pacing or 'standard' post-operative pacing for 48 hours.

The investigators hypothesis that reversal of cardiac dyssynchrony will improve tissue perfusion and cardiac haemodynamics after surgical revascularisation. This will shorten post-operative recovery in cardiac ITU.

Detailed Description

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Patients with poor left ventricular (LV) function are at higher risk of complications after cardiac surgery, compared to patients with preserved LV function. The higher complication rates also lead to prolonged Cardiac Intensive Care (CITU) admissions for monitoring and multi-organ support.

The investigators hypothesise that BiV pacing will reverse cardiac dyssynchrony and improve target organ perfusion. This will be significantly reduced the post operative requirement for Level 3 CITU care.

This study will compare 48 hours of temporary biventricular (BiV) pacing to enhance cardiac function against standard post-operative pacing, in patients with poor LV function undergoing cardiac surgery. Temporary biventricular (BiV) pacing will be achieved with the addition of a third pacing electrode attached to the left ventricle. Using a pulmonary arterial catheter the interventricular (VV) delay will be adjusted to yield the maximum cardiac output at constant heart rate- sequential BiV pacing. A pilot study conducted at the University Hospital of Wales (UHW) showed that this approach is likely to be successful.

The primary endpoint of the study will be the mean duration of Level 3 CITU care required by patients after cardiac surgery. Secondary endpoints will include: haemodynamic improvement with BiV pacing; post-operative renal function; atrial fibrillation (AF)/ ventricular arrhythmias; post operative inotropic requirements and changes in biomarkers- NT Pro BNP and Troponin T.

Conditions

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Cardiac Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Standard pacing

Standard pacing settings prescribed by the cardiac surgeon or intensivist after revascularisation.

Group Type ACTIVE_COMPARATOR

Biventricular pacing

Intervention Type DEVICE

Optimised temporary biventricular pacing.

BiVentricular pacing (BiV).

The group of patients receiving biventricular pacing after cardiac surgery.

Group Type ACTIVE_COMPARATOR

Biventricular pacing

Intervention Type DEVICE

Optimised temporary biventricular pacing.

Interventions

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Biventricular pacing

Optimised temporary biventricular pacing.

Intervention Type DEVICE

Other Intervention Names

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Standard pacing

Eligibility Criteria

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Inclusion Criteria

* Coronary disease scheduled for surgical revascularisation. Ejection fraction \<35% (simpson's method.)

Exclusion Criteria

* Permanent pacemaker or implantable defibrillator. Dialysis dependent renal failure. Permanent atrial fibrillation.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cardiff and Vale University Health Board

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Zaheer R Yousef, MD

Role: STUDY_DIRECTOR

Cardiff and Vale Local Heath Board, Cardiff.

Locations

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Cardiff and Vale University Health Board.

Cardiff, , United Kingdom

Site Status

Morriston Hospital

Swansea, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Russell SJ, Tan C, O'Keefe P, Ashraf S, Zaidi A, Fraser AG, Yousef ZR. Optimized temporary bi-ventricular pacing improves haemodynamic function after on-pump cardiac surgery in patients with severe left ventricular systolic dysfunction: a two-centre randomized control trial. Eur J Cardiothorac Surg. 2012 Dec;42(6):e146-51. doi: 10.1093/ejcts/ezs492.

Reference Type DERIVED
PMID: 23138590 (View on PubMed)

Russell SJ, Tan C, O'Keefe P, Ashraf S, Zaidi A, Fraser AG, Yousef ZR. Temporary epicardial cardiac resynchronisation versus conventional right ventricular pacing after cardiac surgery: study protocol for a randomised control trial. Trials. 2012 Feb 20;13:20. doi: 10.1186/1745-6215-13-20.

Reference Type DERIVED
PMID: 22348447 (View on PubMed)

Other Identifiers

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09/CAD/4628

Identifier Type: -

Identifier Source: org_study_id

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