Tricuspid Regurgitation Study

NCT ID: NCT01093001

Last Updated: 2016-11-03

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

119 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-05-31

Study Completion Date

2016-05-31

Brief Summary

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The effect of cardiac pacing leads on tricuspid regurgitation is unclear. This study will determine whether using a smaller diameter leads and an alternate position in the ventricle, the proximal septum, will reduce tricuspid regurgitation than larger leads placed in the apex.

Detailed Description

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Leads are commonly placed in the right ventricular apex. It is not known whether placing similar leads higher on the septum where there will be less redundancy or pressure on the septal leaflet will change the extent and severity of tricuspid regurgitation following pacemaker/ICD implantation. Data has shown that right ventricular pacing can give rise to right ventricular dysfunction, which in turn may give rise to enlargement of the right ventricle and cause tricuspid regurgitation.

The study will answer the clinically relevant questions on device lead-related tricuspid regurgitation.

This study is a single center prospective study at the Mayo Clinic, Rochester. The study will enroll 200 eligible subjects and follow for 12 months. 50 pacemaker subjects will be randomized to right ventricular apex pacing 50 pacemaker subjects will be randomized to right ventricular septum pacing 50 pacemaker subjects will be randomized to left ventricular pacing via coronary sinus 50 ICD subjects will be enrolled with right ventricular apex pacing.

A baseline heart failure assessment and Two Dimensional echocardiography will be performed before device implant.

A Two Dimensional echo will be performed 24 hours after device implant. If significance TR is present a Three Dimensional echo will be performed. At 12 months post implant heart failure assessment and Two Dimensional echo will be performed.

Conditions

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Tricuspid Regurgitation Right Ventricular Dysfunction Left Ventricular Dysfunction

Keywords

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Reduce Tricuspid Regurgitation Reduce Right Ventricular pacing Lead position Lead size

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Lead size

The pacemaker lead will be \< or = to 7Fr. The ICD lead will be 9 Fr.

Group Type ACTIVE_COMPARATOR

Echo

Intervention Type OTHER

Two dimensional echocardiography will be performed to reassess Tricuspid Regurgitation.

RV Lead position

50 patients will be randomized to RV apex lead placement.

Group Type ACTIVE_COMPARATOR

Echo

Intervention Type OTHER

Two dimensional echocardiography will be performed to reassess Tricuspid Regurgitation

Mid-Septum Lead position

50 patients will be randomized to RV mid-septum lead placement.

Group Type ACTIVE_COMPARATOR

Echo

Intervention Type OTHER

Two dimensional echocardiography will be performed to reassess Tricuspid Regurgitation.

CS lead position

50 patients will have lead placed in the CS

Group Type ACTIVE_COMPARATOR

Echo

Intervention Type OTHER

Two dimensional echocardiography will be performed to reassess Tricuspid Regurgitation.

Interventions

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Echo

Two dimensional echocardiography will be performed to reassess Tricuspid Regurgitation.

Intervention Type OTHER

Echo

Two dimensional echocardiography will be performed to reassess Tricuspid Regurgitation

Intervention Type OTHER

Echo

Two dimensional echocardiography will be performed to reassess Tricuspid Regurgitation.

Intervention Type OTHER

Echo

Two dimensional echocardiography will be performed to reassess Tricuspid Regurgitation.

Intervention Type OTHER

Other Intervention Names

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Medtronic Starfix lead

Eligibility Criteria

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Inclusion Criteria

* 18 years of either sex

* Patient is recommended to receive a pacemaker or an ICD
* Provide informed consent

Exclusion Criteria

* Pregnant or breastfeeding women
* Congenital heart disease
* Pre-existing moderate or severe TR
* An existing pacemaker or defibrillator
* Pulmonary hypertension
* Pacemaker dependence
* Unable to give informed consent
* Not feasible for patient to be followed up at Mayo Clinic
* Acute myocardial infarction within 7 days
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Abbott Medical Devices

INDUSTRY

Sponsor Role collaborator

Mayo Clinic

OTHER

Sponsor Role lead

Responsible Party

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Yong-Mei Cha

Cardiovascular Division

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Yong-Mei Cha, MD

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic

Locations

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Mayo Clinic

Rochester, Minnesota, United States

Site Status

Countries

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United States

References

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1. Lin G, Nishimura R, Connolly H, Dearani J, Sundt T, Hayes D: Severe symptomatic tricuspid valve regurgitation due to permanent pacemaker or implantable cardioverter-defibrillator leads. JACC 2005; 45:1672-1675. 2. Leibowitz D, Rosenheck S, Pollak A, Geist M, Gilon D: Transvenous pacemaker leads do not worsen tricuspid regurgitation: a prospective echocardiographic study. Arrhythmias, Electrophysiology and Electrocardiography 2000; 93:74-77. 3. Kucukarslan N, Kirilmaz A, Ulusoy E, Yokusoglu M, Gramatnikovski N, Ozal E, Tatar H: Tricuspid insufficiency does not increase early after permanent implantation of pacemaker leads. J Card Surg 2006; 21:391-394. 4. Wilkoff B, Invesigators DT: The dual chamber and WI implantable defibrillator (DAVID) Trial: rationale, design, results, clinical implications and lessons for future trials. Cardiac Electrophysiol Review 2004; 7:468-472.

Reference Type BACKGROUND

Other Identifiers

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08-008690

Identifier Type: -

Identifier Source: org_study_id