Prevention of Syncope by Cardiac Pacing in Patients With Bifascicular Block

NCT ID: NCT01463358

Last Updated: 2021-04-19

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

101 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-03-31

Study Completion Date

2011-05-31

Brief Summary

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Study Objective

The purpose of this study is to evaluate the efficacy of bradycardia pacing with respect to patient symptoms in patients with bifascicular block and syncope of unexplained origin.

Detailed Description

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Primary endpoint

First occurrence of a composite of Syncope of any origin OR Presyncopal episode with documented cardioinhibitory origin OR Atrioventricular block of any degree; all associated with patient symptoms

Design:

* Randomized, prospective, single blinded, two parallel arms
* Treatment group : DDD60 - programmed in DDD mode / 60 lower limit
* Control Group: DDI30 - programmed in DDI mode / 30 lower limit
* Randomization type: block randomization: Block size: 4, allocation ratio 1:1

Sample: 100 patients

Population

* Patients with bifascicular block with at least one syncopal episode within the last 6 months preceding enrollment.
* Patients should be negative to a series of pre-enrollment screening in order to exclude:
* Brady-tachy syndrome, vasovagal syncope or carotid sinus syndrome, atrial fibrillation, inducible AV block
* Ejection fraction \>=40%
* Mean nocturnal heart rate \>=35 bpm

Conditions

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Bifascicular Block Syncope

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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DDI30

Control group based only on backup pacing with lower rate 30 ppm

Group Type OTHER

DDD60 (INSIGNIA® pacing systems Guidant (Boston Scientific)

Intervention Type DEVICE

pacing in DDDI30 is supposed to act as a safety backup upfront to episodes of syncope, presyncope or AV block, but not supposed to reduce symptoms.

DDD60

Treatment arm based on full pacing support (60 Lower Rate)

Group Type ACTIVE_COMPARATOR

DDD60 (INSIGNIA® pacing systems Guidant (Boston Scientific)

Intervention Type DEVICE

pacing in DDD60 is supposed to prevent events of syncope, presyncope of cardioinhibitory origin and symptom associated to av block

Interventions

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DDD60 (INSIGNIA® pacing systems Guidant (Boston Scientific)

pacing in DDD60 is supposed to prevent events of syncope, presyncope of cardioinhibitory origin and symptom associated to av block

Intervention Type DEVICE

DDD60 (INSIGNIA® pacing systems Guidant (Boston Scientific)

pacing in DDDI30 is supposed to act as a safety backup upfront to episodes of syncope, presyncope or AV block, but not supposed to reduce symptoms.

Intervention Type DEVICE

Other Intervention Names

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INSIGNIA® pacing systems Guidant (Boston Scientific) INSIGNIA® pacing systems Guidant (Boston Scientific)

Eligibility Criteria

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Inclusion Criteria

* Evidence of Bifascicular block
* At least one episode of syncope during last 6 months from the enrollment

Exclusion Criteria

* Patients with Brady-tachy syndrome that needs of pacemaker to prevent the symptomatic bradycardia o symptomatic tachycardia arrhythmia
* Patients with vasovagal syndrome by positive TTT or carotid sinus syndrome
* Patients with Chronic Atrial Fibrillation
* Patients with Atrial Ventricular Block induces at EPS
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Boston Scientific Corporation

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Massimo Santini, MD,FESC,FACC

Role: PRINCIPAL_INVESTIGATOR

Ospedale San Filippo Neri, Roma, Italy

Locations

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Ospedale Santa Maria Annunziata

Bagno a Ripoli, , Italy

Site Status

Azienda Ospedaliera S. Sebastiano

Caserta, , Italy

Site Status

Ospedale Valduce

Como, , Italy

Site Status

Azienda Ospedaliera Osp. Maggiore

Crema, , Italy

Site Status

Nuovo Ospedale S. Giovanni di Dio

Florence, , Italy

Site Status

Ospedale Villa Scassi

Genova, , Italy

Site Status

Ospedale Umberto I

Mestre, , Italy

Site Status

Ospedale GB Grassi

Ostia - Roma, , Italy

Site Status

Ospedale Civile G. De Lellis

Rieti, , Italy

Site Status

Azienda Ospedaliera S. Filippo Neri

Roma, , Italy

Site Status

Ospedale Sandro Pertini

Roma, , Italy

Site Status

Policlinico Casilino

Roma, , Italy

Site Status

Countries

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Italy

References

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Brignole M, Donateo P, Tomaino M, Massa R, Iori M, Beiras X, Moya A, Kus T, Deharo JC, Giuli S, Gentili A, Sutton R; International Study on Syncope of Uncertain Etiology 3 (ISSUE-3) Investigators. Benefit of pacemaker therapy in patients with presumed neurally mediated syncope and documented asystole is greater when tilt test is negative: an analysis from the third International Study on Syncope of Uncertain Etiology (ISSUE-3). Circ Arrhythm Electrophysiol. 2014 Feb;7(1):10-6. doi: 10.1161/CIRCEP.113.001103. Epub 2013 Dec 12.

Reference Type DERIVED
PMID: 24336948 (View on PubMed)

Santini M, Castro A, Giada F, Ricci R, Inama G, Gaggioli G, Calo L, Orazi S, Viscusi M, Chiodi L, Bartoletti A, Foglia-Manzillo G, Ammirati F, Loricchio ML, Pedrinazzi C, Turreni F, Gasparini G, Accardi F, Raciti G, Raviele A. Prevention of syncope through permanent cardiac pacing in patients with bifascicular block and syncope of unexplained origin: the PRESS study. Circ Arrhythm Electrophysiol. 2013 Feb;6(1):101-7. doi: 10.1161/CIRCEP.112.975102. Epub 2013 Feb 6.

Reference Type DERIVED
PMID: 23390123 (View on PubMed)

Other Identifiers

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GDT-20040601-PRESS-1

Identifier Type: -

Identifier Source: org_study_id

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