Ventricular Pace Suppression Versus Intrinsic Rhythm Support Study

NCT ID: NCT01528657

Last Updated: 2015-10-22

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

230 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-12-31

Study Completion Date

2015-08-31

Brief Summary

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The objective of this study is to intra-individually compare the performances of two pacemaker algorithms designed to reduce unnecessary right ventricular pacing: Intrinsic Rhythm Support Plus (IRSplus) and Ventricular Pace Suppression (VpS). The study will compare ventricular pacing percentage, long-term atrio-ventricular conduction time, occurrences of atrial tachyarrhythmic events and atrial fibrillation burden percentage in patients implanted with a pacemaker for Sick Sinus Syndrome.

Detailed Description

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Conditions

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Sick Sinus Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Ventricular Pace Suppression (VpS)

The function Ventricular Pace Suppression (VpS) is activated

Group Type EXPERIMENTAL

Ventricular Pace Suppression (Vps)

Intervention Type OTHER

Unnecessary ventricular pacing is avoided by promoting intrinsic conduction. In case of intrinsic conduction, the device switches from a DDD mode to an ADI mode.

Intrinsic Rhythm Support (IRSplus)

The function Intrinsic Rhythm Support (IRSplus) is activated

Group Type EXPERIMENTAL

Intrinsic rhythm support (IRSplus)

Intervention Type OTHER

All parameters of the AV hysteresis functions are set in a way to maintain spontaneous AV conduction of the patient's heart as long as possible.

Interventions

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Ventricular Pace Suppression (Vps)

Unnecessary ventricular pacing is avoided by promoting intrinsic conduction. In case of intrinsic conduction, the device switches from a DDD mode to an ADI mode.

Intervention Type OTHER

Intrinsic rhythm support (IRSplus)

All parameters of the AV hysteresis functions are set in a way to maintain spontaneous AV conduction of the patient's heart as long as possible.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients over 18 years of age;
* Patient has proven informed consent;
* Subject with indication of dual chamber pacemaker due to Sinus Node Dysfunction;
* Subjects with a dual chamber pacemaker already implanted within six months from enrollment, provided that ventricular pacing percentage ≤ 40% and with the right ventricular lead in the apical position;
* Stable medical situation;
* Stable geographical situation;

Exclusion Criteria

* Permanent or paroxysmal AV block ≥ II;
* Permanent Atrial fibrillation/Atrial flutter;
* Device Replacement;
* Patient with a poor echocardiographic window;
* Patient already implanted with the right ventricular lead not in the apical position;
* Subjects with a dual chamber pacemaker, implanted later than six months;
* Subjects with a dual chamber pacemaker with ventricular pacing percentage ≥ 40%;
* Contraindication for DDD(R)-ADI(R) or DDD(R) pacing modes;
* VpS or IRSplus algorithm contraindications;
* Age \< 18 years;
* Life expectancy \< 12 months;
* Cardiac surgery planned within the FU period;
* Participation to another clinical investigation;
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Biotronik SE & Co. KG

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Alessandro Capucci

Role: PRINCIPAL_INVESTIGATOR

A.O.U. Ospedali Riuniti, Ancona

Valeria Calvi

Role: PRINCIPAL_INVESTIGATOR

A.O.U. Policlinico-Vittorio Emanuele, Catania

Marco Brieda

Role: PRINCIPAL_INVESTIGATOR

A.O. Santa Maria degli Angeli, Pordenone

Ennio Pisanò

Role: PRINCIPAL_INVESTIGATOR

P.O. Vito Fazzi, Lecce

Vittorio Giudici

Role: PRINCIPAL_INVESTIGATOR

Ospedale Bolognini, Seriate

Locations

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Ospedale Bolognini

Seriate, Bergamo, Italy

Site Status

P.O. F. Ferrari

Casarano, Lecce, Italy

Site Status

A.O. Destra Secchia

Pieve di Coriano, Mantova, Italy

Site Status

Ospedale San Leonardo

Castellammare di Stabia, Napoli, Italy

Site Status

Ospedale SS. Trinità

Borgomanero, Novara, Italy

Site Status

Ospedale SS. Cosma e Damiano

Pescia, Pistoia, Italy

Site Status

Ospedale Santa Croce

Moncalieri, Torino, Italy

Site Status

Ospedale S.Antonio Abate

Gallarate, Varese, Italy

Site Status

Ospedale Dell'Angelo

Mestre, Venezia, Italy

Site Status

A.O.U. Ospedali Riuniti di Ancona

Ancona, , Italy

Site Status

Ospedale Degli Infermi

Biella, , Italy

Site Status

A.O.U. Policlinico-Vittorio Emanuele

Catania, , Italy

Site Status

Ospedale S. Giuseppe

Empoli, , Italy

Site Status

Osp. Civile F. Veneziale

Isernia, , Italy

Site Status

P.O. Vito Fazzi

Lecce, , Italy

Site Status

A.O.R.N. dei Colli - PO "V. Monaldi"

Napoli, , Italy

Site Status

A.O. Santa Maria Degli Angeli

Pordenone, , Italy

Site Status

A.O. San Carlo

Potenza, , Italy

Site Status

Ospedale Degli Infermi

Rimini, , Italy

Site Status

Ospedale SS. Giovanni e Paolo

Venezia, , Italy

Site Status

Countries

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Italy

References

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Vassallo JA, Cassidy DM, Miller JM, Buxton AE, Marchlinski FE, Josephson ME. Left ventricular endocardial activation during right ventricular pacing: effect of underlying heart disease. J Am Coll Cardiol. 1986 Jun;7(6):1228-33. doi: 10.1016/s0735-1097(86)80140-1.

Reference Type BACKGROUND
PMID: 3711479 (View on PubMed)

Prinzen FW, Peschar M. Relation between the pacing induced sequence of activation and left ventricular pump function in animals. Pacing Clin Electrophysiol. 2002 Apr;25(4 Pt 1):484-98. doi: 10.1046/j.1460-9592.2002.00484.x.

Reference Type BACKGROUND
PMID: 11991375 (View on PubMed)

Prinzen FW, Augustijn CH, Arts T, Allessie MA, Reneman RS. Redistribution of myocardial fiber strain and blood flow by asynchronous activation. Am J Physiol. 1990 Aug;259(2 Pt 2):H300-8. doi: 10.1152/ajpheart.1990.259.2.H300.

Reference Type BACKGROUND
PMID: 2386214 (View on PubMed)

Thambo JB, Bordachar P, Garrigue S, Lafitte S, Sanders P, Reuter S, Girardot R, Crepin D, Reant P, Roudaut R, Jais P, Haissaguerre M, Clementy J, Jimenez M. Detrimental ventricular remodeling in patients with congenital complete heart block and chronic right ventricular apical pacing. Circulation. 2004 Dec 21;110(25):3766-72. doi: 10.1161/01.CIR.0000150336.86033.8D. Epub 2004 Dec 6.

Reference Type BACKGROUND
PMID: 15583083 (View on PubMed)

Kanzaki H, Bazaz R, Schwartzman D, Dohi K, Sade LE, Gorcsan J 3rd. A mechanism for immediate reduction in mitral regurgitation after cardiac resynchronization therapy: insights from mechanical activation strain mapping. J Am Coll Cardiol. 2004 Oct 19;44(8):1619-25. doi: 10.1016/j.jacc.2004.07.036.

Reference Type BACKGROUND
PMID: 15489094 (View on PubMed)

Maurer G, Torres MA, Corday E, Haendchen RV, Meerbaum S. Two-dimensional echocardiographic contrast assessment of pacing-induced mitral regurgitation: relation to altered regional left ventricular function. J Am Coll Cardiol. 1984 Apr;3(4):986-91. doi: 10.1016/s0735-1097(84)80357-5.

Reference Type BACKGROUND
PMID: 6707363 (View on PubMed)

Vanderheyden M, Goethals M, Anguera I, Nellens P, Andries E, Brugada J, Brugada P. Hemodynamic deterioration following radiofrequency ablation of the atrioventricular conduction system. Pacing Clin Electrophysiol. 1997 Oct;20(10 Pt 1):2422-8. doi: 10.1111/j.1540-8159.1997.tb06081.x.

Reference Type BACKGROUND
PMID: 9358483 (View on PubMed)

Nielsen JC, Kristensen L, Andersen HR, Mortensen PT, Pedersen OL, Pedersen AK. A randomized comparison of atrial and dual-chamber pacing in 177 consecutive patients with sick sinus syndrome: echocardiographic and clinical outcome. J Am Coll Cardiol. 2003 Aug 20;42(4):614-23. doi: 10.1016/s0735-1097(03)00757-5.

Reference Type BACKGROUND
PMID: 12932590 (View on PubMed)

Nielsen JC, Andersen HR, Thomsen PE, Thuesen L, Mortensen PT, Vesterlund T, Pedersen AK. Heart failure and echocardiographic changes during long-term follow-up of patients with sick sinus syndrome randomized to single-chamber atrial or ventricular pacing. Circulation. 1998 Mar 17;97(10):987-95. doi: 10.1161/01.cir.97.10.987.

Reference Type BACKGROUND
PMID: 9529267 (View on PubMed)

Nahlawi M, Waligora M, Spies SM, Bonow RO, Kadish AH, Goldberger JJ. Left ventricular function during and after right ventricular pacing. J Am Coll Cardiol. 2004 Nov 2;44(9):1883-8. doi: 10.1016/j.jacc.2004.06.074.

Reference Type BACKGROUND
PMID: 15519023 (View on PubMed)

Sweeney MO, Hellkamp AS, Ellenbogen KA, Greenspon AJ, Freedman RA, Lee KL, Lamas GA; MOde Selection Trial Investigators. Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction. Circulation. 2003 Jun 17;107(23):2932-7. doi: 10.1161/01.CIR.0000072769.17295.B1. Epub 2003 Jun 2.

Reference Type BACKGROUND
PMID: 12782566 (View on PubMed)

Calvi V, Pisano EC, Brieda M, Melissano D, Castaldi B, Guastaferro C, Nigro G, Madalosso M, Orsida D, Rovai N, Gargaro A, Capucci A. Atrioventricular Interval Extension Is Highly Efficient in Preventing Unnecessary Right Ventricular Pacing in Sinus Node Disease: A Randomized Cross-Over Study Versus Dual- to Atrial Single-Chamber Mode Switch. JACC Clin Electrophysiol. 2017 May;3(5):482-490. doi: 10.1016/j.jacep.2016.11.011. Epub 2017 Feb 1.

Reference Type DERIVED
PMID: 29759604 (View on PubMed)

Other Identifiers

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BA098

Identifier Type: -

Identifier Source: org_study_id

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