Benefit of Dual-chamber Pacing With Closed Loop Stimulation (CLS) in Tilt-induced Cardioinhibitory Reflex Syncope

NCT ID: NCT02324920

Last Updated: 2021-11-17

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

128 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-10-31

Study Completion Date

2020-07-31

Brief Summary

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The purpose of this study is to assess whether the Closed Loop Stimulation (CLS) in addition to the DDD pacing is effective in reducing syncopal recurrences. The study hypothesis is that DDD pacing with CLS stimulation is able to prevent syncopal recurrences completely or partially by transforming syncope in pre-syncope.

Detailed Description

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Conditions

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Syncope

Keywords

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Syncope Closed Loop Stimulation CLS

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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DDD+CLS

The pacemaker will be programmed in a dual-chamber DDD pacing mode with the Closed Loop Stimulation (CLS) function ON.

Group Type EXPERIMENTAL

DDD-CLS

Intervention Type DEVICE

ODO

The pacemaker will be programmed in ODO mode.

Group Type PLACEBO_COMPARATOR

ODO

Intervention Type DEVICE

Interventions

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DDD-CLS

Intervention Type DEVICE

ODO

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

Patients affected by clinical diagnosis of reflex syncope who meet all the following criteria:

* age \>=40 years
* significant limitation of social and working life due to unpredictable or frequent syncope recurrences, ≥2 within the last year.
* type 2B cardio-inhibitory response to TT (according to the VASIS classification).
* Alternative therapies have failed or were not feasible.
* exclusion of other possible competitive causes of syncope.

Exclusion Criteria

\- Any other indication to IPG, implantable defibrillator (ICD), cardiac resynchronization therapy (CRT), according to current guidelines

Any cardiac dysfunctions possibly leading to loss of consciousness:

* overt heart failure;
* ejection fraction (LVEF) \<40% (Echo-assessed within 3-month prior to study participation);
* myocardial infarction;
* diagnosis of hypertrophic or dilated cardiomyopathy;
* clinically significant valvular disease;
* sinus bradycardia \<50 bpm or sinoatrial block;
* Mobitz I second-degree atrioventricular block;
* Mobitz II second or third-degree atrioventricular block;
* bundle-branch block;
* rapid paroxysmal supraventricular tachycardia or ventricular tachycardia;
* preexcited QRS complexes;
* prolonged QT interval;
* Brugada syndrome;
* arrhythmogenic right ventricular cardiomyopathy
* Symptomatic orthostatic hypotension diagnosed by standing BP measurement;
* Nonsyncopal loss of consciousness (eg, epilepsy, psychiatric, metabolic, drop-attack, cerebral transient ischemic attack, intoxication, cataplexy).
* Symptomatic cardioinhibitory carotid sinus hypersensitivity.
Minimum Eligible Age

40 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

Locations

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CHUS Sherbrooke

Sherbrooke, , Canada

Site Status

Pais d'Aix

Aix-en-Provence, , France

Site Status

Hopital de la Timone

Marseille, , France

Site Status

Clinique Pasteur

Toulouse, , France

Site Status

Azienda Ospedaliera Pia Fondazione di Culto e Religione Cardinale G. Panico

Tricase, BA, Italy

Site Status

Policlinico Consorziale

Bari, , Italy

Site Status

Ospedale Centrale di Bolzano

Bolzano, , Italy

Site Status

A.O. Pugliese-Ciaccio

Catanzaro, , Italy

Site Status

Ospedale San Martino

Genova, , Italy

Site Status

Azienda Ospedaliera Niguarda Ca' Granda

Milan, , Italy

Site Status

A.O. Dei Colli - Monaldi - University of Campania "Luigi Vanvitelli"

Napoli, , Italy

Site Status

Azienda Ospedaliera Universitaria Federico II

Napoli, , Italy

Site Status

A.O.U. San Luigi Gonzaga

Orbassano, , Italy

Site Status

AO di Parma

Parma, , Italy

Site Status

Arcispedale Santa Maria Nuova

Reggio Emilia, , Italy

Site Status

Policlinico Casilino

Roma, , Italy

Site Status

AMC Academic Medical Center

Amsterdam, , Netherlands

Site Status

Rijnstate Ziekenjuis

Arnhem, , Netherlands

Site Status

Zuyderland Medisch Centrum

Heerlen, , Netherlands

Site Status

Santa Marta

Lisbon, , Portugal

Site Status

Hospital De Bellvitge

Barcelona, , Spain

Site Status

Hospital Universitario Vall d'Hebròn

Barcelona, , Spain

Site Status

Hospital Universitario Nuestra Senora de la Candelaria

Santa Cruz, , Spain

Site Status

Hospital Virgen del Rocio

Seville, , Spain

Site Status

Countries

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Canada France Italy Netherlands Portugal Spain

References

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Brignole M, Russo V, Arabia F, Oliveira M, Pedrote A, Aerts A, Rapacciuolo A, Boveda S, Deharo JC, Maglia G, Nigro G, Giacopelli D, Gargaro A, Tomaino M; BioSync CLS trial Investigators. Cardiac pacing in severe recurrent reflex syncope and tilt-induced asystole. Eur Heart J. 2021 Feb 1;42(5):508-516. doi: 10.1093/eurheartj/ehaa936.

Reference Type DERIVED
PMID: 33279955 (View on PubMed)

Brignole M, Tomaino M, Aerts A, Ammirati F, Ayala-Paredes FA, Deharo JC, Del Rosso A, Hamdan MH, Lunati M, Moya A, Gargaro A; BIOSync Study Steering Committee. Benefit of dual-chamber pacing with Closed Loop Stimulation in tilt-induced cardio-inhibitory reflex syncope (BIOSync trial): study protocol for a randomized controlled trial. Trials. 2017 May 4;18(1):208. doi: 10.1186/s13063-017-1941-4.

Reference Type DERIVED
PMID: 28472974 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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BA103

Identifier Type: -

Identifier Source: org_study_id