The Pacing vs No Pacing Study - PNP Study

NCT ID: NCT02498639

Last Updated: 2015-07-15

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-04-30

Study Completion Date

2016-01-31

Brief Summary

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Pilot interventional study, without drug, randomized 1: 1, open-label comparison of efficacy and safety between the technique of percutaneous balloon aortic valvuloplasty without rapid ventricular pacing vs valvuloplasty during rapid ventricular pacing (using a temporary pacemaker device with CE mark). It is expected to enroll 100 patients. Randomization is done through a dedicated computer program.

Detailed Description

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The aim is to compare, in terms of procedural success and safety, the procedure of percutaneous balloon aortic valvuloplasty (BAV) without rapid ventricular pacing with the same procedure carried out with the aid of rapid ventricular pacing.

It is a pilot study with the objective to enroll 100 consecutive patients matching inclusion and exclusion criteria who are randomized 1:1 in two arms: in the first patients undergo procedure of BAV without rapid pacing, in the second BAV with rapid ventricular pacing able to help in balloon stabilization during inflations.

Efficacy will be studied analysing changes in transvalvular gradient from baseline to post-BAV. Safety outcomes will be collected both at discharge and at 30-day. Other procedural data will be object of direct comparison.

Conditions

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Aortic Valve Stenosis

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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BAV without pacing

Patients undergo percutaneous balloon aortic valvuloplasty (BAV) without previous insertion of a temporary pacemaker lead in the right ventricle. Stabilization of the balloon during inflation is done without rapid pacing.

Group Type ACTIVE_COMPARATOR

percutaneous balloon aortic valvuloplasty

Intervention Type PROCEDURE

Percutaneous BAV is performed according to the standard retrograde technique. The measurement of the trans-aortic gradient is given by two catheters placed one in the left ventricle, the other in ascending aorta. An extra stiff wire is placed in the left ventricular cavity. A balloon (size fitting the valve annulus) is inserted over the wire and a series of three inflations is performed at nominal pressure.

The procedure terminates in case of:

1. Reduction of the mean aortic gradient ≥50%.
2. Aortic pressure drop during the inflations, indicative of valve orifice sealing.
3. Intraprocedural complication.
4. Poor compliance of the patient. If none is met, the balloon is changed with a bigger one and a new series of three inflations performed. Aortic gradient is finally recorded.

BAV with pacing

Patients undergo percutaneous balloon aortic valvuloplasty (BAV) after previous insertion of a temporary pacemaker lead in the right ventricle. Stabilization of the balloon during inflation is done under rapid pacing.

Group Type ACTIVE_COMPARATOR

percutaneous balloon aortic valvuloplasty

Intervention Type PROCEDURE

Percutaneous BAV is performed according to the standard retrograde technique. The measurement of the trans-aortic gradient is given by two catheters placed one in the left ventricle, the other in ascending aorta. An extra stiff wire is placed in the left ventricular cavity. A balloon (size fitting the valve annulus) is inserted over the wire and a series of three inflations is performed at nominal pressure.

The procedure terminates in case of:

1. Reduction of the mean aortic gradient ≥50%.
2. Aortic pressure drop during the inflations, indicative of valve orifice sealing.
3. Intraprocedural complication.
4. Poor compliance of the patient. If none is met, the balloon is changed with a bigger one and a new series of three inflations performed. Aortic gradient is finally recorded.

Interventions

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percutaneous balloon aortic valvuloplasty

Percutaneous BAV is performed according to the standard retrograde technique. The measurement of the trans-aortic gradient is given by two catheters placed one in the left ventricle, the other in ascending aorta. An extra stiff wire is placed in the left ventricular cavity. A balloon (size fitting the valve annulus) is inserted over the wire and a series of three inflations is performed at nominal pressure.

The procedure terminates in case of:

1. Reduction of the mean aortic gradient ≥50%.
2. Aortic pressure drop during the inflations, indicative of valve orifice sealing.
3. Intraprocedural complication.
4. Poor compliance of the patient. If none is met, the balloon is changed with a bigger one and a new series of three inflations performed. Aortic gradient is finally recorded.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* diagnosis of severe symptomatic aortic valve stenosis.
* no immediate indication to aortic valve replacement (AVR).
* indication to balloon aortic valvuloplasty (BAV).
* written expression of informed consent.

Exclusion Criteria

* clinical presentation in cardiogenic shock at the time of BAV.
* clinical presentation in acute pulmonary edema not previously stabilized by medical therapy.
Minimum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IRCCS Azienda Ospedaliero-Universitaria di Bologna

OTHER

Sponsor Role lead

Responsible Party

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Dr. Antonio Marzocchi

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Antonio Marzocchi, MD

Role: PRINCIPAL_INVESTIGATOR

IRCCS Azienda Ospedaliero-Universitaria di Bologna

Locations

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Institute of Cardiology, Azienda Ospedaliero-Universitaria di Bologna

Bologna, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Antonio Marzocchi, MD

Role: CONTACT

00390512144475

Francesco Saia, MD

Role: CONTACT

00390512144475

Facility Contacts

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Francesco Saia, MD

Role: primary

00390512144475

Gianni Dall'Ara, MD

Role: backup

00390512144475

Other Identifiers

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CE41/2015/O/Sper

Identifier Type: -

Identifier Source: org_study_id

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