Left Bundle Branch Area Pacing in Patients After TAVR

NCT ID: NCT05024279

Last Updated: 2023-01-31

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

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-08-06

Study Completion Date

2025-04-30

Brief Summary

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Prospective, randomized, single center clinical trial to compare the outcome of left bundle branch area pacing versus right ventricular apical pacing in patients with higher degree atrio-ventricular block and a normal left ventricular function after transcatheter aortic valve replacement.

Detailed Description

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Transcatheter aortic valve replacement (TAVR) is a well-established treatment of aortic valve stenosis. Yet, requiry of permanent pacing due to new onset atrio-ventricular conduction block remains a frequent complication. Standard right ventricular pacing (RVP) at high pacing burden may lead to deterioration of left ventricular function. Left-Bundle-Area Pacing (LBBP) is a new, innovative method of physiological ventricular stimulation resulting in narrow, physiological QRS complexes.

In this prospective, randomized, single center clinica trial, patients are included after TAVR and with normal left ventricular function who require pacing due to a higher degree atriao-ventricular block with an anticipated high pacing burden. Patients will be randomized to receive either left bundle branch area pacing (intervention) or right ventricular apical pacing (control).

The results will confirm the feasibility of LBBP in patients following TAVR. Results will further investigate the primary outcome of a clinically relevant QRS narrowing and a combination of exploratory secondary endpoints including clinical outcomes, functional status, laboratory biomarkers, and quality of life.

Conditions

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Aortic Valve Stenosis AV Block Pacing-Induced Cardiomyopathy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

1:1 randomization
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Intervention Arm

Patients are randomized to receive left bundle branch are pacing due to higher degree AV block

Group Type EXPERIMENTAL

Left bundle branch area pacing

Intervention Type DEVICE

Left bundle branch area pacing will be applied as established in the literature using commercially available equipment.

In case of unsuccessful application of left bundle branch area pacing, cross-over to right ventricular pacing is allowed.

Control Arm

Patients are randomized to receive standard right ventricular pacing due to higher degree AV block.

Group Type ACTIVE_COMPARATOR

Right ventricular pacing

Intervention Type DEVICE

Right ventricular pacing as the standard, established form of pacing will be applied in the control group. No cross-over to the intervention arm is anticipated.

Interventions

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Left bundle branch area pacing

Left bundle branch area pacing will be applied as established in the literature using commercially available equipment.

In case of unsuccessful application of left bundle branch area pacing, cross-over to right ventricular pacing is allowed.

Intervention Type DEVICE

Right ventricular pacing

Right ventricular pacing as the standard, established form of pacing will be applied in the control group. No cross-over to the intervention arm is anticipated.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Successful TAVR implantation for classical (high flow high gradient), symptomatic aortic valve stenosis
* LVEF ≥50%
* Guideline-based indication for pacing due to AV block III°, AV block II°, or symptomatic bradycardic atrial fibrillation with an expecteed ventricular pacing burden \>20%
* Signed informeed conseent to study participation

Exclusion Criteria

* LVEF \<50%
* Expected pacing burden \<20%
* Pre-existing implanted cardiac device
* Participation in a concurring interventional trial
* age \<18 years
* Current preegnancy
* life expectancy \<6 months
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ludwig-Maximilians - University of Munich

OTHER

Sponsor Role lead

Responsible Party

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Moritz F. Sinner

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Moritz F Sinner, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

LMU Klinikum, Dept. of Cardiology

Stephanie Fichtner, MD

Role: PRINCIPAL_INVESTIGATOR

LMU Klinikum, Dept. of Cardiology

Locations

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LMU Klinikum

Munich, Bavaria, Germany

Site Status

Countries

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Germany

Other Identifiers

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21-0575

Identifier Type: -

Identifier Source: org_study_id

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