Pacing the Atrium to Confirm or Exclude Pacemaker Indication in TAVI

NCT ID: NCT05278585

Last Updated: 2023-11-29

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

RECRUITING

Total Enrollment

500 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-09-01

Study Completion Date

2024-06-30

Brief Summary

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The current observational registry aims to evaluate in patients undergoing TAVI implantation:

1. the positive and negative predictive value for PPM post TAVI of Wenckebach phenomenona (WB) during RAP during the TAVI procedure,
2. baseline and procedural characteristics of TAVI-implantation associated with new conduction abnormalities and need for PPM implantation,
3. peri-procedural safety, in-hospital and 1-month outcomes after TAVI implantation.

Detailed Description

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The persistent growth in transcatheter aortic valve implantation (TAVI) calls for optimized early discharge programs to handle the increasing patient load. While access site bleeding and stroke rate have decreased with improved technologies and operators' experience, acquired conduction abnormalities necessitating prolonged rhythm-monitoring and permanent pacemaker (PPM) implantation have remained largely unchanged, and even up to 39.9% for some TAVI platforms. Prompt identification of patients necessitating PPM implantation leads to optimal patient care and use of resources. Conversely, prompt identification of patients with low -to no- risk for PPM post TAVI shortens their hospitalization and facilitates early and safe discharge.

Several baseline characteristics such as age, preexistent right bundle branch block (RBBB) and the use of self-expanding valves are associated with post-TAVI PPM implantation, but more practical and clinically more relevant parameters are needed with high negative and positive predictive values that could support clinical decision-making.

En passant rapid atrial pacing (RAP) immediately following TAVI has recently been reported to be a valuable tool in PPM risk stratification. The absence of Wenckebach phenomena post implantation at RAP up to 120/' has a negative predictive value for PPM of 98.7%.2 First use of RAP in routine practice at AZ Sint Jan Brugge can confirm these first results (unpublished data). This technique improves our clinical assessment and identification of low-risk patients for PPM suitable for safe early discharge, as well as high-risk patients requiring further rhythm monitoring and eventual PPM implantation.

The current observational registry aims to evaluate in patients undergoing TAVI implantation:

1. the positive and negative predictive value for PPM post TAVI of Wenckebach phenomenona (WB) during RAP during the TAVI procedure,
2. baseline and procedural characteristics of TAVI-implantation associated with new conduction abnormalities and need for PPM implantation,
3. peri-procedural safety, in-hospital and 1-month outcomes after TAVI implantation.

Conditions

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Aortic Valve Stenosis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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RAP TAVI group

All patients in sinus rhythm with TAVI

RAP TAVI

Intervention Type PROCEDURE

All patients undergoing TAVI with no pre-existing pacemaker and in sinus rhythm at the time of the procedure will receive RAP by placing the temporary wire in the right atrium

Interventions

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RAP TAVI

All patients undergoing TAVI with no pre-existing pacemaker and in sinus rhythm at the time of the procedure will receive RAP by placing the temporary wire in the right atrium

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* All patients in sinus rhythm with TAVI

Exclusion Criteria

* Patients in atrial fibrillation at the time of the implantation
* Patients with pre-existent pacemaker
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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AZ Sint-Jan AV

OTHER

Sponsor Role lead

Responsible Party

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Ian Buysschaert, MD PhD

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ian Buysschaert, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

AZ Sint Jan

Locations

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Algemeen Stedelijk Ziekenhuis Aalst

Aalst, , Belgium

Site Status RECRUITING

OLV Aalst

Aalst, , Belgium

Site Status RECRUITING

ZNA Middelheim

Antwerp, , Belgium

Site Status RECRUITING

AZ Sint Jan

Bruges, , Belgium

Site Status RECRUITING

CHU Charleroi-Chimay

Charleroi, , Belgium

Site Status RECRUITING

Grand Hôpital de Charleroi

Charleroi, , Belgium

Site Status RECRUITING

Ziekenhuis Oost-Limburg

Genk, , Belgium

Site Status RECRUITING

UZ Brussel

Jette, , Belgium

Site Status RECRUITING

UZ Leuven

Leuven, , Belgium

Site Status RECRUITING

Citadelle Hospital

Liège, , Belgium

Site Status RECRUITING

Clinique Saint-Luc Bouge

Namur, , Belgium

Site Status RECRUITING

AZ Delta

Roeselare, , Belgium

Site Status RECRUITING

Countries

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Belgium

Central Contacts

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Ian Buysschaert, MD, PhD

Role: CONTACT

+32050452670

Emma Christiaen, Msc

Role: CONTACT

+32050453293

Facility Contacts

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An Roets

Role: primary

Steve Aerts

Role: primary

Petra Vanextergem

Role: primary

Ian Buysschaert, MD PhD

Role: primary

+32 50 45 26 70

Asuncion Conde Y Bolado

Role: primary

Amandine Jourdan

Role: primary

Lieke Peeters

Role: primary

Ingrid Lemoine

Role: primary

Marina Claes

Role: primary

Sophie Jacquet

Role: primary

Soon-Ja Collard

Role: primary

Els Vancayseele

Role: primary

Other Identifiers

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version 1 21/02/2022

Identifier Type: -

Identifier Source: org_study_id