Clinical Efficacy of Left Bundle Branch Area Pacing for Patients With Permanent Atrial Fibrillation and Heart Failure

NCT ID: NCT05549544

Last Updated: 2024-01-10

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

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-07-18

Study Completion Date

2024-12-31

Brief Summary

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This is a multicenter, randomized controlled study. This study aims to compare the clinical efficacy of LBBAP with traditional biventricular pacing in patients with permanent atrial fibrillation and heart Failure

Detailed Description

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LBBAP-AFHF is a prospective, multicenter, randomized controlled trial that is designed to determine whether left bundle branch area pacing (LBBAP) may show superiority of improved LV function as compared with traditional biventricular pacing (BiVP) in patients with permanent atrial fibrillation and heart failure (LVEF\<50%) who receive atrioventricular nodal ablation due to fast ventricular rate or require high percentage of ventricular pacing due to slow ventricular rate. The primary endpoint of this trial is the change in the LVEF at 6 months after device implantation from baseline. A CRT-P/D device would be implanted and LBBAP lead would be connected to the RA port and LV lead to the LV port. Patients who receive successful LBBAP and BiVP simultaneously during the procedure would be 1:1 randomized to LBBAP or BiVP group after the procedure by device programming. Patients will be followed at 3 and 6 months post-discharge for LVEF and other echographic parameters (including LVESV, response rate), and rehospitalization for heart failure or all-cause death.

Conditions

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Left Bundle Branch Area Pacing Biventricular Pacing Heart Failure Permanent Atrial Fibrillation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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LBBAP group

Device: Left bundle branch area pacing(LBBAP) LBBAP is a novel physiological pacing form for ventricular pacing. In patients who received LBBAP, the pacing lead will be placed at the left bundle branch area to achieve a narrow-paced QRS duration.

Group Type EXPERIMENTAL

Left bundle branch area pacing

Intervention Type DEVICE

Left bundle branch area pacing is a novel physiological pacing modality and is reported to be feasible and safe in patients with heart failure and left bundle branch block.

BiVP group

Device: Biventricular pacing (BiVP) Biventricular pacing is the traditional pacing modality for patients with heart failure. For BiVP, one pacing lead was placed in the coronary sinus, named LV lead, and another lead was placed in the right ventricule.

Group Type ACTIVE_COMPARATOR

Biventricular pacing

Intervention Type DEVICE

Biventricular pacing is a widely-established modality to treat heart failure in patients with heart failure

Interventions

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Left bundle branch area pacing

Left bundle branch area pacing is a novel physiological pacing modality and is reported to be feasible and safe in patients with heart failure and left bundle branch block.

Intervention Type DEVICE

Biventricular pacing

Biventricular pacing is a widely-established modality to treat heart failure in patients with heart failure

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Adult patients aged more than 18 years old
* Patients diagnosed with heart failure (LVEF\<50%) and have received optimal medical therapy for at least 3 months
* Patients with permanent atrial fibrillation (QRS duration \<130ms) which need ventricular pacing, including:

1. LVEF\<50%, NYHA II-IV, drug-refractory atrial fibrillation with the fast ventricular rate, planned atrioventricular nodal ablation due to 1). anticipated low success rate of atrial fibrillation catheter ablation or 2). patients refused to receive catheter ablation or 3). refused to receive another catheter ablation after a previous history of failed procedures
2. LVEF\<50%, NYHA II-IV, atrial fibrillation with slow ventricular rate, anticipated ventricular pacing burden ≥ 40%
* Written informed consent was provided

Exclusion Criteria

* expected survival time is less than 12 months
* Prior history of mechanical tricuspid valve replacement and/or congenital heart disease (including dextrocardia, transposition of the great arteries, single left persistent left superior vena cava, etc.)
* Plan for PCI or CABG due to unstable angina or myocardial infarction in 3 months
* Surgery is required within 1 year due to severe structural heart disease
* Pregnancy, planned pregnancy or heart transplant
* Prior history of HCM and/or ventricular septal defect repair, who are unlikely to achieve successful LBBAP procedure.
* Failure of lead placement due to abnormal anatomy of the coronary sinus or enlarged right atrium, which makes it unable to switch from one pacing modality to another
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Second Hospital of Hebei Medical University

OTHER

Sponsor Role collaborator

The First Affiliated Hospital with Nanjing Medical University

OTHER

Sponsor Role collaborator

Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University

OTHER

Sponsor Role collaborator

Peking University First Hospital

OTHER

Sponsor Role collaborator

Fu Wai Hospital, Beijing, China

OTHER

Sponsor Role lead

Responsible Party

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Xiaohan Fan

Professor, MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Xiaohan Fan, PhD

Role: PRINCIPAL_INVESTIGATOR

Chinese Academy of Medical Sciences, Fuwai Hospital

Locations

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Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences

Beijing, Beijing Municipality, China

Site Status RECRUITING

Peking University First Hospital

Beijing, Beijing Municipality, China

Site Status NOT_YET_RECRUITING

Sun Yat-sen Memorial Hospital, Sun Yat-sen University

Guangzhou, Guangdong, China

Site Status NOT_YET_RECRUITING

The Second Hospital of Hebei Medical University

Shijiazhuang, Hebei, China

Site Status NOT_YET_RECRUITING

The first affiliated hospital of Nanjing medical university

Nanjing, Jiangsu, China

Site Status NOT_YET_RECRUITING

Countries

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China

Central Contacts

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Haojie Zhu, M.D

Role: CONTACT

+8613167310573

Xiaofei Li, M.D

Role: CONTACT

+8617801013995

Facility Contacts

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Haojie Zhu

Role: primary

+8613167310573

Xiaofei Li

Role: backup

+8617801013995

Jing Zhou

Role: primary

Yangxin Chen

Role: primary

Ruiqin Xie

Role: primary

Jiangang Zou

Role: primary

Other Identifiers

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2022-1704

Identifier Type: -

Identifier Source: org_study_id

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