Conduction System Pacing Versus Biventricular Resynchronization in Patients With Chronic Heart Failure

NCT ID: NCT05572736

Last Updated: 2025-06-08

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

COMPLETED

Clinical Phase

NA

Total Enrollment

179 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-11-07

Study Completion Date

2025-01-10

Brief Summary

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The purpose of this study is to evaluate the efficacy and safety of conduction system pacing versus biventricular pacing in patients with chronic heart failure with reduced ejection fraction and left bundle branch block.

Detailed Description

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Conditions

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Heart Failure Left Bundle-Branch Block Cardiac Resynchronization Conduction System Pacing

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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Conduction system pacing

Patients will be randomized 1:1 to either conduction system pacing or biventricular pacing.

Group Type EXPERIMENTAL

Conduction system pacing

Intervention Type DEVICE

Pacing from the His-Purkinje system (His-bundle pacing, left bundle branch area pacing, or deep septal pacing).

Biventricular pacing

Patients will be randomized 1:1 to either conduction system pacing or biventricular pacing.

Group Type ACTIVE_COMPARATOR

Biventricular pacing

Intervention Type DEVICE

Pacing from the coronary sinus and right ventricular leads.

Interventions

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Conduction system pacing

Pacing from the His-Purkinje system (His-bundle pacing, left bundle branch area pacing, or deep septal pacing).

Intervention Type DEVICE

Biventricular pacing

Pacing from the coronary sinus and right ventricular leads.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Male or female, age ≥18 years
* Established diagnosis of symptomatic heart failure (New York Heart Association class II-III)
* Left ventricular ejection fraction ≤35% in prior 3 months
* Left bundle branch block (QRS ≥130 ms)
* Clinical indication for cardiac resynchronization therapy
* Patients should be clinically stable
* Patients should receive background standard of care for heart failure with reduced ejection fraction, with the maximum tolerated doses of ACE inhibitor or ARB or ARNI, beta-blocker, and mineralocorticoid receptor antagonist

Exclusion Criteria

* Life expectancy \<12 months due to any disease
* Dementia or advanced cerebrovascular disease
* NYHA class IV
* Plan to implant an implantable cardioverter defibrillator (ICD), with or without resynchronization therapy (CRT-D)
* Enrollment in other clinical trials involving cardiac pacing
* Pregnancy or pre-menopausal women who do not use regular contraceptive methods
* Patients unable to understand and sign the consent for participation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ministry of Health, Brazil

OTHER_GOV

Sponsor Role collaborator

Hospital Moinhos de Vento

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Carisi Polanczyk, MD PhD

Role: STUDY_CHAIR

Hospital Moinhos de Vento

Andre d'Avila, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Harvard Medical School (HMS and HSDM)

Alexander Dal Forno, MD

Role: PRINCIPAL_INVESTIGATOR

Hospital SOS Cardio

Leandro Zimerman, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital Moinhos de Vento

Luis E Rohde, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital Moinhos de Vento

Andre Zimerman, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital Moinhos de Vento

Caique Ternes, MD

Role: PRINCIPAL_INVESTIGATOR

Hospital Moinhos de Vento

Fernanda D Alves, PhD

Role: STUDY_DIRECTOR

Hospital Moinhos de Vento

Locations

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Fundação Hospital do Coração Francisca Mendes

Manaus, Amazonas, Brazil

Site Status

Hospital Universitário Cassiano Antônio de Moraes

Vitória, Espírito Santo, Brazil

Site Status

Hospital Ana Nery

Salvador, Estado de Bahia, Brazil

Site Status

Hospital Geral Universitário de Cuiabá

Cuiabá, Mato Grosso, Brazil

Site Status

Instituto de Medicina Integral Professor Fernando Figueira

Recife, Pernambuco, Brazil

Site Status

Hospital Universitário da Universidade Federal do Piauí

Teresina, Piauí, Brazil

Site Status

Hospital Moinhos de Vento

Porto Alegre, Rio Grande do Sul, Brazil

Site Status

Hospital de Clínicas de Porto Alegre

Porto Alegre, Rio Grande do Sul, Brazil

Site Status

Hospital Mãe de Deus

Porto Alegre, Rio Grande do Sul, Brazil

Site Status

SOS Cardio

Florianópolis, Santa Catarina, Brazil

Site Status

Instituto de Cardiologia de Santa Catarina

São José, Santa Catarina, Brazil

Site Status

Instituto Nacional de Cardiologia

Rio de Janeiro, , Brazil

Site Status

Beneficência Portuguesa

São Paulo, , Brazil

Site Status

Hospital Alemão Oswaldo Cruz

São Paulo, , Brazil

Site Status

Countries

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Brazil

References

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Zimerman A, Dal Forno A, Rohde LE, Ternes CM, Alves FD, Decker SR, Silveira AD, Damiani LP, Martinelli Filho M, Costa R, Fagundes AA, Barbosa RM, Gadelha EB, Lima CE, Silva MA, Maldonado JA, de Oliveira JC, Mallmann F, Baggio JM Jr, Duarte CE, Zimerman LI, D'Avila A, Polanczyk CA. Conduction system pacing vs biventricular resynchronization in heart failure with reduced ejection fraction and left bundle branch block: Rationale and design of the PhysioSync-HF Trial. Am Heart J. 2025 Dec;290:38-45. doi: 10.1016/j.ahj.2025.06.002. Epub 2025 Jun 3.

Reference Type DERIVED
PMID: 40473010 (View on PubMed)

Other Identifiers

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NUP: 25000.123471/2021-59

Identifier Type: -

Identifier Source: org_study_id

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