"Physiological vs Right Ventricular Pacing Outcome Trial Evaluated for bradyCardia Treatment" (PROTECT-HF)

NCT ID: NCT05815745

Last Updated: 2025-11-28

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

2600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-06-05

Study Completion Date

2029-12-04

Brief Summary

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The PROTECT-HF multi-centre randomised controlled trial will compare two different pacing approaches for treating patients with slow heart rates. In it the investigators will compare a long-standing standard approach for pacing; right ventricular pacing, with a new form of pacing, physiological pacing (His and Left bundle area pacing) in 2600 patients.

Patients will be allocated at random to receive either right ventricular pacing or physiological pacing. Endpoint measurements will be undertaken at baseline, and at six-monthly intervals post-randomisation. Treatment allocation will be blinded to the endpoint assessor and the patient.

Recruitment and pacemaker implantation will be carried out at each participating centre. The primary analysis will be intention to treat. The investigators will also perform an on-treatment analysis.

2048 patients are needed to detect the expected effect size with 85% power. A total of 2600 patients will be recruited to allow for patient drop-out and crossover.

500-patient sub-study will assess within patient, and between groups, echocardiographic changes over a 24-month period to try and improve mechanistic understanding of PICM (Pacing Induced Cardiomyopathy).

Detailed Description

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Patients entering the study will attend for implantation of a pacemaker device and be randomised to either right ventricular pacing or physiological pacing.

Patients at sites participating in echo sub-study will be informed of and given opportunity to consent to echo sub-study, this will be optional to them, even if they have consented to the main study.

Conditions

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Bradycardia Pacing Right Ventricular Pacing His Bundle Pacing Left Bundle Branch Area 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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Right ventricular pacing

Right ventricular pacing (apical or septal lead locations as per the implanting physicians' normal practice)

Group Type ACTIVE_COMPARATOR

Pacemaker - Right Ventricular pacing

Intervention Type DEVICE

Right ventricular pacing (apical or septal lead locations as per the implanting physicians' normal practice).

Physiological pacing

The approach for physiological pacing will be either His bundle pacing or left bundle pacing at the operator's discretion. If both of these are not achieved biventricular pacing will be performed.

Group Type EXPERIMENTAL

Pacemaker - Physiological pacing

Intervention Type DEVICE

The approach for physiological pacing will be either His bundle pacing or left bundle pacing at the operator's discretion. If both of these are not achieved biventricular pacing will be performed.

Interventions

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Pacemaker - Physiological pacing

The approach for physiological pacing will be either His bundle pacing or left bundle pacing at the operator's discretion. If both of these are not achieved biventricular pacing will be performed.

Intervention Type DEVICE

Pacemaker - Right Ventricular pacing

Right ventricular pacing (apical or septal lead locations as per the implanting physicians' normal practice).

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1\. Adults aged over 18 with left ventricular ejection fraction \>35% and one or more of the following guideline based ventricular pacing indications:

1. Permanent or intermittent 3rd degree AV block
2. Permanent or intermittent Mobitz type II AV block
3. First Degree AV block with a pacing indication
4. Slow chronic Atrial Fibrillation or Proposed AV node ablation
5. Bifascicular block with a pacing indication
6. Trifascicular block with a pacing indication
7. Wenckebach with a pacing indication

Exclusion Criteria

1. Patients who are likely to only need occasional ventricular pacing, i.e. those with isolated sick sinus syndrome.
2. Pregnant women.
3. Unable to provide informed consent.
4. Those with comorbidity leading to a life expectancy \<1year.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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British Heart Foundation

OTHER

Sponsor Role collaborator

Imperial College London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Beacon Hospital

Dublin, , Ireland

Site Status RECRUITING

Univerisity Medical Centre Ljubljana

Ljubljana, , Slovenia

Site Status RECRUITING

Aberdeen Royal Infirmary

Aberdeen, , United Kingdom

Site Status RECRUITING

Queen's Hospital

Barking, , United Kingdom

Site Status RECRUITING

Good Hope Hospital

Birmingham, , United Kingdom

Site Status RECRUITING

Queen Elizabeth Hospital

Birmingham, , United Kingdom

Site Status RECRUITING

University Hospital Dorset

Bournemouth, , United Kingdom

Site Status RECRUITING

Royal SUSSEX County Hospital

Brighton, , United Kingdom

Site Status RECRUITING

Bristol Heart Institute

Bristol, , United Kingdom

Site Status RECRUITING

Royal Papworth Hospital

Cambridge, , United Kingdom

Site Status RECRUITING

St Richard's Hospital

Chichester, , United Kingdom

Site Status RECRUITING

University Hospital Coventry

Coventry, , United Kingdom

Site Status RECRUITING

Croydon

Croydon, , United Kingdom

Site Status RECRUITING

Royal Infirmary of Edinburgh

Edinburgh, , United Kingdom

Site Status RECRUITING

Victoria Hospital

Fife Keith, , United Kingdom

Site Status RECRUITING

Medway Maritime Hospital

Gillingham, , United Kingdom

Site Status RECRUITING

Wycombe Hospital

High Wycombe, , United Kingdom

Site Status RECRUITING

Forth Valley Royal Hospital

Larbert, , United Kingdom

Site Status RECRUITING

Leeds Teaching Hospital

Leeds, , United Kingdom

Site Status RECRUITING

Glenfield Hospital

Leicester, , United Kingdom

Site Status RECRUITING

Liverpool Heart and Chest Hospital

Liverpool, , United Kingdom

Site Status RECRUITING

Hammersmith Hospital

London, , United Kingdom

Site Status RECRUITING

Kettering Hospital

London, , United Kingdom

Site Status RECRUITING

King's College Hospital

London, , United Kingdom

Site Status RECRUITING

Royal Free London/ Barnet Hospital

London, , United Kingdom

Site Status RECRUITING

St Bartholomew's Hospital

London, , United Kingdom

Site Status RECRUITING

Watford General Hospital

London, , United Kingdom

Site Status RECRUITING

James Cook Hospital

Middlesbrough, , United Kingdom

Site Status RECRUITING

King's Mill Hospital

Nottingham, , United Kingdom

Site Status RECRUITING

Nottingham City Hospital

Nottingham, , United Kingdom

Site Status RECRUITING

John Radcliffe Hospital

Oxford, , United Kingdom

Site Status RECRUITING

Derriford Hospital

Plymouth, , United Kingdom

Site Status RECRUITING

Queen Alexandra Hospital

Portsmouth, , United Kingdom

Site Status RECRUITING

Royal Berkshire

Reading, , United Kingdom

Site Status RECRUITING

East Surrey

Redhill, , United Kingdom

Site Status RECRUITING

Rotherham General Hospital

Rotherham, , United Kingdom

Site Status RECRUITING

Northern General

Sheffield, , United Kingdom

Site Status RECRUITING

Wexham Park Hospital

Slough, , United Kingdom

Site Status RECRUITING

Southampton

Southampton, , United Kingdom

Site Status RECRUITING

Morriston Hospital

Swansea, , United Kingdom

Site Status RECRUITING

Great Western

Swindon, , United Kingdom

Site Status RECRUITING

Musgrove Park Hospital

Taunton, , United Kingdom

Site Status RECRUITING

Torbay Hospital

Torquay, , United Kingdom

Site Status RECRUITING

UHS Worthing

Worthing, , United Kingdom

Site Status RECRUITING

York Hospital

York, , United Kingdom

Site Status RECRUITING

Countries

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Ireland Slovenia United Kingdom

Central Contacts

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Zachary Whinnett

Role: CONTACT

+447749576830

Daniel Keene

Role: CONTACT

+442075949776

Facility Contacts

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Dr Cian Mangan

Role: primary

Dr David Zizek

Role: primary

Valerie Harris

Role: primary

Katrina Frayna

Role: primary

Daniel Lenton

Role: primary

Sophia Duong

Role: primary

Tanith Changuion

Role: primary

Fiona Ingoldby

Role: primary

Sheila Bell

Role: primary

Jessica Strange

Role: backup

Joanna Oliveira

Role: primary

Katherine Nicholas

Role: primary

Nigel Edwards

Role: primary

Jacqueline Adabie-Ankrah

Role: primary

Marie Callaghan

Role: primary

Claire Hart

Role: backup

Sandra Pirie

Role: primary

Suzanne Williams

Role: primary

Josephine Chaplin

Role: primary

Elaine Wilson

Role: primary

Marie Callaghan

Role: primary

Elizabeth Cox

Role: primary

Sharon Glynn

Role: primary

Nandita Kaza

Role: primary

Eva Kisakye

Role: primary

Abigail Knighton

Role: primary

Susana Ramos Vasquez

Role: primary

Role: backup

Ben Romano

Role: primary

Mary James

Role: primary

Beverly Atkinson

Role: primary

Rebecca Rudd

Role: primary

Edelline Makondo

Role: primary

Katharine New

Role: primary

Lorraine Madziva

Role: primary

Pedro Bragasardo

Role: primary

Mark Brunton

Role: primary

Julie Houghton

Role: primary

Rachel Walker

Role: primary

Olivia Holmes

Role: primary

Victoria Ugochukwu

Role: primary

Lisa Fletcher

Role: primary

Debbie Williams

Role: primary

Suzannah Pegler

Role: primary

Helen Mills

Role: primary

Lisa Felmelden

Role: primary

Samantha Margerison

Role: primary

Julie Anderson

Role: primary

Provided Documents

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Document Type: Study Protocol: Protocol_v9.0_16.06.2025

View Document

Other Identifiers

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22HH7931

Identifier Type: -

Identifier Source: org_study_id

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