Study Results
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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RECRUITING
70 participants
OBSERVATIONAL
2023-08-01
2026-02-02
Brief Summary
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1. What impact does coronary artery disease have on the ability for a patient to tolerate VT?
2. Does treatment of coronary artery disease with stents improve the tolerability of VT?
Participants who are undergoing a clinically indicated coronary angiogram or coronary angioplasty procedure will have measurements of blood pressure, coronary pressure and coronary flow made during pacing at a range of heart rates.
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Detailed Description
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If VT is not tolerated then current practice is to offer an implantable cardioverter defibrillator (ICD) which can deliver a shock to the heart if dangerous heart rhythms are detected. While shocks can be life-saving, they are also harmful, including causing psychological distress. ICDs also frequently deliver shocks when they are not needed.
If research could identify which factors predispose a person to be stable or unstable in VT, this would allow doctors to help them in a range of ways. One way would be to treat patients to improve the tolerance of VT, so avoiding the need for an ICD. Another would be to assess the the risk of instability and so allow a patient-centred decision on whether an ICD is needed.
In this study the investigators plan to recruit patients who are referred for a coronary angiogram. During the angiogram, the investigators will stimulate the heart at a range of fast heart rates and measure their blood pressure and flow in their coronary arteries. In patients who undergo stenting for a coronary stenosis, the investigators will also make these measurements after stenting so they can see if there is any difference. By recruiting a range of different cardiology patients, the investigators will be able to assess which factors contribute to stability during VT.
Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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Controls
10 patients with unobstructed coronary arteries, normal microvascular function and normal LV function.
Pressure and flow measurement during simulated VT
Participants undergoing coronary angiography will have measurements of blood pressure, coronary pressure and coronary flow during simulated VT. VT will be simulated using pacing at a range of heart rates.
Coronary artery disease
25 patients with severe, single-vessel coronary artery disease of the proximal LAD or proximal other dominant vessel awaiting PCI.
Pressure and flow measurement during simulated VT
Participants undergoing coronary angiography will have measurements of blood pressure, coronary pressure and coronary flow during simulated VT. VT will be simulated using pacing at a range of heart rates.
Microvascular dysfunction
15 patients with without severe disease in any coronary artery, impaired microvascular function and normal LV function.
Pressure and flow measurement during simulated VT
Participants undergoing coronary angiography will have measurements of blood pressure, coronary pressure and coronary flow during simulated VT. VT will be simulated using pacing at a range of heart rates.
Heart failure
20 patients with LV systolic dysfunction (LVEF\<40%).
Pressure and flow measurement during simulated VT
Participants undergoing coronary angiography will have measurements of blood pressure, coronary pressure and coronary flow during simulated VT. VT will be simulated using pacing at a range of heart rates.
Interventions
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Pressure and flow measurement during simulated VT
Participants undergoing coronary angiography will have measurements of blood pressure, coronary pressure and coronary flow during simulated VT. VT will be simulated using pacing at a range of heart rates.
Eligibility Criteria
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Inclusion Criteria
* Referred for coronary angiography or coronary angioplasty
* Suitable for percutaneous physiological interrogation and PCI when clinically indicated
Exclusion Criteria
* Pregnant or breastfeeding women
* Unstable coronary artery disease (acute coronary syndrome)
* Severe multivessel coronary artery disease suitable for coronary artery bypass grafting
* Severe heart valve disease
* Severe (NYHA IV) heart failure
18 Years
ALL
No
Sponsors
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Imperial College London
OTHER
Responsible Party
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Principal Investigators
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Ricardo Petraco
Role: PRINCIPAL_INVESTIGATOR
Senior Clinical Research Fellow
Locations
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Imperial College NHS Foundation Trust
London, , United Kingdom
Countries
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Central Contacts
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Facility Contacts
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Other Identifiers
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22HH7955
Identifier Type: -
Identifier Source: org_study_id
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