Reversibility of Cardiac Conduction Disturbances Following TAVI

NCT ID: NCT06481137

Last Updated: 2024-07-01

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

209 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-06-17

Study Completion Date

2026-12-31

Brief Summary

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The management of patients with conduction disturbances (CDs) after transcatheter aortic valve implantation (TAVI) is unclear, especially in those with de novo electrocardiographic CDs (ECG-CDs) such as left bundle branch block.

In this study, the investigators will evaluate the incidence of retrogradation of infra-Hisian CDs in patients with de novo ECG-CDs and positive electrophysiological study (EPS) 3-7 days following TAVI. In addition, the investigators will evaluate the need for cardiac pacing and the incidence of clinical events in patients with negative EPS performed 3-7 days following TAVI.

In this multicenter, longitudinal, prospective study, patients with clinical indication of EP study due to new-onset ECG-CDs after TAVI will be included. A permanent pacemaker will be implanted in patients with positive EPS and a second EPS will be performed in 30-45 days. Additionally, these patients will undergo 4-week continuous monitoring using the ePatch (Philips) long-term Holter recorder, to identify episodes of paroxysmal complete atrioventricular block. Patients with negative EP study will undergo clinical follow-up and continuous monitoring for 4 weeks.

Detailed Description

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Conditions

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Aortic Stenosis Transcatheter Aortic Valve Implantation Conduction Disturbances

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Positive initial (3-7 days following TAVI) electrophysiological study (EP+)

Permanent pacemaker implantation. Continuous ECG monitoring during 4 weeks. Second EP study 30-45 days after TAVI.

Group Type EXPERIMENTAL

Electrophysiological study (EP study)

Intervention Type DIAGNOSTIC_TEST

Electrophysiological study: A second EP study 30-45 days after TAVI will be performed in the group of patients with positive EP study 3-7 days after TAVI.

ePatch (extended Holter Monitoring)

Intervention Type DIAGNOSTIC_TEST

Continuous cardiac rhythm monitoring using the ePatch (Philips) will be performed during 4 weeks after TAVI

Negative initial (3-7 days following TAVI) electrophysiological study (EP-)

Continuous ECG monitoring during 4 weeks.

Group Type OTHER

ePatch (extended Holter Monitoring)

Intervention Type DIAGNOSTIC_TEST

Continuous cardiac rhythm monitoring using the ePatch (Philips) will be performed during 4 weeks after TAVI

Interventions

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Electrophysiological study (EP study)

Electrophysiological study: A second EP study 30-45 days after TAVI will be performed in the group of patients with positive EP study 3-7 days after TAVI.

Intervention Type DIAGNOSTIC_TEST

ePatch (extended Holter Monitoring)

Continuous cardiac rhythm monitoring using the ePatch (Philips) will be performed during 4 weeks after TAVI

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Patients with indication for electrophysiological (EP) study after TAVI implantation according to European Guidelines. Patients must have persistent electrocardiographic conduction disturbances (ECG-CDs) that are present from day 2 after TAVI implantation (≥ 48h post-procedure):
* De novo LBBB with QRS complex \>150ms and/or PR interval ≥240ms.
* QRS widening or post-procedural PR lengthening \> 20ms in patients with baseline ECG-CDs.

Exclusion Criteria

* Patients with previous pacemaker or implantable defibrillator.
* Patients with baseline complete right bundle branch block.
* Patients in need of cardiac resynchronization or physiological stimulation following TAVI.
* Valve-in-valve procedures.
* TAVI procedures in patients with severe aortic insufficiency.
* Inability to sign the informed consent form.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Universitari de Bellvitge

OTHER

Sponsor Role collaborator

Hospital Universitario La Paz

OTHER

Sponsor Role collaborator

Hospital Vall d'Hebron

OTHER

Sponsor Role collaborator

Hospital Universitario Ramon y Cajal

OTHER

Sponsor Role collaborator

Hospital Universitario A Coruna Spain

UNKNOWN

Sponsor Role collaborator

Hospital Clinico Universitario de Santiago

OTHER

Sponsor Role collaborator

Hospital Universitario Central de Asturias

OTHER

Sponsor Role collaborator

Hospital Universitario Marqués de Valdecilla

OTHER

Sponsor Role collaborator

Hospital Clínico Universitario de Valladolid

OTHER

Sponsor Role collaborator

Institut d'Investigació Biomèdica de Bellvitge

OTHER

Sponsor Role lead

Responsible Party

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Guillem Muntané Carol

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Hospital Universitari de Bellvitge

L'Hospitalet de Llobregat, Barcelona, Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Guillem Muntané Carol, MD, PhD

Role: CONTACT

+342607500 ext. 7539

Facility Contacts

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Hospital Universitari de Bellvitge

Role: primary

+342607500 ext. 7539

Other Identifiers

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PI23/00310

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

ICPS025/24

Identifier Type: -

Identifier Source: org_study_id

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