Efficacy and Safety of Leadless Pacemakers Versus Left Bundle Area Pacing - A Preliminary Exploration
NCT ID: NCT06690333
Last Updated: 2025-05-30
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
NA
75 participants
INTERVENTIONAL
2024-11-05
2026-12-31
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
OTHER
SINGLE
Study Groups
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Left bundle area pacing
Transvenous pacemaker with left bundle area pacing
Pacemaker
Transvenous pacemaker with left bundle area pacing
MICRA AV
Transcatheter pacemaker with MICRA AV
Pacemaker
Transcatheter pacemaker with MICRA AV
Interventions
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Pacemaker
Transvenous pacemaker with left bundle area pacing
Pacemaker
Transcatheter pacemaker with MICRA AV
Eligibility Criteria
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Inclusion Criteria
2. Planned for:
1. permanent pacemaker implantation for AV node disease (first, second or third degree), OR
2. post-TAVR patient requiring permanent pacemaker implantation
3. Preserved ejection fraction \> 50%
4. Preserved sinus node function
5. Willingness to adhere to study restrictions and comply with all post-procedural follow-up requirements
6. Life expectancy \> 1 year
7. Female subject of childbearing potential is not pregnant, not breast feeding, does not plan to be pregnant during the course of the study, and agrees to use a highly effective contraceptive method (i.e. IUD, birth control, vasectomized partner, sexual abstinence, etc.) during the course of the study.
8. Subject has been informed of the nature of the study, agrees to its provision and has provided written informed consent, approved by the IRB
Exclusion Criteria
2. Anatomical restriction for either MICRA or transvenous pacing such as
1. Access vein occlusion or thrombosis
2. previous radiation therapy at insertion site
3. inferior vena cava filter
3. Endstage renal disease (ESRD)/on dialysis
4. Dementia (inability to give consent)
5. Moderate to Severe or Severe Tricuspid valve regurgitation
6. Moderate to Severe or Severe Mitral valve regurgitation
7. History of mitral or tricuspid valve surgery
8. Preexisting implanted pacemaker or ICD or lead
9. Subject is allergic to titanium
10. Life expectancy \< 1 year
11. Recurrent or high risk of infections
12. Active malignancy requiring systemic chemotherapy or local chest radiation
13. Subject has myocardial infarction, unstable angina, cerebrovascular accident, or heart failure admission within 3 months of the baseline visit
14. CABG, valve surgery or PCI within the last 3 months except TAVR
15. Other major cardiac surgery within the last 6 months
16. Persistent and permanent atrial fibrillation diagnosed by a healthcare provider
17. NYHA class 3 or 4 Heart Failure
18. Evidence of renal injury (12 hours post-TAVR)
19. Access site complication(s) post-TAVR
20. Suspicion of stroke/cerebrovascular accident (CVA) or transient ischemic attack (TIA) within 12 hours post-TAVR
21. Physician suspicion that ambulation to pre-TAVR activities post-pacemaker implantation would be unattainable
22. Other post-TAVR complications that in the opinion of the investigator may seriously confound study outcomes
18 Years
ALL
No
Sponsors
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Medtronic
INDUSTRY
NCH Healthcare System, Inc. dba Naples Comprehensive Health and dba NCH
OTHER
Responsible Party
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Dinesh Sharma
MD
Principal Investigators
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Dinesh Sharma, MD
Role: PRINCIPAL_INVESTIGATOR
NCH Healthcare
Locations
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NCH Healthcare
Naples, Florida, United States
Massachusetts General Hospital
Boston, Massachusetts, United States
Countries
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Central Contacts
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Facility Contacts
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References
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Vijayaraman P, Sharma PS, Cano O, Ponnusamy SS, Herweg B, Zanon F, Jastrzebski M, Zou J, Chelu MG, Vernooy K, Whinnett ZI, Nair GM, Molina-Lerma M, Curila K, Zalavadia D, Haseeb A, Dye C, Vipparthy SC, Brunetti R, Moskal P, Ross A, van Stipdonk A, George J, Qadeer YK, Mumtaz M, Kolominsky J, Zahra SA, Golian M, Marcantoni L, Subzposh FA, Ellenbogen KA. Comparison of Left Bundle Branch Area Pacing and Biventricular Pacing in Candidates for Resynchronization Therapy. J Am Coll Cardiol. 2023 Jul 18;82(3):228-241. doi: 10.1016/j.jacc.2023.05.006. Epub 2023 May 21.
Chinitz L, Ritter P, Khelae SK, Iacopino S, Garweg C, Grazia-Bongiorni M, Neuzil P, Johansen JB, Mont L, Gonzalez E, Sagi V, Duray GZ, Clementy N, Sheldon T, Splett V, Stromberg K, Wood N, Steinwender C. Accelerometer-based atrioventricular synchronous pacing with a ventricular leadless pacemaker: Results from the Micra atrioventricular feasibility studies. Heart Rhythm. 2018 Sep;15(9):1363-1371. doi: 10.1016/j.hrthm.2018.05.004. Epub 2018 May 11.
Sanchez R, Nadkarni A, Buck B, Daoud G, Koppert T, Okabe T, Houmsse M, Weiss R, Augostini R, Hummel JD, Kalbfleisch S, Daoud EG, Afzal MR. Incidence of pacing-induced cardiomyopathy in pacemaker-dependent patients is lower with leadless pacemakers compared to transvenous pacemakers. J Cardiovasc Electrophysiol. 2021 Feb;32(2):477-483. doi: 10.1111/jce.14814. Epub 2020 Nov 25.
Duray GZ, Ritter P, El-Chami M, Narasimhan C, Omar R, Tolosana JM, Zhang S, Soejima K, Steinwender C, Rapallini L, Cicic A, Fagan DH, Liu S, Reynolds D; Micra Transcatheter Pacing Study Group. Long-term performance of a transcatheter pacing system: 12-Month results from the Micra Transcatheter Pacing Study. Heart Rhythm. 2017 May;14(5):702-709. doi: 10.1016/j.hrthm.2017.01.035. Epub 2017 Feb 10.
Udo EO, Zuithoff NP, van Hemel NM, de Cock CC, Hendriks T, Doevendans PA, Moons KG. Incidence and predictors of short- and long-term complications in pacemaker therapy: the FOLLOWPACE study. Heart Rhythm. 2012 May;9(5):728-35. doi: 10.1016/j.hrthm.2011.12.014. Epub 2011 Dec 17.
Vijayaraman P, Ponnusamy S, Cano O, Sharma PS, Naperkowski A, Subsposh FA, Moskal P, Bednarek A, Dal Forno AR, Young W, Nanda S, Beer D, Herweg B, Jastrzebski M. Left Bundle Branch Area Pacing for Cardiac Resynchronization Therapy: Results From the International LBBAP Collaborative Study Group. JACC Clin Electrophysiol. 2021 Feb;7(2):135-147. doi: 10.1016/j.jacep.2020.08.015. Epub 2020 Oct 28.
Zhang S, Guo J, Tao A, Zhang B, Bao Z, Zhang G. Clinical outcomes of left bundle branch pacing compared to right ventricular apical pacing in patients with atrioventricular block. Clin Cardiol. 2021 Apr;44(4):481-487. doi: 10.1002/clc.23513. Epub 2021 Mar 11.
Kiehl EL, Makki T, Kumar R, Gumber D, Kwon DH, Rickard JW, Kanj M, Wazni OM, Saliba WI, Varma N, Wilkoff BL, Cantillon DJ. Incidence and predictors of right ventricular pacing-induced cardiomyopathy in patients with complete atrioventricular block and preserved left ventricular systolic function. Heart Rhythm. 2016 Dec;13(12):2272-2278. doi: 10.1016/j.hrthm.2016.09.027.
Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR, Goldschlager NF, Hamilton RM, Joglar JA, Kim RJ, Lee R, Marine JE, McLeod CJ, Oken KR, Patton KK, Pellegrini CN, Selzman KA, Thompson A, Varosy PD. 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2019 Aug 20;140(8):e382-e482. doi: 10.1161/CIR.0000000000000628. Epub 2018 Nov 6. No abstract available.
Huang HD, Mansour M. Pacemaker Implantation After Transcatheter Aortic Valve Replacement: A Necessary Evil Perhaps But Are We Making Progress? J Am Heart Assoc. 2020 May 5;9(9):e016700. doi: 10.1161/JAHA.120.016700. Epub 2020 May 2. No abstract available.
Dell'Era G, Baroni M, Frontera A, Ghiglieno C, Carbonaro M, Penela D, Romano C, Giordano F, Del Monaco G, Galimberti P, Mazzone P, Patti G. Left bundle branch area versus conventional pacing after transcatheter valve implant for aortic stenosis: the LATVIA study. J Cardiovasc Med (Hagerstown). 2024 Jun 1;25(6):450-456. doi: 10.2459/JCM.0000000000001619. Epub 2024 Apr 1.
Kassab K, Patel J, Feseha H, Kaynak E. MICRA AV implantation after transcatheter aortic valve replacement. Cardiovasc Revasc Med. 2024 Jun;63:31-35. doi: 10.1016/j.carrev.2024.01.005. Epub 2024 Jan 12.
Mechulan A, Prevot S, Peret A, Nait-Saidi L, Miliani I, Leong-Feng L, Leude-Vaillant E, Vaillant A, Cornen A, Latiere B, Giacomoni MP, Collet F, Bechet V, Bouharaoua A, Dieuzaide P. Micra AV leadless pacemaker implantation after transcatheter aortic valve implantation. Pacing Clin Electrophysiol. 2022 Nov;45(11):1310-1315. doi: 10.1111/pace.14545. Epub 2022 Jun 13.
Other Identifiers
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13500
Identifier Type: OTHER
Identifier Source: secondary_id
IRB0081
Identifier Type: -
Identifier Source: org_study_id
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