Cardiac Anodal Biphasic Pacing

NCT ID: NCT07173777

Last Updated: 2025-12-29

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

108 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-02-28

Study Completion Date

2027-07-31

Brief Summary

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The goal of this study is to test a new pacing method called anodal biphasic pacing (ABP) to determine if this pacing works as well-or better-than current pacing methods. This new method may improve how the heart works and reduce some of the problems caused by regular pacing.

Current implantable pacemakers use a monophasic cathodal waveform to stimulate the heart. Monophasic cathodal pacing (MCP) waveforms slow conduction, impair contractility, cause inflammation, increase risk of atrial fibrillation, heart failure, and mortality. Anodal biphasic pacing (ABP) is an alternative waveform that can stimulate the heart. ABP preconditions the heart and then initiates cardiac contraction. ABP may address the limitations of MCP.

Detailed Description

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This study is a single-center, prospective, investigator-initiated, non-randomized, study that will investigate ABP in patients with structurally normal hearts and those with non-ischemic cardiomyopathy who are undergoing interventional cardiac procedure, generator exchange of dual chamber Cardiac implantable electronic device (CIED), or de novo implant or generator exchange of CIED with cardiac resynchronization therapy.

Eligible participants, without heart disease and those with nonischemic cardiomyopathy, undergoing CIED implant or generator exchange or interventional cardiac procedure at Boston Medical Center will be screened and prospectively enrolled. Participants will be stratified by left ventricular ejection fraction (EF): those with severely reduced EF (≤35%), mid-range EF (\> 35%-49%) and normal EF (EF≥ 50%).

Primary efficacy objectives:

1. To identify which patient populations have the greatest and most consistent hemodynamic benefit from ABP as compared with cathodal pacing.
2. To confirm that ABP does not negatively impact non-responders.
3. To define the ideal anodal biphasic waveform characteristics (amplitude and pulse width) that maximizes the positive effect in subjects who demonstrate hemodynamic improvement ABP
4. To assess differences in capture thresholds between anodal biphasic and cathodal pacing.

Secondary safety objectives:

1. To assess and characterize any ventricular arrhythmias associated with anodal biphasic in comparison to cathodal pacing.
2. To assess device safety
3. To assess procedure safety

Conditions

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Cardiac Pacing

Keywords

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Anodal biphasic pacing (ABP) Monophasic cathodal pacing (MCP) Ejection fraction Cardiac implantable electronic device Cardiac contractility modulation Implantable cardiac defibrillator

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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Cohort A

Cardiac patients who are undergoing interventional cardiac procedure including electrophysiology (EP) with planned retrograde left ventricular access or diagnostic coronary catheterization.

Group Type EXPERIMENTAL

Cardiac Waveform Generator

Intervention Type DEVICE

A pacing device that allows for programmable pulse waveforms to generate a predefined set of anodal biphasic waveforms. It possesses a battery-powered floating point gate array (FPGA) using software that allows flexibility in waveform configuration.

Cohort B

Patients who have pacing indication and are undergoing routine generator exchange of dual chamber cardiac implantable electronic device (CIED).

Group Type EXPERIMENTAL

Cardiac Waveform Generator

Intervention Type DEVICE

A pacing device that allows for programmable pulse waveforms to generate a predefined set of anodal biphasic waveforms. It possesses a battery-powered floating point gate array (FPGA) using software that allows flexibility in waveform configuration.

Cohort C

Patients who are undergoing new implant or generator exchange of CIED with cardiac resynchronization therapy.

Group Type EXPERIMENTAL

Cardiac Waveform Generator

Intervention Type DEVICE

A pacing device that allows for programmable pulse waveforms to generate a predefined set of anodal biphasic waveforms. It possesses a battery-powered floating point gate array (FPGA) using software that allows flexibility in waveform configuration.

Interventions

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Cardiac Waveform Generator

A pacing device that allows for programmable pulse waveforms to generate a predefined set of anodal biphasic waveforms. It possesses a battery-powered floating point gate array (FPGA) using software that allows flexibility in waveform configuration.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

Cohort A

• Planned interventional cardiac procedure

Cohort B

* Planned generator exchange of dual chamber cardiac implantable electronic device (CIED)
* Functioning atrial lead

Cohort C

* Planned de novo implant or generator exchange of CIED with cardiac resynchronization therapy
* Functioning atrial lead

Exclusion Criteria

* Permanent atrial fibrillation
* Third degree AV block without stable escape rhythm
* Ischemic heart disease or coronary disease \> 40%
* Unable to receive heparin
* Are not fluent in English
* Unable to read in English
* Not able to provide informed consent
* Women who are pregnant
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Rocky Mountain Biphasic

UNKNOWN

Sponsor Role collaborator

Boston Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Robert Helm, MD

Role: PRINCIPAL_INVESTIGATOR

Boston Medical Center, Cardiology

Locations

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Boston Medical Center

Boston, Massachusetts, United States

Site Status

Countries

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United States

Central Contacts

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Robert Helm, MD

Role: CONTACT

Phone: 617-638-8985

Email: [email protected]

Denise Fine, BS

Role: CONTACT

Phone: 617-638-8716

Email: [email protected]

Facility Contacts

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Robert Helm, MD

Role: primary

Denise Fine, BS

Role: backup

Other Identifiers

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H-46078

Identifier Type: -

Identifier Source: org_study_id