Advancing Clinical Heart Failure Outcomes Leveraging Defibrillation Lead Implant System for Left Bundle Branch Area Pacing
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: LBBAP Therapy, LOT-CRT, ICD, LOT-CRT.
- Кому может быть актуально
- Состояния в реестре: Heart Failure, Systolic Bundle Branch Block, Left. Базовые параметры: от 18 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Список центров уточняется — проверьте первичный протокол.
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Обзор
This 2x2 randomized crossover feasibility study will evaluate the therapeutic value of adding pacing from the left ventricular lead to Left Bundle Branch Area Pacing (LBBAP) using a cardiac resynchronization therapy defibrillator (CRT-D). This combined therapy is known as Left Bundle Branch Optimized Cardiac Resynchronization Therapy (LOT-CRT) and will be compared to LBBAP therapy over sequential 6-month periods in CRT-indicated patients with LBBB. Primary and secondary outcomes are echocardiographic changes. Exploratory assessments will include NT-proBNP and subject-reported quality of life (KCCQ). An observational treatment arm will include subjects who have not been randomized due to unsuccessful implant for real-world observational analysis
Вмешательства
- Устройство LBBAP Therapy
CRT-D programmed for LBBAP (LV lead OFF) - Устройство LOT-CRT
CRT-D programmed for LOT-CRT (LBBAP + LV lead ON) - Устройство ICD
ICD programmed for LBBAP - Устройство LOT-CRT
CRT-D programmed for LOT-CRT (LBBAP + LV lead ON)
Первичные конечные точки
- Left ventricular ejection fraction (LVEF) [Срок оценки: Baseline, 6 months, 12 months]
- Left ventricular end-systolic volume (LVESV) [Срок оценки: Baseline, 6 months, 12 months]
Вторичные конечные точки (2)
- Left ventricular ejection fraction (LVEF) [Срок оценки: Baseline, 6 months]
- Left ventricular end-systolic volume (LVESV) [Срок оценки: Baseline, 6 months]
Критерии участия
Критерии включения
- Subject meets current ACC/AHA/HRS guidelines for implantation of a CRT-D device.
- Subject has documented LVEF ≤ 35% within 60 days of enrollment.
- Subject meets the criteria for presence of Strauss-defined LBBB.
- Subject meets NYHA classification II or III.
- Subject is willing and able to provide written consent.
- Subject is at least 18 years of age at the time of consent.
- Subject is geographically stable and willing and able to complete study procedures, including follow-up visits.
- The subject's medical records must be accessible by the enrolling site over the follow-up period.
Критерии исключения
- Subject has documented myocardial infarction before enrollment.
- Subject has non-LBBB conduction patterns such as Right Bundle Branch Block (RBBB) or non-specific IVCD.
- Subject has 2nd or 3rd degree AV block.
- Subject has persistent or permanent atrial fibrillation (AF) or atrial flutter (AFL).
- Subject has intrinsic (non-paced) QRS duration ≤ 120ms.
- Subject with previous or existing pacemaker (including transvenous and transcatheter pacing system), Implantable Cardioverter Defibrillator (ICD, transvenous) or CRT-D (transvenous) device or leads.
- Subject has contraindications for screw-in transvenous lead placement (e.g., mechanical right heart valve).
- Subject underwent valve surgery within 90 days prior to enrollment.
- Subject is unable or unwilling to undergo baseline CMR imaging, if previously collected CMR images are unavailable or do not meet minimum acceptable criteria.
- Subject is post-heart transplantation or is actively listed on the transplantation list.
- Subject is implanted with a left ventricular assist device (LVAD).
- Subject has severe renal disease.
- Subject is on continuous or uninterrupted infusion (inotropic) therapy for heart failure.
- Subject has complex and uncorrected congenital heart disease.
- Subject has life expectancy of less than 12 months.
- Subject is pregnant or breastfeeding.
- Subject is enrolled or planning to enroll in a concurrent clinical study that may confound the results of this study, without documented pre-approval from a Medtronic study manager.
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Перекрёстный дизайн
- Маскирование
- Двойное слепое
- Основная цель
- Лечение
Центры проведения
Список центров уточняется — проверьте первичный протокол.
Идентификаторы
NCT: NCT07526896 · MDT25031