Cardiovascular Disease Clinical Trial
Official title:
Randomized Clinical Study to Assess the Safety and the Effects of Isolated Left Ventricular Pacing in Patients With Bradyarrhythmias
Previous experimental and clinical studies have consistently suggested that right ventricular (RV) apical pacing has important adverse effects. Ventricular pacing, however, is required, and cannot be reduced in many patients with atrioventricular block. The SAFE-LVPACE study is a randomized controlled trial that compare the effects of conventional right ventricular (RV) pacing vs. left ventricular (LV) in patients with AV block.
Over the past several years, there has been growing concern over the significant deleterious
effects of RV pacing, including electromechanical dyssynchrony, proarrhythmia and
development of heart failure (HF). However, it remains unclear whether pacing-related
ventricular dyssynchrony can translate into significant LV structural changes and produce
important clinical impairment in an average pacemaker population with compromised AV
conduction. Alternatively, left ventricular pacing has been shown to minimize ventricular
dyssynchrony and to improve symptoms and prognosis in patients with mild to moderated
systolic HF and prolonged QRS duration.
This randomized controlled study is been conducted to compare the effects of conventional
right ventricular (RV) pacing vs. left ventricular (LV) in patients with AV block. The
hypothesis is that isolated LV pacing through the coronary sinus can be used safely and
provide greater hemodynamic benefits to patients with AV block and normal ventricular
function who require only the correction of heart rate.
Specifically, the investigator aims are to evaluate the safety, efficacy and the effects of
left ventricular pacing using active-fixation coronary sinus lead—the Attain StarFix® Model
4195 OTW Lead, compared to right ventricular pacing in patients with implantation criteria
for conventional pacemaker stimulation.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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