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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04054895
Other study ID # LEVEL-AT
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date September 1, 2019
Est. completion date June 30, 2022

Study information

Verified date August 2022
Source Hospital Clinic of Barcelona
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The LEVEL-AT Trial (LEft VEntricuLar Activation Time Shortening with Physiological Pacing vs Biventricular Resynchronization therapy: a randomized study) is a non-inferiority study that aims to determine if physiological pacing could decrease the left ventricular activation time compared with biventricular therapy.


Description:

To date studies have showed that physiological pacing could get similar clinical and echocardiographic response to that obtained with biventricular therapy. Activation time shortening with permanent physiological pacing has not been studied. This study will randomize 70 patients to a strategy of: biventricular pacing versus physiological pacing. LEVEL-AT study will analyze the following parameters in the 2 groups: shortening of the QRS, activation time with electrocardiographic imaging, echocardiographic asynchrony and ventricular function and clinical parameters (NYHA functional class, mortality and heart failure hospitalization). Clinical, electrocardiographic, echocardiographic and electrocardiographic imaging follow-up will be performed for 1 year.


Recruitment information / eligibility

Status Completed
Enrollment 70
Est. completion date June 30, 2022
Est. primary completion date June 30, 2022
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - The patient must indicate their acceptance to participate in the study by signing an informed consent document. - The patient must be = 18 years of age. - Left bundle branch block, QRS =130 and FEVI <=35% (Indication of cardiac resynchronization IA or IB ESC Guidelines). No indication of stimulation for AV block. - Patients with indication of resynchronization therapy for ventricular dysfunction and indication of cardiac stimulation for AV block according to ESC Guidelines (IA ESC Guidelines). - Non-left bundle branch block, QRS =150 and FEVI <=35% (Indication of cardiac resynchronization IIaB ESC Guidelines). Exclusion Criteria: - Myocardial infarction, unstable angina or cardiac revascularization during the previous 3 months. - Pregnancy. - Participating currently in a clinical investigation that includes an active treatment.

Study Design


Related Conditions & MeSH terms


Intervention

Device:
Lead placed in the His-Purkinje system in order to achieve QRS shortening.
Physiologic pacing to achieve QRS shortening. If the patient has indication of stimulation (AV block), a backup lead will be implanted in the right ventricle. All patients will have a lead placed in the right atrium (except those that have permanent atrial fibrillation).
Lead is placed in a tributary of the coronary sinus.
Biventricular Resynchronization Therapy is the use of a pacemaker with two endocardial leads placed in the right atrium and right ventricle. The third lead is placed in a tributary of the coronary sinus.

Locations

Country Name City State
Spain Hospital Clinic de Barcelona Barcelona Select

Sponsors (3)

Lead Sponsor Collaborator
Josep Lluis Mont Girbau Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Institut d'Investigacions Biomèdiques August Pi i Sunyer

Country where clinical trial is conducted

Spain, 

Outcome

Type Measure Description Time frame Safety issue
Primary Left ventricular activation time. Left ventricular activation time measured by eletrocardiographic imaging. 45 days
Secondary QRS duration. QRS duration (milliseconds) measured with a 12-lead ECG. Implant, 6 months and 12 months.
Secondary Left ventricular activation time. Left ventricular activation time measured by eletrocardiographic imaging 6 months and 12 months.
Secondary Change in left ventricular function. Left ventricular ejection fraction measured with Simpson method with echocardiography. 6 months and 12 months.
Secondary Change in end-systolic volume. End-systolic volume measured with echocardiography. 6 months and 12 months.
Secondary Change in NYHA functional class. NYHA functional class I, II, III, IV. 6 months and 12 months.
Secondary Hospitalization due to heart failure or mortality (combined endpoint). Hospitalization: patient hospitalization (yes/no) Mortality: mortality (yes/no) 1 year.
Secondary Correction of septal flash Correction of septal flash determined with echocardiography (M mode) 15 days
See also
  Status Clinical Trial Phase
Completed NCT01996397 - Acute Feedback on Left ventrIcular Lead Implantation Location for Cardiac Resynchronization Therapy N/A
Active, not recruiting NCT05187611 - Conduction System Pacing vs Biventricular Resynchronization Therapy in Systolic Dysfunction and Wide QRS: CONSYST-CRT. N/A
Active, not recruiting NCT05155865 - Conduction System Pacing Versus Biventricular Pacing for Cardiac resYNChronization N/A