NCT06052475Recruiting
Physiological Versus Right Ventricular Outcome Trial Evaluated for Bradycardia Treatment Upgrades
Source: ClinicalTrials.gov · Last updated 23 Jun 2026
Brief summary (registry, in English)
Guidelines for patients having first-time implants advocate that even when heart function is only mildly impaired, modern pacing approaches should be utilised to avoid the potentially damaging effects of RV pacing to preventing symptoms from pacing induced or worsened cardiomyopathy. However, once a traditional (RV) pacemaker is implanted, development of impaired heart function does not prompt a device upgrade. Even at the end of battery life, physicians simply replace it like-for-like. This trial tests whether such patients have better symptoms and quality of life if changed to a modern physiological pacing strategy from the traditional RV pacing approach. In this crossover trial, participants will be upgraded to a physiological pacing strategy. After their procedure, they will have a one-month run-in period to recover from the procedure (their pacemaker will be programmed to continued RV pacing). They will be have 2 one-month blinded time periods, randomised to physiological pacing or right ventricular pacing alternately. They will subsequently undergo two six-month blinded randomised time periods. Patients will document symptoms monthly on a mobile phone application or computer. At the end of each time period, they will have measurements of heart function, a walking test and quality-of-life questionnaires including the SF-36 questionnaire. The investigators hypothesise that upgrading to physiological pacing strategies will improve patients' quality of life.
- Status (registry)
- Recruiting
- Study type
- Interventional
- Enrollment
- 155 (estimated)
- First submitted
- 19 Sept 2023
- Start date
- 4 Sept 2023
- Primary completion date
- 30 Sept 2026
- Lead sponsor
- Imperial College London
- Diseases
- Heart failure
- NCT number
- NCT06052475
What you commit to
- Study type: Interventional
- Planned participants: 155
- From 4 Sept 2023 to the primary completion date, 30 Sept 2026
- 12 sites in 1 country
- Visits and tests: ask the trial team, the registry does not list them
Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.
Who cannot take part
Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.
Age
- Patients under age 18
Other
- Those unable to provide informed consent
- Pregnant women
Criteria the registry did not label
- Patients with an RV pacemaker and LVEF 35-50% and a high burden of right ventricular pacing (\>40%) who are clinically indicated for a cardiac resynchronisation therapy upgrade procedure and:
- EF reduced by \>5% of increase in LVESV by 10ml since implant
- NT-proBNP \>250ng/L in sinus rhythm
- NT-proBNP \> 750 Ng/L if AF
- Left atrial volume index \> 30ml/m2
- Regular loop diuretics prescribed
- Decline in daily patient activity by \>1 hour per day since implant
- Decrease in device measured thoracic impedance
- Patient reported decline in functional class or exercise tolerance
Age in the registry: 18 years to - · Sex: All · Does not accept healthy volunteers
Sites (12)
Sites in registry order. Pick your city on the disease page to sort them by distance.
| Site | City | Country | Site status |
|---|---|---|---|
| Royal Papworth Hospital Coordinator of this site? Confirm its status | Cambridge | United Kingdom | Recruiting |
| St. Richard's Hospital - University Hospitals Sussex Coordinator of this site? Confirm its status | Chichester | United Kingdom | Recruiting |
| University Hospitals Coventry and Warwickshire NHS Trust Coordinator of this site? Confirm its status | Coventry | United Kingdom | Recruiting |
| Croydon University Hospital - Croydon Health Services Coordinator of this site? Confirm its status | Croydon | United Kingdom | Recruiting |
| Glenfield Hospital Coordinator of this site? Confirm its status | Leicester | United Kingdom | Recruiting |
| King's College Hospital Coordinator of this site? Confirm its status | London | United Kingdom | Recruiting |
| St Bartholomew's Hospital, Barts Health NHS Trust Coordinator of this site? Confirm its status | London | United Kingdom | Recruiting |
| Hammersmith Hospital Coordinator of this site? Confirm its status | London | United Kingdom | Recruiting |
| Oxford University Hospitals Coordinator of this site? Confirm its status | Oxford | United Kingdom | Recruiting |
| University Hospitals Southampton Coordinator of this site? Confirm its status | Southampton | United Kingdom | Recruiting |
| Great Western Hospitals Coordinator of this site? Confirm its status | Swindon | United Kingdom | Recruiting |
| Worthing Hospital - University Hospitals Sussex Coordinator of this site? Confirm its status | Worthing | United Kingdom | Recruiting |
This page is information, not medical advice. Discuss any trial with your doctor.