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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
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

Full criteria on ClinicalTrials.gov

Sites (12)

Sites in registry order. Pick your city on the disease page to sort them by distance.

SiteCityCountrySite status
Royal Papworth Hospital
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CambridgeUnited KingdomRecruiting
St. Richard's Hospital - University Hospitals Sussex
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ChichesterUnited KingdomRecruiting
University Hospitals Coventry and Warwickshire NHS Trust
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CoventryUnited KingdomRecruiting
Croydon University Hospital - Croydon Health Services
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CroydonUnited KingdomRecruiting
Glenfield Hospital
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LeicesterUnited KingdomRecruiting
King's College Hospital
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LondonUnited KingdomRecruiting
St Bartholomew's Hospital, Barts Health NHS Trust
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LondonUnited KingdomRecruiting
Hammersmith Hospital
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LondonUnited KingdomRecruiting
Oxford University Hospitals
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OxfordUnited KingdomRecruiting
University Hospitals Southampton
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SouthamptonUnited KingdomRecruiting
Great Western Hospitals
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SwindonUnited KingdomRecruiting
Worthing Hospital - University Hospitals Sussex
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WorthingUnited KingdomRecruiting

This page is information, not medical advice. Discuss any trial with your doctor.