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Tests personalized heart pacing in people with heart failure and preserved ejection fraction

Tests a personalized pacemaker setting in adults with heart failure and preserved pumping strength.

Plain-language title generated from the registry record
Registry title: ELEVATE-HFpEF Clinical Study

Key facts

Where
Linz, AustriaSee the site

AI summary: who the study is looking for

From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.

The trial is looking for adults aged 40 or older with heart failure and a preserved ejection fraction (the heart still pumps out at least 50% of its blood).

Age
40 years or older
Sex
All sexes can join
Disease stage
Heart failure with a documented ejection fraction of 50% or more in the last 12 months. Either a worsening heart failure episode in the last 12 months, or breathlessness on effort with NYHA class II or higher plus supporting test findings.
Earlier treatment
Must have been on stable guideline-indicated heart failure medication for at least 30 days. Must not have, or plan to have, a pacemaker, ICD or CRT device.
Biomarker or test result
One supporting finding is needed, such as fluid in the lungs on imaging with loop diuretic use, raised NT-proBNP, raised pressures on catheterization or an implanted monitor, or at least 2 echo findings. Average heart rate on a baseline ECG monitor must be at least 5 bpm below the calculated personalized pacing rate.

Main reasons for not taking part

  • Earlier ejection fraction below 50%
  • Pacemaker, ICD or CRT device already implanted or planned
  • Current pregnancy
  • Average heart rate below 50 bpm or bradycardia with symptoms
  • Heart attack or acute coronary syndrome, heart surgery or urgent PCI in the last 3 months

Read by machine on 9 November 2026.

Where in Austria

  • Ordensklinikum Linz GmbH ElisabethinenLinz, AustriaTaking people

Questions to ask the study team

  1. How often do I need to come in, and for how long each time?
  2. Are travel costs paid?
  3. Can I keep my own doctor?
  4. What happens if I want to stop?

Contact the study team: see the registry record → Contacts and Locations

Print a page for my doctor

Trial details

Who runs it
Medtronic Cardiac Rhythm and Heart Failure
Trial code
NCT06678841
Record updated
3 November 2026
Original description
ELEVATE-HFpEF is a prospective, randomized, controlled, double-blinded, multi-center, global, interventional pivotal study evaluating the safety and efficacy of dual chamber personalized pacing compared to minimal or no pacing for the treatment of patients with heart failure with preserved ejection fraction (HFpEF).Read full original descriptionShow less

Randomized Trial of ELEVATEd Cardiac Pacing Rate for Personalized Treatment of Heart Failure With Preserved Ejection Fraction (ELEVATE-HFpEF)

ELEVATE-HFpEF is a prospective, randomized, controlled, double-blinded, multi-center, global, interventional pivotal study evaluating the safety and efficacy of dual chamber personalized pacing compared to minimal or no pacing for the treatment of patients with heart failure with preserved ejection fraction (HFpEF).

Inclusion: Age ≥ 40 years; Documented EF ≥50% within the preceding 12 months; HFpEF defined as:; Documented worsening HF episode (either HF hospitalization or documented urgent clinic visit for HF with intravenous diuretics) within 12-months prior to baseline visit OR; Dyspnea on exertion and New York Heart Association (NYHA) ≥ class II symptoms AND AT LEAST ONE OF THE FOLLOWING CRITERIA:; Interstitial / pulmonary edema on prior chest imaging in the last year AND current loop diuretic use for heart failure; Elevated NT-proBNP in the last year defined as >400 pg/m for patients with no AF or paroxysmal AF, or >900 pg/ml for patients with ≥persistent AF; Mean pulmonary capillary wedge pressure (PCWP) ≥15 mm Hg or LVEDP ≥16 mm Hg at rest on cardiac catheterization OR pulmonary artery diastolic and wedge pressure (PADP) ≥15 mm Hg at rest on implantable monitor (e.g., CardioMEMs); Echo criteria defined by ≥2 of:; LV wall thickness ≥ 12 mm; LV mass index (BSA indexed LVH): sex at birth male >115 g/m2, sex at birth female >95 g/m2; Relative wall thickness ≥0.42; E/e' ≥15 in sinus rhythm (or > 11 in the setting of atrial fibrillation) OR septal <7 cm/s or lateral e' <10cm/s; Tricuspid regurgitation (TR) velocity >2.8 m/s; Left atrial (LA) enlargement, defined by LA volume index >34 ml/m2; Patient is on stable guideline indicated HF medical therapy (Class I recommendations) for at least 30 days; Patient's average heart rate on baseline ambulatory electrocardiographic monitor is at least 5 bpm lower than their calculated personalized cardiac pacing rate (e.g. if a patient's personalized cardiac pacing rate is 70 bpm and their average heart rate on the ambulatory electrocardiographic monitor is less than or equal to 65 bpm the patient is eligible); Patient is willing and able to adhere to the protocol (e.g., patient is able to ambulate independently at baseline).

Exclusion: Patient has a previously implanted, currently implanted, or is intended to have implanted a cardiac implantable electronic device capable of delivering pacing (e.g., pacemaker, implantable cardioverter defibrillator (ICD), cardiac resynchronization therapy (CRT)); Acute coronary syndrome (including MI), cardiovascular surgery, or urgent percutaneous coronary intervention (PCI) within the 3 months prior to baseline visit or an elective PCI within 30 days prior to baseline visit; Current acute decompensated HF requiring intravenous diuretics, vasodilators and/or inotropic drugs; Known contraindication for a pacemaker implant; Patients who are currently enrolled in a potentially confounding drug or device trial during the course of the study. Co-enrollment in concurrent trials is only allowed when documented pre-approval is obtained from the Medtronic Study Manager; Average heart rate <50 bpm or symptomatic bradycardia; Persistent, long-standing persistent, or permanent atrial fibrillation (AF) with an average heart rate <50 bpm or evidence of ventricular pauses exceeding 6 seconds; Uncontrolled hypertension as defined by BP >160/100 mmHg on two measurements ≥15 minutes apart; End Stage Renal Disease (CKD 4 or greater); More than moderate valvular disease (e.g. exclude patients with moderate severe or severe valvular disease); Significant primary pulmonary disease on home oxygen; Improved or recovered EF (i.e., prior LVEF<50%); Current pregnancy (requirement for negative pregnancy test may vary by jurisdiction); Severe obesity defined as BMI >45; Planned AF ablation; Infiltrative cardiomyopathies (e.g., amyloidosis, sarcoidosis); Hypertrophic cardiomyopathies; Advanced co-morbidity with life expectancy < 1 year; Patient is a vulnerable adult (e.g. patient mentally incapable of giving consent).

ClinicalTrials.gov NCT06678841