Comparing 3 pacemaker types in people with heart failure and uneven heartbeat timing
Compares 3 pacemaker types in adults with heart failure and uneven heartbeat timing.
Plain-language title generated from the registry record
Registry title: Comparing Three Types of Specialist Pacemakers to Improve Heart Function and Reduce Rhythm Problems in Heart Failure
Key facts
- Where
- London, United KingdomSee the site
Where in United Kingdom
- Hammersmith Hospital, Imperial College Healthcare NHS TrustLondon, United KingdomTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Imperial College London
- Trial code
- NCT07430553
- Record updated
- 24 February 2026
- Original description
The goal of this clinical trial is to find out which type of specialist pacemaker-known as cardiac resynchronisation therapy (CRT)-works best for people with heart failure and a delay in how the lower chambers of the heart beat together (called electrical dyssynchrony).Read full original descriptionShow less
Randomised Investigation of Physiological, Conventional and Optimised Resynchronisation Therapy in Heart Failure With Prolonged QRS Duration (RIPCORD-CRT)
The goal of this clinical trial is to find out which type of specialist pacemaker-known as cardiac resynchronisation therapy (CRT)-works best for people with heart failure and a delay in how the lower chambers of the heart beat together (called electrical dyssynchrony).
The main aims of the study are:
To compare the effects of conventional biventricular pacing (BVP), conduction system pacing (CSP) and left-bundle optimised CRT (LOT-CRT) on heart failure symptoms and heart rhythm problems over six months.
To explore how these pacing methods affect heart muscle strength, electrical activity, and overall heart function.
Participants will:
Attend four hospital visits over a six-month period.
At Visit 1, meet a member of the research team to discuss the study and have screening tests to check eligibility. Participants will also have a smartphone app installed and receive training on how to record their daily heart failure symptoms.
At Visit 2, have a CRT pacemaker implanted. The type of pacemaker will be chosen at random, with a 1 in 3 chance of receiving:
* Biventricular pacing (BVP); the current standard treatment * Conduction system pacing (CSP) * LOT-CRT (Left-bundle optimised CRT); a combination of both
At Visit 3 (around 12 weeks after implantation) and Visit 4 (6 months after implantation), take part in routine follow-up assessments to check the pacemaker and heart function.
At Visits 2 and 4, also undergo non-invasive electrical mapping tests, including wearing a specialised vest and having a low-dose CT scan of the chest. These tests help researchers understand how the heart's electrical system responds to different pacing methods.
Inclusion: Patients referred/scheduled for a CRT procedure (new implant or upgrade) who have:; Symptomatic heart failure (NYHA II-IV); Reduced ejection fraction (LVEF≤40%); Prolonged QRS duration (≥130ms) and left bundle branch block ECG morphology or very prolonged QRS duration (>150ms) and non-left bundle branch block ECG; Optimal medical therapy for HF.
Exclusion: <18 years old; Pregnant patients (with female patients of childbearing age requiring a negative urine BHCG); Unable to provide informed consent.