Comparison of novel CRT optimisation techniques
Research type
Research Study
Full title
Comparison of automatic optimisation and manual optimisation of cardiac resynchronisation therapy (CRT) using non-invasive cardiac output monitoring (NICOM).
IRAS ID
206767
Contact name
John Hutchinson
Contact email
Sponsor organisation
Papworth Hospital NHS Foundation Trust
Duration of Study in the UK
0 years, 8 months, 22 days
Research summary
The main pumping chambers of the heart are the left and right ventricles. These two ventricles pump simultaneously in normal, healthy individuals. Patients with advanced heart failure, however, have poorly functioning ventricles which do not pump simultaneously.
Cardiac resynchronisation therapy (CRT) is a treatment for advance heart failure. It involves the implantation of a specialised pacemaker; a CRT device. The CRT device helps the heart to pump more effectively by providing simultaneous pumping of the left and right ventricles. This increases the amount of blood that is delivered to the body; the cardiac output.
The CRT device has three leads, which stimulate different parts of the heart at slightly different times to produce synchronised pumping of the left and right ventricles. Time delays between stimulation of different parts of the heart can be modified. In addition, the time delays which produce the biggest increase in cardiac output differ for each patient. Therefore, it is important to tailor time delays to each individual who receives a CRT device and maximise their cardiac output.
At Papworth Hospital this is currently done by manually changing the CRT device settings and seeing what impact this has on the patient’s cardiac output. Cardiac output is measured by non-invasive cardiac output monitoring (NICOM), a technique which involves application of specialised electrodes (stickers) to the chest. The settings that produce the best cardiac output are then used for the patient in the long term.
New CRT devices, however, can perform sophisticated measurements and suggest the best time delays, without the need to perform manual optimisation.
The aim of the study is to compare the best settings as suggested by manual optimisation and automatic, device based optimisation. Any differences in cardiac output produced by these two optimisation techniques will be examined.
REC name
West of Scotland REC 5
REC reference
16/WS/0145
Date of REC Opinion
3 Aug 2016
REC opinion
Further Information Favourable Opinion