Effect of HV optimisation in cardiac resynchronisation therapy

  • Research type

    Research Study

  • Full title

    A randomised cross-over pilot study of the effect of HV interval optimisation in cardiac resynchronisation therapy in patients with heart failure

  • IRAS ID

    152412

  • Contact name

    Theodora Nikolaidou

  • Contact email

    theodora.nikolaidou@hey.nhs.uk

  • Sponsor organisation

    Research and Development Department, Hull and East Yorkshire Hospitals NHS Trust

  • Duration of Study in the UK

    1 years, 6 months, 5 days

  • Research summary

    Is HV interval optimisation in cardiac resynchronisation therapy beneficial in patients with heart failure?
    Cardiac resynchronisation therapy (CRT) is a specialised type of pacemaker used in patients with severe heart failure to improve symptoms and survival. Approximately one third of patients treated with CRT do not notice significant improvement in their symptoms and this may be due to inadequate co-ordination between the upper and lower chambers of the heart (atrioventricular dyssychrony). Currently, pacing timing between the upper and lower chambers of the heart with CRT is set empirically or by pacemaker-derived algorithms. None of these methods have been shown to improve symptoms or outcomes.
    We propose a new method to achieve atrioventricular synchrony in CRT based on measurements of electrical conduction from within the heart. Patients referred for CRT implantation at Castle Hill Hospital are eligible to participate. Participation is expected to last 1 year and will involve 2 additional hospital visits. During CRT implantation, additional measurements, including the His-Ventricular interval (HV interval) will be recorded from within the heart. After implantation, device settings will be adjusted to either standard or HV-optimised settings with cross-over at 4 months. Participants will also undergo blood tests, a walking test, echocardiography and they will be asked to complete a questionnaire.
    Our hypothesis is that patients with HV-optimised settings will derive additional benefit compared to patients with standard pacemaker-determined settings. If our hypothesis is true it will lead to a larger multi-site clinical trial with the aim of improving response and survival rates for CRT in patients with heart failure.

  • REC name

    Yorkshire & The Humber - South Yorkshire Research Ethics Committee

  • REC reference

    16/YH/0185

  • Date of REC Opinion

    5 Jul 2016

  • REC opinion

    Further Information Favourable Opinion