Optimal programming for Cardiac Resynchronisation Therapy
Research type
Research Study
Full title
Is individualised CRT programming superior to nominal settings in the optimisation of biventricular pacing with respect to QRS width?
IRAS ID
260238
Contact name
Lucy Broadhurst
Contact email
Sponsor organisation
Rotherham NHS Foundation Trust
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Can patient-specific programming be used to optimise biventricular pacemaker settings in patients treated with Cardiac Resynchronisation Therapy for heart failure?
Cardiac Resynchronisation Therapy (CRT) has been shown to improve cardiac performance and quality of life in specific patients with heart failure. These patients have poor cardiac pumping capacity and their pumping chambers contract out of sequence, due to a delay in the natural electrical system across the ventricles. The goal of CRT is to reduce the electrical delay and restore synchronisation between the heart chambers. A CRT coordinates contractions between the atria and the ventricles by delivering artificial electrical signals. The main timing intervals are known as the atrioventricular (AV) and interventricular (VV) delay. The best method to optimise the timing of these electrical signals remains unproven. Hence, device programming is left to the discretion of the operator and often remain at out of the box settings.
Importantly, not all patients respond favourably to CRT and approximately 30% are considered non-responders. Multiple factors can influence response to CRT and research has focussed on patient selection and lead placement. However, electrical programming of CRT devices post implant is also an area of great interest. Patient specific characteristics can influence electrical timing. Hence a universal strategy for device programming will be ineffective.
This study will compare five programming strategies tailored to the individual and optimal CRT will be considered as the maximal reduction in ventricular delay. The study may help guide operators to best optimise CRTs in routine practice and how electrically optimised CRT can influence patient outcomes.
This data is recorded as part of our routine clinical dataset for patients undergoing standard CRT implantation. Participants will benefit by contributing towards improving protocols. The study will be completed at Rotherham NHS Foundation Trust and will be completed within 48months.
REC name
London - Brent Research Ethics Committee
REC reference
19/LO/0448
Date of REC Opinion
8 Apr 2019
REC opinion
Further Information Favourable Opinion