SCAR MPP study
Research type
Research Study
Full title
SCar location and Acute haemodynamic Response to MultiPoint Pacing in patients with ischemic cardiomyopathy
IRAS ID
211326
Contact name
Timothy Betts
Contact email
Sponsor organisation
Joint Research Office
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Cardiac Resynchronization Therapy (CRT) is a proven treatment for heart failure. It uses a special pacemaker with two/three leads (insulated wires which take the electrical impulses from the device to the heart) that simultaneously send tiny electrical impulses to both bottom heart chambers (ventricles) and make them beating together in a more synchronized pattern. In most patients this translates into improved symptoms and increased survival. Unfortunately up to one third of the patients do not benefit from CRT therapy.
A new technology called MultiPoint Pacing (MPP) (St. Jude Medical, Sylmar, CA) has recently become available. It allows simultaneous stimulation of 2 different sites in the left ventricle (instead of only one) by using a single lead with four electrodes (quadripolar lead). This pacing strategy should provide improve the response to CRT by recruiting a larger mass of cardiac muscle at the same time.
Both MPP and quadripolar leads have a proven safety and efficacy profile, comparable to other CRT devices, and they are already part of standard care at the OUH. Recent evidence suggests that MPP pacing could have incremental benefits compared to conventional CRT in patients with a previous history of heart attack resulting in LV scar formation.
Our hypothesis is that MPP is particularly beneficial in patients with LV scar when the lead is placed in proximity of the scar. To test this hypothesis, 15 patients with previous heart attack resulting in LV scar and heart failure requiring CRT implant, will be enrolled. In each of them the location of the scar will be identified by cardiac MRI. During the CRT implant procedure, MPP will be tested in 2 different LV sites, close and far from the scar respectively, in terms of acute improvement of LV contraction and resulting pressure.REC name
South Central - Oxford B Research Ethics Committee
REC reference
16/SC/0662
Date of REC Opinion
23 Jan 2017
REC opinion
Further Information Favourable Opinion