Use of cardiac muscle sounds to optimize cardiac resynchronization therapy
A pilot study of the potential application of cardiac muscle sounds to optimize cardiac resynchronization therapy in patients with heart failure
Duration of Study in the UK
1 years, 8 months, 25 days
Heart failure is a leading cause of deaths and hospital admissions. In heart failure, dyssynchronous (not moving together in synchrony) movement of the different chambers of the heart can reduce the heart’s efficiency as a pump to supply blood to the rest of the body, resulting in symptoms such as breathlessness.
Cardiac resynchronisation therapy (CRT) is use of a special type of pacemaker for patients with advanced heart failure who do not respond to medications. CRT works by electrically stimulating the heart muscle in different chambers of the heart to contract (with pacemaker leads connected to a pacemaker box) in synchrony and therefore improve pump efficiency.
However, a third of patients do not respond well to CRT. Commonly, this may be due to incorrect pacemaker settings. Getting the settings right, called CRT optimisation, usually requires echocardiography (ultrasound imaging of the heart) and access to this is highly dependent on availability of local expertise.
There is scientific evidence that heart muscle sound vibrations generated from contraction of the heart muscle can tell us how efficiently the heart works as a pump.
Our primary objective is to investigate the feasibility of using cardiac muscle sounds recorded from outside the chest to identify non-responders to CRT and to guide adjustment of CRT pacemaker settings instead of using echocardiography. This could potentially be a non-invasive, more affordable and accessible method of CRT optimisation that enables more patients to have the best pacemaker settings for their needs.
We propose to record heart muscle sounds externally with a sound recording system in patients diagnosed with heart failure who have been referred for CRT optimisation with echocardiography. We also propose to study the efficacy of CRT optimization in improving long term response to CRT in a prospective cohort of initial non-responders to CRT to support current clinical practice.
East Midlands - Leicester Central Research Ethics Committee
Date of REC Opinion
28 Jan 2015
Further Information Favourable Opinion