Improving CRT Outcome With Non-Invasive Cardiac Mapping (ICONIC-M)
Heart Failure With Reduced Ejection Fraction
About this trial
This is an interventional diagnostic trial for Heart Failure With Reduced Ejection Fraction focused on measuring Cardiac Resynchronization Therapy, Left Bundle Branch Block
Eligibility Criteria
Inclusion Criteria:
- Appropriately signed and dated informed consent.
- Age ≥18 years at time of consent.
- Received optimal medical therapy for HF for at least 3 months before screening
- Patient in sinus rhythm at the time of screening fulfilling Class I or IIa criteria per ESC CRT guidelines 2013 .
- Patient is intended for placement of a CRT device with biventricular (BiV) pacing.
Exclusion Criteria:
- Previous cardiac pacemaker/CRT/ICD implantation
- Acute diseases or exacerbations of chronic diseases (as per the investigator's discretion)
- Contraindications to CT scanning
- Contraindications to body surface ECG mapping: (ongoing wound healing on the chest (e.g. recent surgery), skin diseases, allergic reactions to surface mapping electrodes and medical band-aid)
- Pregnant, or subjects planning to become pregnant within 6 months after signing informed consent (a documented negative pregnancy test (serum or blood) is required for women of childbearing potential)
- Incapacitated individuals, defined as persons who are mentally ill, mentally handicapped, or individuals without legal authority, are excluded from the study population
Sites / Locations
- Amsterdam University Medical Center
- Groningen University Medical Center
- Maastricht University Hospital
- Utrecht University Medical Center
- Hospital da Luz
- Lund University Hospital
- Karolinska University Hospital
- Bart's Hospital
- King's College
- Oxford University Hospital
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Control
Active
The CRT device is implanted according to clinical practice, without pre-implantation planning. The outcome of the procedure is assessed via echography as per clinical practice. In addition to clinical practice, the subjects are required to fill in a quality-of-life questionnaire and are subject to an ECG mapping procedure with the Amycard 01C device, including non-contrast CT, to assess the distance between left ventricular lead placement and the latest electrical activation site in the absence of planning information.
A pre-implantation ECG mapping with the Amycard 01C device, including CT, is performed prior to the CRT device implantation. The resulting target area for the left ventricular lead placement is communicated to the implanting physician, who will attempt to reach a point close to the target, using the available venous access. At six-month follow-up, response to the therapy is assessed using echocardiography, and a second ECG mapping with Amycard 01C is performed, to assess the distance between actual implantation site and target in the presence of pre-implantation planning information.