Mapping and Pacing of the His Bundle for Heart Failure Patients With Left Bundle Branch Block (MAP HIS HF)
Primary Purpose
Heart Failure, Left Bundle-Branch Block
Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Mapping and Pacing the His Bundle
Placing a guidewire in Coronary sinus for measurement of Q-LV during His Bundle pacing or, if needed, for LV pacing
Sponsored by
About this trial
This is an interventional treatment trial for Heart Failure
Eligibility Criteria
Inclusion Criteria:
- Patients are undergoing implant of an Abbott pacemaker or CRT device under standard indications
- An ECG with a wide QRS complex (>130 ms)
- ECG morphology of typical complete LBBB,
- Patients have heart failure with NYHA Class II-IV symptoms,
- LV EF <50%
- At least 18 years old and not pregnant.
- Must provide written informed consent prior to any clinical investigation related procedure.
- Willing to comply with study evaluation requirements
- Female subjects of child-bearing potential are required to have a negative pregnancy test done within 7 days prior to the implant procedure per site standard test. Female patients of childbearing potential should be instructed to use safe contraception (e.g., intrauterine devices, hormonal contraceptives: contraceptive pills, implants, transdermal patches hormonal vaginal devices, injections with prolonged release.)
Exclusion Criteria:
- Patients have non-specific intraventricular conduction delay or right bundle branch block
- Previously implanted cardiac devices with three or more permanent leads
- History of aortic valve repair or replacement
- History of tricuspid valve replacement
- Pregnant or nursing subjects and those who plan pregnancy during the clinical investigation follow-up period.
- Recent (< 3 months) myocardial infarction, ablation, electrolyte imbalance, or any condition within the last 90 days that would contraindicate for pacemaker or CRT implant in the opinion of the investigator
- Presence of other anatomic or comorbid conditions, or other medical, social, or psychological conditions that, in the investigator's opinion, could limit the subject's ability to participate in the clinical investigation or to comply with follow-up requirements, or impact the scientific soundness of the clinical investigation results.
Sites / Locations
- Tampa General HospitalRecruiting
Arms of the Study
Arm 1
Arm Type
Other
Arm Label
Mapping and Pacing the His Bundle
Arm Description
All patients will be in this arm. Mapping and Pacing the His Bundle will be performed.
Outcomes
Primary Outcome Measures
Successful HB pacing sites
Collect 3D Locations and electrogram characteristics (morphology and activation time) at the sites where His Bundle (HB) pacing is associated with left bundle recruitment and corrects electrical dyssynchrony at HB pacing implant procedure.
Secondary Outcome Measures
Success rate of HB pacing
Measure success rate of HB pacing or HB plus Left ventricular (LV) pacing in the correction of electrical dyssynchrony at implant procedure;
Ventricular activation during HB pacing
Collect ventricular activation times during HB pacing or HB plus LV pacing as compared with intrinsic rhythm and other pacing configurations at implant procedure;
Echocardiographic measurements of LV ejection fraction
Collect echo measurements of LV ejection fraction at three-month follow-up visit
Echocardiographic measurements of LV end-systolic volume
Collect echo measurements of LV end-systolic volume at three-month follow-up visit
Capture threshold of HB pacing
Measure capture threshold in volts of HB pacing at implant and at follow-up visits post implant
Lead impedance of HB pacing lead
Measure lead impedance in ohms of HB pacing lead at implant and at follow-up visits post implant
Sensing amplitude of HB pacing lead
Measure sensing amplitude in millivolts of HB pacing lead at implant and at follow-up visits post implant
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03803995
Brief Title
Mapping and Pacing of the His Bundle for Heart Failure Patients With Left Bundle Branch Block
Acronym
MAP HIS HF
Official Title
Mapping and Pacing of the His Bundle for Heart Failure Patients With Left Bundle Branch Block
Study Type
Interventional
2. Study Status
Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 20, 2019 (Actual)
Primary Completion Date
March 20, 2024 (Anticipated)
Study Completion Date
June 20, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Abbott Medical Devices
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
This is a prospective, single-arm, non-randomized, non-blinded study designed to characterize the locations of His Bundle (HB) pacing that results in correction of electrical dyssynchrony and to characterize morphology and activation time of local intracardiac electrogram (IEGM) with an electro-anatomical mapping system during a device implant procedure and secondarily to assess the efficacy of HB pacing or HB plus LV pacing (when indicated) in correction of electrical dyssynchrony in heart failure patients with left bundle branch block.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Heart Failure, Left Bundle-Branch Block
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Mapping and Pacing the His Bundle
Arm Type
Other
Arm Description
All patients will be in this arm. Mapping and Pacing the His Bundle will be performed.
Intervention Type
Procedure
Intervention Name(s)
Mapping and Pacing the His Bundle
Intervention Description
During the device implant procedure, 3D electro-anatomical mapping of the His Bundle region will be performed using EnSite™ Precision™ mapping system and Advisor™ HD Grid mapping catheter. This procedure might be part of the standard-of-care at the participating centers.
Intervention Type
Procedure
Intervention Name(s)
Placing a guidewire in Coronary sinus for measurement of Q-LV during His Bundle pacing or, if needed, for LV pacing
Intervention Description
During the device implant procedure, a VisionWire coronary guidewire will also be placed into a branch of coronary sinus (CS), targeting a lateral branch. This guidewire could be used for collecting local left ventricle (LV) activation time (Q-LV) or pacing the LV. This guidewire could also be used to deliver a LV lead at physician's discretion. This procedure might be part of the standard-of-care at the participating centers.
Primary Outcome Measure Information:
Title
Successful HB pacing sites
Description
Collect 3D Locations and electrogram characteristics (morphology and activation time) at the sites where His Bundle (HB) pacing is associated with left bundle recruitment and corrects electrical dyssynchrony at HB pacing implant procedure.
Time Frame
At device implant procedure
Secondary Outcome Measure Information:
Title
Success rate of HB pacing
Description
Measure success rate of HB pacing or HB plus Left ventricular (LV) pacing in the correction of electrical dyssynchrony at implant procedure;
Time Frame
At device implant procedure
Title
Ventricular activation during HB pacing
Description
Collect ventricular activation times during HB pacing or HB plus LV pacing as compared with intrinsic rhythm and other pacing configurations at implant procedure;
Time Frame
At device implant procedure
Title
Echocardiographic measurements of LV ejection fraction
Description
Collect echo measurements of LV ejection fraction at three-month follow-up visit
Time Frame
At three-month follow-up
Title
Echocardiographic measurements of LV end-systolic volume
Description
Collect echo measurements of LV end-systolic volume at three-month follow-up visit
Time Frame
At three-month follow-up
Title
Capture threshold of HB pacing
Description
Measure capture threshold in volts of HB pacing at implant and at follow-up visits post implant
Time Frame
Implant procedure, up to 3 days after implant procedure, two-week follow-up visit, three-month follow-up visit
Title
Lead impedance of HB pacing lead
Description
Measure lead impedance in ohms of HB pacing lead at implant and at follow-up visits post implant
Time Frame
Implant procedure, up to 3 days after implant procedure, two-week follow-up visit, three-month follow-up visit
Title
Sensing amplitude of HB pacing lead
Description
Measure sensing amplitude in millivolts of HB pacing lead at implant and at follow-up visits post implant
Time Frame
Implant procedure, up to 3 days after implant procedure, two-week follow-up visit, three-month follow-up visit
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients are undergoing implant of an Abbott pacemaker or CRT device under standard indications
An ECG with a wide QRS complex (>130 ms)
ECG morphology of typical complete LBBB,
Patients have heart failure with NYHA Class II-IV symptoms,
LV EF <50%
At least 18 years old and not pregnant.
Must provide written informed consent prior to any clinical investigation related procedure.
Willing to comply with study evaluation requirements
Female subjects of child-bearing potential are required to have a negative pregnancy test done within 7 days prior to the implant procedure per site standard test. Female patients of childbearing potential should be instructed to use safe contraception (e.g., intrauterine devices, hormonal contraceptives: contraceptive pills, implants, transdermal patches hormonal vaginal devices, injections with prolonged release.)
Exclusion Criteria:
Patients have non-specific intraventricular conduction delay or right bundle branch block
Previously implanted cardiac devices with three or more permanent leads
History of aortic valve repair or replacement
History of tricuspid valve replacement
Pregnant or nursing subjects and those who plan pregnancy during the clinical investigation follow-up period.
Recent (< 3 months) myocardial infarction, ablation, electrolyte imbalance, or any condition within the last 90 days that would contraindicate for pacemaker or CRT implant in the opinion of the investigator
Presence of other anatomic or comorbid conditions, or other medical, social, or psychological conditions that, in the investigator's opinion, could limit the subject's ability to participate in the clinical investigation or to comply with follow-up requirements, or impact the scientific soundness of the clinical investigation results.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Wenwen Li, PhD
Phone
4085226207
Email
wenwen.li@abbott.com
Facility Information:
Facility Name
Tampa General Hospital
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bengt Herweg, MD
12. IPD Sharing Statement
Learn more about this trial
Mapping and Pacing of the His Bundle for Heart Failure Patients With Left Bundle Branch Block
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