Heart failure is a major health problem in Canada. Recent advances in medical and device therapy have helped to reduce the morbidity and mortality of patients with this problem. Among these treatments, cardiac resynchronization therapy (CRT) has very recently been shown to be effective to improve functional class, quality of life and exercise tolerance of the patients with the most severe symptoms of heart failure and a prolonged duration of the QRS on the 12-lead Electrocardiography (ECG).
Resynchronization of the failing ventricle is currently achieved by pacing the left and right ventricles simultaneously with specialized electrodes and a cardiac stimulator. However, controversy persists concerning the optimal configuration for cardiac pacing in these patients. Right ventricular pacing alone has been shown to be deleterious in some patient populations. The benefits of biventricular pacing in heart failure patients may be due primarily to left ventricular stimulation and may, in some patients, be decreased by the presence of simultaneous RV stimulation. Preliminary data from our own animal work suggest that in the majority of cases, LV stimulation alone is better than RV stimulation, and that BiV stimulation represents an intermediary situation between LV and RV stimulation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
120
University of Alberta Hospital
Edmonton, Alberta, Canada
QEII Health Sciences Centre
Halifax, Nova Scotia, Canada
Hamilton Health Sciences Center
Hamilton, Ontario, Canada
Total exercise duration at a constant submaximal load (defined as 75% of peak exercise during the baseline metabolic evaluation); study is powered to detect a min difference of 300 sec (+25% from baseline) in the primary endpoint between the 2 treatments
Time frame: one year
Clinical & electrical endpoints and echocardiographic & nuclear medicine evaluation of LV function. Dyssynchrony evaluation will help advancing the understanding of the physiopathology of heart failure and response to resynchronization therapy.
Time frame: one year
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University of Ottawa Heart Institute
Ottawa, Ontario, Canada
Sunnybrook & Women's Hospital
Toronto, Ontario, Canada
St-Michael's Hospital
Toronto, Ontario, Canada
CHUS-Fleurimont
Fleurimont, Quebec, Canada
CHUM-Hôpital Hotel-Dieu
Montreal, Quebec, Canada
Sacre-Coeur Hospital
Montreal, Quebec, Canada
Montreal Heart Institute Research Center
Montreal, Quebec, Canada
...and 1 more locations