The SEPTAL-PM study is aimed to compare the right ventricular apical and right ventricular septal position of the right ventricular lead in patients implanted with a pacemaker for conventional anti-bradycardia pacing indications requiring permanent right ventricular pacing ; the primary endpoint is the evolution of the left ventricular ejection fraction assessed by contrast echocardiography at 18-months follow-up.
Classically the right ventricular pacing (RV) lead position is the RV apex. Several small studies suggested that the septal position which provided a more physiological conduction pattern would improve left ventricular function and dimensions and the patients' outcome. The SEPTAL-PM study is a parallel randomized prospective simple-blinded and multicenter national study with a follow-up duration of 18 month. A total of 180 patients will be enrolled. It was designed to demonstrate that in patients requiring permanent RV pacing for high degree atrio-ventricular conduction disorders the septal pacing would preserve the LVEF and LV dimensions but also the quality of life and the exercise tolerance. The primary endpoint is the evolution of the LVEF assessed by contrast echocardiography. The secondary endpoints are: the quality of life SF 36 questionnaire, the NYHA class, the 6-minute-walk test, the QRS duration, the LV end-systolic and diastolic volumes, the NT-pro BNP, MMP 2-9 and TIMP-1 dosages, stimulation and detection ventricular thresholds. Other reported parameters are: the probes position and electric parameters, all causes of mortality, cardiovascular mortality, hospitalisations for cardiovascular causes, serious adverse events.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
141
The RV lead is implanted at the apex or at the interventricular septum
CHU d'Angers
Angers, France
Service de cardiologie-CHU de Brest
Brest, France
Service de cardiologie-CHU de Nantes
Nantes, France
CHU de Poitiers
Poitiers, France
CHU de Rennes
Left ventricular ejection fraction
Time frame: 18 months
Quality of life questionnaire SF 36
Time frame: 18 months
NYHA class
Time frame: 1, 6, 12, 18 months
6-minute-walk test
Time frame: 1, 18 months
LV end-systolic and diastolic volumes
Time frame: 18 months
QRS duration,
Time frame: 1, 6, 12, 18 months
Evolution of cardiac remodeling markers: MMP2-9 and TIMP-1 and NT-pro BNP dosage
Time frame: 18 months
All causes and cardiovascular mortality, hospitalizations for cardiovascular cause
Time frame: 18 months
Serious adverse events
Time frame: 18 months
Stimulation and detection ventricular thresholds
Time frame: 1, 6, 12, 18 months
Probes position and electric parameters
Time frame: 18 months
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Rennes, France