Preload and Autonomic Responses With Cardiac Neuromodulation Therapy (CNT) (CS-06)

BackBeat Medical Inc30 enrolled

Overview

This investigation will evaluate the effect of RV pacing lead position on cardiac function and the modulation of the autonomic nervous system with Cardiac Neuromodulation Therapy (CNT) pacing signals. The study will be performed acutely prior to a pacemaker implant.

Subjects indicated for a dual chamber pacemaker implant or replacement who are not 100% dependent on right ventricular pacing may be eligible to participate in the study. This investigation will evaluate the effect of RV pacing lead position on cardiac function and the modulation of the autonomic nervous system using Cardiac Neuromodulation Therapy (CNT) pacing signals at different positions of the RV pacing lead. A standard conductance catheter will be introduced through the femoral artery and advanced into the left ventricle to measure cardiac volumes and pressure. Arterial blood pressure will be measured from the other femoral artery with an additional sheath. The Moderato® IPG will be used to generate Cardiac Neuromodulation Therapy (CNT) signals and deliver them to the patient through the cable and leads. A range of CNT signal parameters will be used to assess the effect on sympathetic activity at different positions of the RV pacing lead. Ventricular pressure and volume readings from the conductance catheter and arterial pressure readings will be recorded and analyzed to assess the effect of CNT signals on cardiac function, sympathetic activity and blood pressure. The effects of CNT signal over a range of parameter settings will be studied for the different RV lead positions.

Study Type

INTERVENTIONAL

Allocation

Purpose

BASIC_SCIENCE

Masking

NONE

Enrollment

Conditions

Bradycardia Hypertension, Systolic

Interventions

Moderato IPG's CNT pacing signalsDEVICE

Assesment of cardiac function and sympatheric activity will be obtained simultaneously

CD Leycom Pressure/Volume Combination CathetersDEVICE

Simultaneous recording of the Pressure, Volume measurements and ECG signals will be done for constant monitoring of intra-ventricular pressure and volume.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Subject is ≥ 18 years of age 2. Subject requires implantation or replacement of a dual chamber pacemaker or requires an upgrade from a single chamber to a dual chamber pacemaker 3. Subject has known Hypertension 4. Subject is willing and able to comply with the study and procedures. Exclusion Criteria: 1. Subject has symptoms of heart failure, NYHA Class II or greater 2. Subject has significant (\>2+) mitral regurgitation, aortic regurgitation or aortic stenosis. 3. Subject has permanent atrial fibrillation 4. Subject has atrial fibrillation on the day of the study. 5. Subject has hypertrophic cardiomyopathy, restrictive cardiomyopathy or interventricular septal thickness ≥15 mm 6. Subject is on dialysis 7. Subject has a history of prior neurological events (stroke or TIA) within the past year or a neurological event (stroke or TIA) at any prior time that has resulted in residual neurologic deficit. 8. Subject has a history of autonomic dysfunction 9. Women who are pregnant or breast-feeding 10. Subject cannot or is unwilling to provide informed consent.

Locations (1)

Na Homolce Hospital

Prague, Czechia

RECRUITING

Outcomes

Primary Outcomes

Effects of the Moderato CNT pacing signals on cardiac function

Left ventricular pressure (mmHg) and Volume (ml) will be obtained by a multisensor catheter which provides real-time, beat-to-beat intra-ventricular measurement of cardiac function and performance. Data will be used to generate Pressure-Volume Loops, an aknowledged way to describe hemodynamic changes. CNT signals (alternating short and long atrioventicular sequences 40-150 ms) will be delivered at the same by right ventricular pacemaker leads temporarely connected to the Moderato device.

Time frame: approximately one hour

Effects of CNT pacing signals on blood pressure

Blood pressure (mmHg) will be obtained in parallel with a Millar catheter from the femoral artery througout the study.

Time frame: aproximately onr hour

Central Contacts

Yuval Mika, PhD

CONTACT

+18569123155 ymika@orchestrabiomed.com

Norbert Rosenthal

CONTACT

+491792482543 nrosenthal@orchestrabiomed.com

Data from ClinicalTrials.gov

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