Conduction System Pacing International Registry (CONSPIRE)

N/AActive Not RecruitingNCT04831125

University of Chicago383 enrolled

Overview

The purpose of this registry study is to collect information about routine clinical practices with device implantation to treat bradycardia and cardiac systolic dysfunction (heart rhythm disorders) across global centers of excellence in cardiac pacing. In particular, this study will examine the use of conduction system pacing (CSP) in clinical practice. Information collected in the registry will help researchers better characterize strengths and limitations of current technology and treatments.

During this past decade, there has been a dramatic surge in interest in new physiologic pacing strategies which engage and take advantage of the intrinsic cardiac conduction system. These approaches include His bundle pacing (HBP) as well as approaches which seek to pace the proximal left conduction system (LCS), including left bundle branch area pacing (LBBAP) or pacing in the region of the left posterior fascicle. Left ventricular septal pacing (LVS) has also been proposed as another means to avoid dyssynchrony with early data suggestive of comparable electrical synchronization as biventricular pacing. These approaches utilize approved pacing systems and leads which are delivered to new targets in the His-Purkinje system or LV endocardial fibers. Despite the growing interest in HBP, LCS, and LVS, the majority of data are from disparate cohort studies and there has been a lack of uniformity in assembling data or analyzing and interpreting outcomes. The goal of the Conduction System Pacing International Registry (CONSPIRE) is to systematically and prospectively collect data across multiple centers of excellence on the early implementation of permanent conduction system pacing devices in order to characterize strengths and limitations of current technology. The study will evaluate patient selection, intraprocedural characteristics, and clinical outcomes among patients receiving conduction system pacing (CSP) as part of their routine clinical care.

Study Type

OBSERVATIONAL

Enrollment

383

Conditions

Bradyarrhythmia Heart Failure

Interventions

Data collectionOTHER

Data collection on the use of pacemaker, implantable cardioverter-defibrillator (ICD), and cardiac resynchronization therapy (CRT) devices and leads that are approved for clinical use.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Meets American College of Cardiology (ACC)/American Heart Association (AHA)/Heart Rhythm Society (HRS) guidelines for bradycardia, or * Meets ACC/AHA/HRS guidelines for cardiac resynchronization therapy (CRT). Exclusion Criteria: * Age \< 18 years * Inability of patient capacity to provide consent for themselves either due to medical or psychiatric comorbidity * Pregnancy * Difficulty with follow-up

Locations (8)

University of Arizona

Tucson, Arizona, United States

University of Chicago

Chicago, Illinois, United States

Icahn School of Medicine at Mount Sinai & Mount Sinai Hospital

New York, New York, United States

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Outcomes

Primary Outcomes

Implant characteristics

Data will be collected on CSP lead position based on reported anatomical position (e.g., His bundle location, left bundle branch area or left bundle branch pacing location, or left ventricular septal pacing location)

Time frame: Month 0, during procedure

QRS duration measured by electrocardiography at baseline

Data will be collected on QRS duration (milliseconds) prior to implant

Time frame: Baseline, within 1 month prior to procedure

QRS morphology captured by surface electrocardiography at baseline

Data will be collected on QRS morphology (e.g., narrow QRS, left bundle branch block, right bundle branch block, left anterior or posterior hemiblock, nonspecific intraventricular conduction delay, or predominantly paced QRS) prior to implant

Time frame: Baseline, within 1 month prior to procedure

QRS duration measured by electrocardiography after implant

Data will be collected on QRS duration (milliseconds) after implant procedure

Time frame: Month 0, pre discharge

QRS morphology captured by surface electrocardiography after implant

Data will be collected on QRS morphology \[e.g., narrow QRS, left bundaloid QRS in V1, or right bundaloid QRS in V1\] after implant procedure

Time frame: Month 0, pre discharge

Procedure-related complications

Data will be collected to characterize procedure-related complications

Time frame: Through 12 months

Changes in left ventricular ejection fraction

Data will be collected to characterize changes in left ventricular ejection fraction

Data from ClinicalTrials.gov

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