CardioInsight 1 RBBB

Chinese University of Hong Kong93 enrolled

Overview

Cardiac resynchronization therapy (CRT) is an established therapy for symptomatic heart failure patients. However, there are still 30 to 40% of studied patients being nonresponder to CRT. The plausible reasons of lack of effect of CRT in these patients include relative less baseline electrical dyssynchrony. The aim of our study is to investigate whether there is an optimal configuration of CRT delivery that varies between patients with different pattern of activation delay.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Heart Failure

Interventions

Electrical Activation Mapping Guided Cardiac resynchronization therapyDEVICE

To study the feasibility to optimize configuration of CRT delivery for acute correction of electrical dyssynchrony using a noninvasive mapping of global electrical activation

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adult (aged 18 or above) of both sexes * Ischemic or non-ischemic cause of heart failure * QRS duration \> 120 ms, non-left bundle branch block (LBBB) type of conduction disturbance * NYHA class III or above * Informed consent by the patient * Already received stable dose of guideline directed medical therapy for at least 3 months Exclusion Criteria: * LBBB patients * Pregnant women * Participation in another study * Patient with contraindication to left ventricle catheterization by a retrograde aortic approach

Locations (1)

The Chinese University of Hong Kong

Shatin, Hong Kong

RECRUITING

Outcomes

Primary Outcomes

Left Ventricle (LV) end systolic volume reduction

The responder rate of greater than 10% of LV end systolic volume reduction measured by echocardiogram

Time frame: 6 months

Secondary Outcomes

Electrical dyssynchrony index

The acute electrical dyssynchrony indices (the standard deviation of activation times throughout the epicardium) of different methods of CRT delivery. Lower indicate larger improvement.

Time frame: During procedure

Hemodynamic response monitoring

monitor the difference in hemodynamic responses of different methods of CRT delivery method. The hemodynamic response will be maximal dp/dt as measured by pressure wire introduced into the left ventricle during the procedure.

Time frame: During procedure

Procedure outcome with optimal CRT delivery

Procedure outcome measured by procedure duration and implantation success rate of the optimal CRT delivery method as determined by the best improvement in electrical dyssynchrony indices.

Time frame: During procedure

Cine images and chest X ray

Cine images (PA, LAO 300, RAO 300) and Chest X ray (PA view) of patients will be obtained for evaluation of changes in disease

Time frame: 6 months

Echocardiogram parameter: left ventricular systolic and diastolic volume

left ventricular systolic and diastolic volume at baseline, 3 months and 6 months : , left ventricular ejection fraction, degree of mitral regurgitation, strain imaging will be aggregated to arrive at an overall change in echocardiogram parameters as together they represent integrated heart function collectively, as reflected by the listed echocardiogram parameters.

Central Contacts

Daniel Xu

CONTACT

35051518 danielxu@cuhk.edu.hk

Data from ClinicalTrials.gov

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