Left Bundle Branch Pacing vs Right Ventricular Pacing on AHRE Burden in Patients With Preserved LVEF
NCT07250529 · Status: RECRUITING · Phase: NA · Type: INTERVENTIONAL · Enrollment: 244
Last updated 2026-03-13
Summary
This prospective, randomized controlled trial aims to evaluate the effect of left bundle branch pacing (LBBP) compared with conventional right ventricular (RV) pacing on the cumulative duration (total time) of atrial high-rate episodes (AHREs) in patients with preserved left ventricular ejection fraction (LVEF) who are expected to require frequent ventricular pacing.
Atrial High-Rate Episodes (AHREs) are defined as episodes of atrial tachyarrhythmia that are automatically recorded by device diagnostics and detected by implanted cardiac devices. These episodes usually have an atrial rate ≥170 beats per minute and a duration ≥6 minutes. AHREs are linked to a higher risk of thromboembolic events and clinical atrial fibrillation (AF), and they may indicate subclinical AF or other atrial tachyarrhythmias.
Chronic RV pacing has been linked to mechanical and electrical dyssynchrony, which may encourage atrial remodeling and the development of AF. LBBP provides a more physiological ventricular activation and may reduce atrial tachyarrhythmia time (AHRE time).
Patients with LVEF \>50% and atrioventricular (AV) conduction disorders requiring a dual-chamber pacemaker will be randomized to either conventional RV septal pacing or LBBP.
Conditions
- Atrial Fibrillation (AF)
- Pacemaker Therapy
- Atrioventricular Block
- Preserved Ejection Fraction
Interventions
- DEVICE
-
Right Ventricular Pacing
Implantation of a dual-chamber pacemaker with the ventricular lead placed in the RV septum. At follow-up, the ventricular pacing percentage and pacing configuration will be noted. All devices used in this study are commercially available in the European Union and carry a valid CE mark.
- DEVICE
-
Left Bundle Branch Pacing
Implantation of a dual-chamber pacemaker with the ventricular lead placed at the left bundle branch area. Physiological pacing will be programmed into the devices and, at follow-up, the percentage of spontaneous pacing will be noted. All devices used in this study are commercially available in the European Union and carry a valid CE mark.
Sponsors & Collaborators
-
University Hospital of Patras
lead OTHER
Study Design
- Allocation
- RANDOMIZED
- Purpose
- PREVENTION
- Masking
- NONE
- Model
- PARALLEL
Eligibility
- Min Age
- 18 Years
- Sex
- ALL
- Healthy Volunteers
- No
Timeline & Regulatory
- Start
- 2026-02-05
- Primary Completion
- 2029-04-20
- Completion
- 2029-06-20
Countries
- Greece
Study Locations
More Related Trials
-
Left Bundle Branch Pacing Versus Conventional Pacing in Atrioventricular Block
NCT05129098 ·Status: COMPLETED ·Phase: NA
-
Left vs Left Randomized Clinical Trial
NCT05650658 ·Status: RECRUITING ·Phase: NA
-
Acute Hemodynamic Effects of Pacing the His Bundle in Heart Failure
NCT04701112 ·Status: TERMINATED ·Phase: NA
-
Safety and Effectiveness of Left Bundle Branch Pacing in Patients With Cardiac Dysfunction and AV Block
NCT05553626 ·Status: UNKNOWN ·Phase: NA
-
His-bundle Pacing vs. Right Ventricular Apical Pacing in Patients With Reduced Ejection Fraction
NCT04529577 ·Status: RECRUITING ·Phase: NA
-
Changes in Myocardial Perfusion During Chronic Multi Site Biventricular Versus Right Ventricular Apex Pacing in Patients With Normal Left Ventricular Function Undergoing His Bundle Ablation for Drug-refractory Atrial Fibrillation
NCT00528307 ·Status: TERMINATED ·Phase: NA
-
The Left Bundle Cardiac Resynchronization Therapy Trial
NCT05434962 ·Status: ACTIVE_NOT_RECRUITING ·Phase: NA
-
Direct HIS-pacing as an Alternative to BiV-pacing in Symptomatic HFrEF Patients With True LBBB
NCT03614169 ·Status: COMPLETED ·Phase: NA
-
Bi-ventricular Epicardial Activation in Left Bundle Area Pacing: a Comparison Study
NCT05401851 ·Status: UNKNOWN ·Phase: NA
-
Central Haemodynamics and Pacing for AV Block
NCT07276490 ·Status: RECRUITING ·Phase: NA
-
Conduction System Pacing With Left Bundle Branch Pacing as Compared to Standard Right Ventricular Pacing
NCT05015660 ·Status: RECRUITING ·Phase: NA
-
Efficacy and Safety of Left Bundle Area Pacing Vs Right Ventricular Apical Pacing in Patients with Atrioventricular Block
NCT06674967 ·Status: NOT_YET_RECRUITING
-
Mapping and Pacing of the His Bundle for Heart Failure Patients With Left Bundle Branch Block
NCT03803995 ·Status: COMPLETED ·Phase: NA
-
Left Bundle Branch Area Pacing in Patients After TAVR
NCT05024279 ·Status: UNKNOWN ·Phase: NA
-
Correlation of Typical LBBB Mechanical Activation Pattern by 2D Strain Echocardiography With Acute GWE Improvement in Patients Receiving LBBp or Conventional BiVp for Cardiac Resynchronization Therapy (Echo LBBp)
NCT06689111 ·Status: RECRUITING ·Phase: NA
-
Clinical Prospective ranDomized Trial to Evaluate the Non-inferiority of Left Bundle Branch Area Pacing Vs Cardiac ResynchronIzatioN Therapy With ECG guIded AV Optimization
NCT07107048 ·Status: NOT_YET_RECRUITING ·Phase: NA
-
Left Bundle Branch Area Pacing in Patients With Heart Failure
NCT06488989 ·Status: ACTIVE_NOT_RECRUITING ·Phase: NA
-
Direct HIS/LBB Pacing as an Alternative to Biventricular Pacing in Patients With HFrEF and a Typical LBBB.
NCT04409119 ·Status: COMPLETED ·Phase: NA
-
Risk Stratification in Patients With Preserved Ejection Fraction
NCT02124018 ·Status: COMPLETED
-
Effects of Preferential Left Ventricular Pacing on Ventriculoarterial Coupling and Clinical Course of Heart Failure
NCT04420065 ·Status: UNKNOWN ·Phase: NA
-
Feasibility of Simplified Permanent Left Bundle Branch Pacing Without Electrophysiological Recording System
NCT05553431 ·Status: UNKNOWN ·Phase: NA
-
Conduction System Pacing Versus Biventricular Pacing After Atrioventricular Node Ablation
NCT05467163 ·Status: ACTIVE_NOT_RECRUITING ·Phase: NA
-
LEft VEntricuLar Activation Time Shortening With Physiological Pacing vs Biventricular Resynchronization Therapy
NCT04054895 ·Status: COMPLETED ·Phase: NA
-
AVEIR™ Leadless Pacemaker Registry in Europe and MIddle East Region (PREMIER LEADLESS)
NCT06782152 ·Status: NOT_YET_RECRUITING
-
Protection of Cardiac Function With Left Bundle Branch Pacing in Patients With Atrioventricular Block
NCT04624763 ·Status: ACTIVE_NOT_RECRUITING ·Phase: NA