Ablate and Pace HIS Study
Research type
Research Study
Full title
Safety and Efficacy of distal His Bundle Pacing compared to right ventricular pacing in patients with symptomatic atrial fibrillation undergoing AV node ablation with evidence of heart failure, a randomised control study.
IRAS ID
320385
Contact name
Mokhtar Ibrahim
Contact email
Sponsor organisation
University hospitals of Leicester
Duration of Study in the UK
5 years, 0 months, 1 days
Research summary
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, and estimates suggest its prevalence is increasing. Despite the advances in AF ablation strategies, the outcome of ablation procedures in persistent AF is still unsatisfactory. In addition, many patients are not candidates for ablation due to advanced age, comorbidities and previous failed ablation procedures.\nIt is well known that there is no mortality benefit form rhythm versus rate control strategy in AF, therefore the increased number of AV node ablation and pacemaker insertion for patients with symptomatic AF with uncontrolled heart rate. Following AV node ablation, it is understandable that these patients will be paced 100% of the time where the value of physiological pacing will be at its most.\nThe current standard practice if to pace the right ventricle for this cohort of patients unless they have severe LV systolic dysfunction when a biventricular pacing might be recommended. Previous data showed that RV pacing only can lead to deterioration of LV function, worsening of heart failure symptoms and increased mortality.\nHis bundle pacing is a novel technique of pacing through placing the pacemaker lead on the junction box between the top an bottom chamber of the heart. This will allow the utilisation of the normal/ intrinsic HIS Purkinje (eclectic cables) to stimulate the ventricles. This can offer a physiological pacing modality and reduce pacing induced cardiomyopathy specially in pacing dependent pacing. \nWe propose that the new method of HIS pacing is safe, effective and superior to the existing method of RV pacing in patients with atrial fibrillation who demonstrate signs of heart failure.
REC name
North West - Greater Manchester East Research Ethics Committee
REC reference
23/NW/0114
Date of REC Opinion
28 May 2023
REC opinion
Further Information Favourable Opinion