Multisite pacing in patients with repaired Tetralogy of Fallot
Research type
Research Study
Full title
Evaluation of the effects of multi- or single site right ventricular pacing on QRS duration and parameters of biventricular function in adult patients with repaired Tetralogy of Fallot
IRAS ID
127962
Contact name
Tom Wong
Contact email
Sponsor organisation
Royal Brompton and Harefield Hospital
Research summary
Patients with Tetralogy of Fallot or other forms of RV infundibular disease have residual dilatation and systolic dysfunction of the right ventricle. Additionally, most patients have intra right ventricular conduction delays secondary to surgery and subsequent negative remodelling, which affects the mechanical ventricular function and the coordination of contraction of the two ventricles. The surface ECG QRS width is the traditional marker for the presence of intraventricular conduction delay and is widely recognized as a marker of increased risk of sudden death in this population. Emulating the numerous previous studies in patients with heart failure, broad QRS and left bundle branch block having undergone resynchronization by implantation of a biventricular pacing device, we designed a study aiming to test the hypothesis that long-term uni/multisite RV pacing at the latest RV activation site in sinus rhythm will prevent the progressive deterioration of the RV function with measurable beneficial consequences on the echocardiographic parameters of right +/_ left ventricular systolic and diastolic function in patients with repaired TOF. The acute outcome will consist of obtaining a narrowing of the QRS width along with acute improvement of parameters of cardiac output, whereas in the long-term, shortening of the QRS width is expected to translate into improvement of the parameters of (bi)ventricular function. Secondarily, we hypothesize that this intervention will not affect patients’ exercise capacity and will not lead to an increase in the arrhythmia burden.
REC name
London - Brighton & Sussex Research Ethics Committee
REC reference
14/LO/1547
Date of REC Opinion
28 Oct 2014
REC opinion
Further Information Favourable Opinion