Optimisation of CRT during exercise using atrial pacing

• Research type

  Research Study

• Full title

  Optimisation of Cardiac Resynchronisation Therapy devices during exercise and with atrial pacing.

• IRAS ID

  227879

• Contact name

  Peter Pugh

• Contact email

  peter.pugh@addenbrookes.nhs.uk

• Sponsor organisation

  Cambridge University Hospitals NHS Foundation Trust

• Duration of Study in the UK

  3 years, 0 months, 1 days

• Research summary

  Cardiac Resynchronisation Therapy (CRT) is a well-known treatment for patients with heart failure. It is a special pacemaker that consists of three pacing leads, which are implanted in the right atrium (right upper chamber of the heart), right ventricle (right pumping chamber of the heart) and on the surface of the left ventricle (main pumping chamber). CRT helps by improving cop- ordination between the top and the bottom chambers of the heart.
  It is known that up to 30% of patients of patients undergoing CRT pacemaker implantation do not attain symptomatic benefit. Inadequate pacemaker programming is associated with a poor outcome. Given the inherent risks and costs of pacemaker implantation and maintenance, a reduction in the rate of CRT “non-responders” is an important goal.
  The precise requirements vary from person to person, so the settings on the pacemaker are “optimised” for each individual, by adjusting the programming. Optimising the pacemaker is usually done at rest. However, studies have shown that optimising the pacemaker with a higher heart rate during exercise, using an exercise bike, can also provide additional benefit. Some patients are unable to exercise and an alternative method is to speed the heart rate up using the pacemaker itself. The best way of undertaking the optimisation procedure is not clear. We wish to compare the two methods of optimising to see if one method is better or if the two are comparable. We will be using ultrasound scan of the heart to optimise the pacemaker and also to assess response to optimisation. Patients will also be asked to fill in questionnaires to assess their ability of performing certain activities.

• REC name

  East of England - Cambridge South Research Ethics Committee

• REC reference

  18/EE/0147

• Date of REC Opinion

  15 Aug 2018

• REC opinion

  Further Information Favourable Opinion