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Prevention of Syncope by Cardiac Pacing in Patients With Bifascicular Block

Not Applicable
Completed
Conditions
Bifascicular Block
Syncope
Interventions
Device: DDD60 (INSIGNIA® pacing systems Guidant (Boston Scientific)
Registration Number
NCT01463358
Lead Sponsor
Boston Scientific Corporation
Brief Summary

Study Objective

The purpose of this study is to evaluate the efficacy of bradycardia pacing with respect to patient symptoms in patients with bifascicular block and syncope of unexplained origin.

Detailed Description

Primary endpoint

First occurrence of a composite of Syncope of any origin OR Presyncopal episode with documented cardioinhibitory origin OR Atrioventricular block of any degree; all associated with patient symptoms

Design:

* Randomized, prospective, single blinded, two parallel arms

* Treatment group : DDD60 - programmed in DDD mode / 60 lower limit

* Control Group: DDI30 - programmed in DDI mode / 30 lower limit

* Randomization type: block randomization: Block size: 4, allocation ratio 1:1

Sample: 100 patients

Population

* Patients with bifascicular block with at least one syncopal episode within the last 6 months preceding enrollment.

* Patients should be negative to a series of pre-enrollment screening in order to exclude:

* Brady-tachy syndrome, vasovagal syncope or carotid sinus syndrome, atrial fibrillation, inducible AV block

* Ejection fraction \>=40%

* Mean nocturnal heart rate \>=35 bpm

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
101
Inclusion Criteria
  • Evidence of Bifascicular block
  • At least one episode of syncope during last 6 months from the enrollment
Exclusion Criteria
  • Patients with Brady-tachy syndrome that needs of pacemaker to prevent the symptomatic bradycardia o symptomatic tachycardia arrhythmia
  • Patients with vasovagal syndrome by positive TTT or carotid sinus syndrome
  • Patients with Chronic Atrial Fibrillation
  • Patients with Atrial Ventricular Block induces at EPS

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
DDI30DDD60 (INSIGNIA® pacing systems Guidant (Boston Scientific)Control group based only on backup pacing with lower rate 30 ppm
DDD60DDD60 (INSIGNIA® pacing systems Guidant (Boston Scientific)Treatment arm based on full pacing support (60 Lower Rate)
Primary Outcome Measures
NameTimeMethod
Combined Endpoint Defined as First Occurrence Among the Following Events 1)Syncope Episode of Any Origin; 2)Presyncopal Episode With Documented Cardioinhibitory Origin 3) Atrioventricular Block of Any Degree Associated With Patient Symptoms2 years

Number of participants experiencing syncope episodes, symptomatic pre-syncopal episodes associated with a device intervention (ventricular pacing) and symptomatic episodes associated with documentation of intermittent or permanent atrio-ventricular block

Secondary Outcome Measures
NameTimeMethod
Occurrence of First Symptomatic Episode (Syncope or Pre-syncope), Independently From Origin.2 years
Atrial Fibrillation2 years

patients presenting with at least one episode of atrial fibrillation during the 2 years follow up period

Trial Locations

Locations (12)

Ospedale Santa Maria Annunziata

🇮🇹

Bagno a Ripoli, Italy

Azienda Ospedaliera S. Sebastiano

🇮🇹

Caserta, Italy

Ospedale Valduce

🇮🇹

Como, Italy

Azienda Ospedaliera Osp. Maggiore

🇮🇹

Crema, Italy

Nuovo Ospedale S. Giovanni di Dio

🇮🇹

Firenze, Italy

Ospedale Umberto I

🇮🇹

Mestre, Italy

Ospedale Villa Scassi

🇮🇹

Genova, Italy

Ospedale GB Grassi

🇮🇹

Ostia - Roma, Italy

Ospedale Civile G. De Lellis

🇮🇹

Rieti, Italy

Azienda Ospedaliera S. Filippo Neri

🇮🇹

Roma, Italy

Ospedale Sandro Pertini

🇮🇹

Roma, Italy

Policlinico Casilino

🇮🇹

Roma, Italy

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