Atrioventricular Block, Bradycardia, Sinus Node Dysfunction
Conditions
Keywords
Pacemaker, Bundle of His, Left Bundle Branch
Brief summary
This is a voluntary research study to find out which location in the heart a pacemaker wire is the most efficient for a patient's heart and for battery life. Patients who volunteer and are eligible for the study will be randomized to receive one of two positions for the wire to be screwed into, in addition to studying multiple positions in the heart during the pacemaker insertion. Enrolled patients will be in the study for 1 year. They will also have an Ultrasound of their heart performed to assess how the pacemaker wire is affecting their heart. Pacemakers are connected to the heart by wires that are screwed into the heart. The wires can be connected to the heart in different places, which can affect how well the heart beats over time. The typical position is at the tip of the heart. This position may cause the heart to beat inefficiently. Over time, this could lead to weakened heart muscle, irregular heart rhythm, and more hospitalizations. The heart has special muscle cells and fibers that carry electrical signals through and around the heart. An alternative spot to place the pacemaker wire is in an area where these special cells are grouped together (called the HIS bundle). The pacemaker wire can be connected to the heart at a location which may allow the heart to beat more efficiently when compared to putting the wire at traditional spots in the heart (called HIS bundle pacing). However, sometimes connecting the wire into the HIS bundle may cause the pacemaker battery to wear out faster. Physicians can also connect the pacemaker wired near the HIS bundle (called Left left Bundle bundle area pacing). The study physicians hope this will allow the heart to beat more efficiently without causing the battery to wear out faster. The study physicians would like to study how different wire positions change heart beat efficiency and how long the pacemaker battery lasts when the wires are placed in different locations. This study will connect the pacemaker wire at either the HIS Bundle or the left bundle area pacing, to see how effectively the heart pumps and how much battery is being used.
Detailed description
This is a single center, open label, prospective randomized pilot study to evaluate the capture threshold of His Bundle versus left bundle area pacing. Secondary analysis will focus on changes in left ventricular performance and mechanical synchrony. Symptomatic bradyarrhythmias are effectively treated with cardiac pacemakers.The amount of pacing by the lead positioned in the bottom chamber of the heart at traditional sites such as the right ventricular apex have been associated with increased rates of atrial fibrillation, heart failure, and mortality. Traditional pacing sites result in cardiac electromechanical dyssynchrony, for which alternate pacing sites to minimize these untoward effects have been sought. HIS bundle pacing, which utilizes a patient's native conduction, has demonstrated improved electrical synchrony and left ventricular function when compared to traditional pacing at the tip of the bottom chamber. Barriers to wide spread application to this technique include the His bundle anatomic location and its attendant difficulties associated with implant, as well as higher capture thresholds leading to decreased battery duration of the pacemaker. An alternative to HIS bundle pacing is placing the lead just past the HIS bundle area, which is further in the heart, and to actively fixate the lead into the interventricular septum. This is referred to as Left Bundle Pacing, as it may electrically capture the left bundle, which would simulate a patient's native conduction. The researchers will evaluate the two different pacing sites (HIS bundle and Left Bundle area sites) to determine how effectively the heart pumps with each pacing site. Patients requiring pacemaker implant will be screened for study eligibility and approached for informed consent. Baseline assessments including echocardiogram and ECG will be obtained. A standard of care echo done within 3 months of the procedure will be used as the baseline echo. Once enrolled, the researchers will randomize patients to one of two arms. One arm will fixate the ventricular pacemaker lead to the HIS bundle area while the other arm will have the leads fixed into the left bundle area. The pacemaker wires will be connected in accordance with randomization group. The day after the procedure, a chest x-ray, EKG and pacemaker evaluation will be performed. An echocardiogram will be obtained at 3 months post procedure. At 6 and 12 months post procedure, EKG rhythm strips will be obtained from patients' standard of care remote pacemaker monitoring systems.
Interventions
DEVICESelect Secure pacing lead
A Select Secure pacing lead is placed in the bundle of His or Left bundle branch area based upon randomization
Sponsors
David Haines, MD
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Single center, open label, randomized, prospective
Eligibility
Sex/Gender
ALL
Age
19 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Over 18 years old. 2. With signed consent. 3. Pacemaker indication according to 2018 American College of Cardiology/American Heart Association/Heart Rhythm Society Guideline on the Evaluation and Management of Patients with Bradycardia and Cardiac Conduction Delay. With one or both of the following: 1. Symptomatic sinus node dysfunction. 2. Symptomatic Atrioventricular (AV) block or high degree AV block. 3. Tachy-Brady syndrome
Exclusion criteria
1. Previously implanted cardiac pacing devices except transvenous temporary pacemaker. 2. Patients who are eligible for appropriate cardiac resynchronization therapy(CRT) or implantable cardiovert defibrillator (ICD) implantation 3. Patients with prior septal myectomy 4. Patients with prior surgical or transcatheter aortic valve replacement 5. Anatomy precluding implant evaluated during the screening or identified during the procedure. 6. Those without ability to achieve selective His bundle pacing evaluated during the screening or identified during the procedure 7. Pregnant women
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ventricular Capture Threshold, 3 Months Unipolar or Bipolar | 3 months | Ventricular capture threshold is the minimum amplitude of electrical signal from the pacemaker that consistently results in capture of the ventricular myocardium (normal contraction of the ventricle after electrical depolarization) with a 1.0 millisecond pulse width setting in unipolar or Bipolar output modes, measured in volts. During pacemaker placement, the ideal ventricular capture threshold is determined by delivering a series of pulses starting at 0.75 volts and increasing by 0.125 V with each trial until consistent ventricular contraction is achieved. Pacemaker settings are programmed using the ventricular capture threshold, adjusted to include a safety margin, and may be re-adjusted over time if clinically necessary. The measurement is automatically recorded within the pacemaker and will be interrogated from the pacemaker device at 3 months post implantation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Stroke Volume - Intrinsic Conduction | at index procedure prior to lead fixation | Volume of blood in milliliters pumped from the left ventricle of the heart at each beat with no pacing applied |
| Mechanical Dyssynchrony of Anterior Left Ventricle Myocardial Wall- Intrinsic Conduction | at index procedure prior to lead fixation | Time to peak systolic velocity of the anterior left ventricle myocardial wall in milliseconds with no pacing applied, elicited by tissue Doppler |
| Mechanical Dyssynchrony of Inferior Left Ventricle Myocardial Wall- Intrinsic Conduction | at index procedure prior to lead fixation | Time to peak systolic velocity of the inferior left ventricle myocardial wall in milliseconds with no pacing applied, elicited by tissue Doppler |
| Mechanical Dyssynchrony of Inferior-septal Left Ventricle Myocardial Wall- Intrinsic Conduction | at index procedure prior to lead fixation | Time to peak systolic velocity of the inferior-septal left ventricle myocardial wall in milliseconds with no pacing applied, elicited by tissue Doppler |
| Mechanical Dyssynchrony of Left Ventricle Anterior-septal Myocardial Wall- Intrinsic Conduction | at index procedure prior to lead fixation | Time to peak systolic velocity of the left ventricle anterior-septal myocardial wall in milliseconds with no pacing applied, elicited by tissue Doppler |
| Mechanical Dyssynchrony of Lateral Left Ventricle Myocardial Wall- Intrinsic Conduction | at index procedure prior to lead fixation | Time to peak systolic velocity of the lateral left ventricle myocardial wall in milliseconds with no pacing applied, elicited by tissue Doppler |
| Mechanical Dyssynchrony of Inferior-lateral Left Ventricle Myocardial Wall- Intrinsic Conduction | at index procedure prior to lead fixation | Time to peak systolic velocity of the inferior-lateral left ventricle myocardial wall in milliseconds with no pacing applied, elicited by tissue Doppler |
| QRS Duration - Intrinsic Conduction | at index procedure prior to lead fixation | Duration (time in milliseconds) of the QRS wave complex interval measured from the end of the PR interval to the end of the S wave measured on a 12-lead electrocardiogram, with intrinsic conduction (prior to implantation of the pacemaker), indicating the length of time required for the electrical depolarization of the right and left ventricles of the heart and contraction of the large ventricular muscles. |
| QRS Duration After Lead Fixation | at index procedure following final lead fixation | Duration (time in milliseconds) of the QRS wave complex interval measured from the end of the PR interval to the end of the S wave measured on a 12-lead electrocardiogram, with intrinsic conduction (prior to implantation of the pacemaker), indicating the length of time required for the electrical depolarization of the right and left ventricles of the heart and contraction of the large ventricular muscles. A normal duration is between 80-100 milliseconds. A QRS duration of greater than 120 milliseconds is considered abnormal. |
| Left Ventricular Ejection Fraction (LVEF) - 3 Months | 3 months | LVEF is the percentage of blood pumped from the left ventricle of the heart with each beat. It is calculated as the fraction of chamber volume ejected in systole (stroke volume) in relation to the volume of the blood in the ventricle at the end of diastole (end-diastolic volume). Volumes are measured via ultrasound in an echocardiogram. A healthy LVEF ranges from 50-70%. LVEF less than 40% are considered low and indicate some degree of heart failure. LVEF less than 35% are considered dangerous and indicate a subject at risk for arrhythmia. |
| Left Ventricular Ejection Fraction (LVEF) - Intrinsic Conduction | at index procedure prior to lead fixation | Percentage of blood pumped from the left ventricle of the heart at each beat with no pacing applied |
| Mechanical Dyssynchrony of Anterior Left Ventricle Myocardial Wall - 3 Months | 3 months | Time to peak systolic velocity of the anterior left ventricle myocardial wall in milliseconds 3 months after final pacing lead fixation, elicited by tissue Doppler |
| Mechanical Dyssynchrony of Inferior Left Ventricle Myocardial Wall - 3 Months | 3 months | Time to peak systolic velocity of the inferior left ventricle myocardial wall in milliseconds 3 months after final pacing lead fixation, elicited by tissue Doppler |
| Mechanical Dyssynchrony of Left Ventricle Anterior-septal Myocardial Wall - 3 Months | 3 months | Time to peak systolic velocity of the left ventricle anterior-septal myocardial wall in milliseconds 3 months after final pacing lead fixation, elicited by tissue Doppler |
| Mechanical Dyssynchrony of Left Ventricle Inferior-septal Myocardial Wall- 3 Months | 3 months | Time to peak systolic velocity of the left ventricle inferior-septal myocardial wall in milliseconds 3 months after final pacing lead fixation, elicited by tissue Doppler |
| Mechanical Dyssynchrony of Lateral Left Ventricle Myocardial Wall- 3 Months | 3 months | Time to peak systolic velocity of the lateral left ventricle myocardial wall in milliseconds 3 months after final lead fixation, elicited by tissue Doppler |
| Mechanical Dyssynchrony of Inferior-lateral Left Ventricle Myocardial Wall- 3 Months | 3 months | Time to peak systolic velocity of the inferior-lateral left ventricle myocardial wall in milliseconds 3 months after final lead fixation, elicited by tissue Doppler |
| QRS Duration- 3 Months | 3 months | Duration (time in milliseconds) of the QRS wave complex interval measured from the end of the PR interval to the end of the S wave measured on a 12-lead electrocardiogram, 3 months after final pacing lead fixation, indicating the length of time required for the electrical depolarization of the right and left ventricles of the heart and contraction of the large ventricular muscles. A normal duration is between 80-100 milliseconds. A QRS duration of greater than 120 milliseconds is considered abnormal. |
| Capture Threshold - 6 Months, Unipolar or Bipolar | 6 months | Ventricular capture threshold is the minimum amplitude of electrical signal from the pacemaker that consistently results in capture of the ventricular myocardium (normal contraction of the ventricle after electrical depolarization) with a 1.0 millisecond pulse width setting in unipolar or Bipolar output modes, whichever value is lower, measured in volts. During pacemaker placement, the ideal ventricular capture threshold is determined by delivering a series of pulses starting at 0.75 volts and increasing by 0.125 V with each trial until consistent ventricular contraction is achieved. Pacemaker settings are programmed using the ventricular capture threshold, adjusted to include a safety margin, and may be re-adjusted over time if clinically necessary. The measurement is automatically recorded within the pacemaker and will be interrogated from the pacemaker device at 3 months post implantation. |
| Capture Threshold - 12 Months, Unipolar or Bipolar | 12 months | Ventricular capture threshold is the minimum amplitude of electrical signal from the pacemaker that consistently results in capture of the ventricular myocardium (normal contraction of the ventricle after electrical depolarization) with a 1.0 millisecond pulse width setting in unipolar or Bipolar output modes, whichever value is lower, measured in volts. During pacemaker placement, the ideal ventricular capture threshold is determined by delivering a series of pulses starting at 0.75 volts and increasing by 0.125 V with each trial until consistent ventricular contraction is achieved. Pacemaker settings are programmed using the ventricular capture threshold, adjusted to include a safety margin, and may be re-adjusted over time if clinically necessary. The measurement is automatically recorded within the pacemaker and will be interrogated from the pacemaker device at 3 months post implantation. |
| Stroke Volume - 3 Months | 3 months | Volume of blood in milliliters pumped from the left ventricle of the heart at each beat 3 months after final pacing lead fixation |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Selective or Non Selective His Bundle Pacing Pacemaker wires placed in Bundle of His
Select Secure pacing lead: A Select Secure pacing lead is placed in the bundle of His or Left bundle branch area based upon randomization | 3 |
| Left Bundle Area Pacing Pacemaker wires placed in Left Bundle Branch area
Select Secure pacing lead: A Select Secure pacing lead is placed in the bundle of His or Left bundle branch area based upon randomization | 6 |
| Total | 9 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| 3 Month Follow up | Physician Decision | 0 | 1 |
| 6month Follow up | Physician Decision | 1 | 3 |
Baseline characteristics
| Characteristic | Left Bundle Area Pacing | Total | Selective or Non Selective His Bundle Pacing |
|---|---|---|---|
| Age, Continuous | 78.83 years STANDARD_DEVIATION 9.7 | 79.44 years STANDARD_DEVIATION 8.95 | 80.67 years STANDARD_DEVIATION 9.02 |
| Race and Ethnicity Not Collected | — | 0 Participants | — |
| Region of Enrollment United States | 6 participants | 9 participants | 3 participants |
| Sex: Female, Male Female | 2 Participants | 3 Participants | 1 Participants |
| Sex: Female, Male Male | 4 Participants | 6 Participants | 2 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 3 | 0 / 6 |
| other Total, other adverse events | 0 / 3 | 0 / 6 |
| serious Total, serious adverse events | 0 / 3 | 0 / 6 |
Outcome results
Primary
Ventricular Capture Threshold, 3 Months Unipolar or Bipolar
Ventricular capture threshold is the minimum amplitude of electrical signal from the pacemaker that consistently results in capture of the ventricular myocardium (normal contraction of the ventricle after electrical depolarization) with a 1.0 millisecond pulse width setting in unipolar or Bipolar output modes, measured in volts. During pacemaker placement, the ideal ventricular capture threshold is determined by delivering a series of pulses starting at 0.75 volts and increasing by 0.125 V with each trial until consistent ventricular contraction is achieved. Pacemaker settings are programmed using the ventricular capture threshold, adjusted to include a safety margin, and may be re-adjusted over time if clinically necessary. The measurement is automatically recorded within the pacemaker and will be interrogated from the pacemaker device at 3 months post implantation.
Time frame: 3 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Selective or Non Selective His Bundle Pacing | Ventricular Capture Threshold, 3 Months Unipolar or Bipolar | 0.66 volts | Standard Deviation 0.14 |
| Left Bundle Area Pacing | Ventricular Capture Threshold, 3 Months Unipolar or Bipolar | 0.65 volts | Standard Deviation 0.13 |
Secondary
Capture Threshold - 12 Months, Unipolar or Bipolar
Ventricular capture threshold is the minimum amplitude of electrical signal from the pacemaker that consistently results in capture of the ventricular myocardium (normal contraction of the ventricle after electrical depolarization) with a 1.0 millisecond pulse width setting in unipolar or Bipolar output modes, whichever value is lower, measured in volts. During pacemaker placement, the ideal ventricular capture threshold is determined by delivering a series of pulses starting at 0.75 volts and increasing by 0.125 V with each trial until consistent ventricular contraction is achieved. Pacemaker settings are programmed using the ventricular capture threshold, adjusted to include a safety margin, and may be re-adjusted over time if clinically necessary. The measurement is automatically recorded within the pacemaker and will be interrogated from the pacemaker device at 3 months post implantation.
Time frame: 12 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Selective or Non Selective His Bundle Pacing | Capture Threshold - 12 Months, Unipolar or Bipolar | 1.31 Volts | Standard Deviation 0.61 |
| Left Bundle Area Pacing | Capture Threshold - 12 Months, Unipolar or Bipolar | 1.12 Volts | Standard Deviation 0 |
Secondary
Capture Threshold - 6 Months, Unipolar or Bipolar
Ventricular capture threshold is the minimum amplitude of electrical signal from the pacemaker that consistently results in capture of the ventricular myocardium (normal contraction of the ventricle after electrical depolarization) with a 1.0 millisecond pulse width setting in unipolar or Bipolar output modes, whichever value is lower, measured in volts. During pacemaker placement, the ideal ventricular capture threshold is determined by delivering a series of pulses starting at 0.75 volts and increasing by 0.125 V with each trial until consistent ventricular contraction is achieved. Pacemaker settings are programmed using the ventricular capture threshold, adjusted to include a safety margin, and may be re-adjusted over time if clinically necessary. The measurement is automatically recorded within the pacemaker and will be interrogated from the pacemaker device at 3 months post implantation.
Time frame: 6 months
Population: 4 patients completed data collection for 6 month follow-up
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Selective or Non Selective His Bundle Pacing | Capture Threshold - 6 Months, Unipolar or Bipolar | 1.18 Volts | Standard Deviation 0.79 |
| Left Bundle Area Pacing | Capture Threshold - 6 Months, Unipolar or Bipolar | 0.93 Volts | Standard Deviation 0.08 |
Secondary
Left Ventricular Ejection Fraction (LVEF) - 3 Months
LVEF is the percentage of blood pumped from the left ventricle of the heart with each beat. It is calculated as the fraction of chamber volume ejected in systole (stroke volume) in relation to the volume of the blood in the ventricle at the end of diastole (end-diastolic volume). Volumes are measured via ultrasound in an echocardiogram. A healthy LVEF ranges from 50-70%. LVEF less than 40% are considered low and indicate some degree of heart failure. LVEF less than 35% are considered dangerous and indicate a subject at risk for arrhythmia.
Time frame: 3 months
Population: Echocardiogram data not collected for any subject for any outcome in this study
Secondary
Left Ventricular Ejection Fraction (LVEF) - Intrinsic Conduction
Percentage of blood pumped from the left ventricle of the heart at each beat with no pacing applied
Time frame: at index procedure prior to lead fixation
Population: Echocardiogram data not collected for any subject for any outcome in this study.
Secondary
Mechanical Dyssynchrony of Anterior Left Ventricle Myocardial Wall - 3 Months
Time to peak systolic velocity of the anterior left ventricle myocardial wall in milliseconds 3 months after final pacing lead fixation, elicited by tissue Doppler
Time frame: 3 months
Population: Echocardiogram data not collected for any subject for any outcome in this study
Secondary
Mechanical Dyssynchrony of Anterior Left Ventricle Myocardial Wall- Intrinsic Conduction
Time to peak systolic velocity of the anterior left ventricle myocardial wall in milliseconds with no pacing applied, elicited by tissue Doppler
Time frame: at index procedure prior to lead fixation
Population: Echocardiogram data not collected for any subject for any outcome in this study
Secondary
Mechanical Dyssynchrony of Inferior-lateral Left Ventricle Myocardial Wall- 3 Months
Time to peak systolic velocity of the inferior-lateral left ventricle myocardial wall in milliseconds 3 months after final lead fixation, elicited by tissue Doppler
Time frame: 3 months
Population: Echocardiogram data not collected for any subject for any outcome in this study
Secondary
Mechanical Dyssynchrony of Inferior-lateral Left Ventricle Myocardial Wall- Intrinsic Conduction
Time to peak systolic velocity of the inferior-lateral left ventricle myocardial wall in milliseconds with no pacing applied, elicited by tissue Doppler
Time frame: at index procedure prior to lead fixation
Population: Echocardiogram data not collected for any subject for any outcome in this study
Secondary
Mechanical Dyssynchrony of Inferior Left Ventricle Myocardial Wall - 3 Months
Time to peak systolic velocity of the inferior left ventricle myocardial wall in milliseconds 3 months after final pacing lead fixation, elicited by tissue Doppler
Time frame: 3 months
Population: Echocardiogram data not collected for any subject for any outcome in this study
Secondary
Mechanical Dyssynchrony of Inferior Left Ventricle Myocardial Wall- Intrinsic Conduction
Time to peak systolic velocity of the inferior left ventricle myocardial wall in milliseconds with no pacing applied, elicited by tissue Doppler
Time frame: at index procedure prior to lead fixation
Population: Echocardiogram data not collected for any subject for any outcome in this study
Secondary
Mechanical Dyssynchrony of Inferior-septal Left Ventricle Myocardial Wall- Intrinsic Conduction
Time to peak systolic velocity of the inferior-septal left ventricle myocardial wall in milliseconds with no pacing applied, elicited by tissue Doppler
Time frame: at index procedure prior to lead fixation
Population: Echocardiogram data not collected for any subject for any outcome in this study
Secondary
Mechanical Dyssynchrony of Lateral Left Ventricle Myocardial Wall- 3 Months
Time to peak systolic velocity of the lateral left ventricle myocardial wall in milliseconds 3 months after final lead fixation, elicited by tissue Doppler
Time frame: 3 months
Population: Echocardiogram data not collected for any subject for any outcome in this study
Secondary
Mechanical Dyssynchrony of Lateral Left Ventricle Myocardial Wall- Intrinsic Conduction
Time to peak systolic velocity of the lateral left ventricle myocardial wall in milliseconds with no pacing applied, elicited by tissue Doppler
Time frame: at index procedure prior to lead fixation
Population: Echocardiogram data not collected for any subject for any outcome in this study
Secondary
Mechanical Dyssynchrony of Left Ventricle Anterior-septal Myocardial Wall - 3 Months
Time to peak systolic velocity of the left ventricle anterior-septal myocardial wall in milliseconds 3 months after final pacing lead fixation, elicited by tissue Doppler
Time frame: 3 months
Population: Echocardiogram data not collected for any subject for any outcome in this study
Secondary
Mechanical Dyssynchrony of Left Ventricle Anterior-septal Myocardial Wall- Intrinsic Conduction
Time to peak systolic velocity of the left ventricle anterior-septal myocardial wall in milliseconds with no pacing applied, elicited by tissue Doppler
Time frame: at index procedure prior to lead fixation
Population: Echocardiogram data not collected for any subject for any outcome in this study
Secondary
Mechanical Dyssynchrony of Left Ventricle Inferior-septal Myocardial Wall- 3 Months
Time to peak systolic velocity of the left ventricle inferior-septal myocardial wall in milliseconds 3 months after final pacing lead fixation, elicited by tissue Doppler
Time frame: 3 months
Population: Echocardiogram data not collected for any subject for any outcome in this study
Secondary
QRS Duration- 3 Months
Duration (time in milliseconds) of the QRS wave complex interval measured from the end of the PR interval to the end of the S wave measured on a 12-lead electrocardiogram, 3 months after final pacing lead fixation, indicating the length of time required for the electrical depolarization of the right and left ventricles of the heart and contraction of the large ventricular muscles. A normal duration is between 80-100 milliseconds. A QRS duration of greater than 120 milliseconds is considered abnormal.
Time frame: 3 months
Population: 1 patient in the left bundle area pacing group had data missing for this outcome
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Selective or Non Selective His Bundle Pacing | QRS Duration- 3 Months | 108.67 milliseconds | Standard Deviation 19.22 |
| Left Bundle Area Pacing | QRS Duration- 3 Months | 123 milliseconds | Standard Deviation 46.26 |
Secondary
QRS Duration After Lead Fixation
Duration (time in milliseconds) of the QRS wave complex interval measured from the end of the PR interval to the end of the S wave measured on a 12-lead electrocardiogram, with intrinsic conduction (prior to implantation of the pacemaker), indicating the length of time required for the electrical depolarization of the right and left ventricles of the heart and contraction of the large ventricular muscles. A normal duration is between 80-100 milliseconds. A QRS duration of greater than 120 milliseconds is considered abnormal.
Time frame: at index procedure following final lead fixation
Population: One patient in left bundle area pacing group had missing data for this outcome
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Selective or Non Selective His Bundle Pacing | QRS Duration After Lead Fixation | 129.33 millliseconds | Standard Deviation 35.8 |
| Left Bundle Area Pacing | QRS Duration After Lead Fixation | 129.8 millliseconds | Standard Deviation 10.83 |
Secondary
QRS Duration - Intrinsic Conduction
Duration (time in milliseconds) of the QRS wave complex interval measured from the end of the PR interval to the end of the S wave measured on a 12-lead electrocardiogram, with intrinsic conduction (prior to implantation of the pacemaker), indicating the length of time required for the electrical depolarization of the right and left ventricles of the heart and contraction of the large ventricular muscles.
Time frame: at index procedure prior to lead fixation
Population: One patient in HIS bundle pacing group had no data for this outcome.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Selective or Non Selective His Bundle Pacing | QRS Duration - Intrinsic Conduction | 145 milliseconds | Standard Deviation 21.21 |
| Left Bundle Area Pacing | QRS Duration - Intrinsic Conduction | 124.83 milliseconds | Standard Deviation 26.63 |
Secondary
Stroke Volume - 3 Months
Volume of blood in milliliters pumped from the left ventricle of the heart at each beat 3 months after final pacing lead fixation
Time frame: 3 months
Population: Echocardiogram data not collected for any subject for any outcome in this study
Secondary
Stroke Volume - Intrinsic Conduction
Volume of blood in milliliters pumped from the left ventricle of the heart at each beat with no pacing applied
Time frame: at index procedure prior to lead fixation
Population: Echocardiogram data not collected for any subject for any outcome in this study