Efficacy of a Pacemaker Algorithm in Promotion of the Intrinsic Heart Activity.

Medtronic

Status and phase

Unknown

Phase 4

Conditions

Bradycardia; Sick Sinus Syndrome, AV Block

Treatments

Procedure: Required pacemaker setting

Device: Vitatron C50 D Model C50A2 of Vitatron C60 DR model C60A2

Study type

Interventional

Funder types

Industry

Identifiers

NCT00156741

CMD 287

Details and patient eligibility

About

The purpose of this study is to provide evidence that the Refined Ventricular Pacing Algorithm leads to clinically relevant reduction (at least 50% reduction) of the incidence of ventricular pacing.

Full description

Electrical stimulation in the apex of the right ventricle ( ventricular pacing) usually improves the heart function of patients with a pacemaker and can even be life-saving. However, evidence is accumulating that ventricular pacing may also have undesired long-term cardiac effects. Therefore, it makes sense to limit ventricular pacing to the absolute required minimum. The functionality RVP (Refined Ventricular Pacing) in the C-series 2nd generation pacemakers of Vitatron B.V. Arnhem, the Netherlands is designed to reduce ventricular pacing.

After implantation of the Vitatron C50 D model C50A2 (pacemaker) or Vitatron C60 DR model C60A2 (pacemaker) and a 4-6 weeks stabilization period, proper functioning of pacemaker and leads (stimulation- and sensing parameters) is checked. The pacemakers will be programmed according to predefined settings.

In the following 4-weeks Baseline period diagnostic data (atrial fibrillation burden and percentage of ventricular pacing (% VP)) are collected in the pacemaker memory. Based on these data, patients will be excluded from further participation (patients with more than 15% atrial fibrillation) or subdivided into three groups: (a) < 30% VP (30- VP group), (b) >30% VP, Sick Sinus Syndrome and normal conductivity (SSS group), (c) >30% VP, 1st or 2nd degree AV block. Patients in these three groups will be treated for 4 weeks alternatively with the RVP functionality switched ON or OFF. The order will be determined by randomization. At the end of these two cross-over periods the % VP and the judgment of the patients of the last period will be assessed. Adverse events will be recorded from the moment of study enrolment.

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patients shall be willing to sign the Patient Informed Consent for this study
Patients shall have at least one of the following indications for a pacemaker: - Sick Sinus Syndrome with normal QRS complexes
First degree AV block with a PR interval <220 ms for patients < 70 years of age, or <_ 260 for patients over 70 years
Second-degree AV block, mobitz I (wenckebach) or mobitz II
Patients shall be available for follow-up for the duration of their participation.

Exclusion criteria

Patients involved in another investigation study conducted in parallel to this study
Patients younger than 18 years of age and/or patients that do NOT meet other local requirements for participation
Pregnant patients
Patients with lead integrity problems (and the lead is not being replaced)
Patients with persistant AF
Patients with a complete AV block
Patients with NYHA (New York Heart Association0 class III and IV
Patients who underwent thoracic surgery in the last three months or are expected to have in the near future
Patients with a 2:1 block
Patients with a life expectancy less than half a year