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Trial registered on ANZCTR
Registration number
ACTRN12624000304538
Ethics application status
Approved
Date submitted
21/02/2024
Date registered
22/03/2024
Date last updated
22/03/2024
Date data sharing statement initially provided
22/03/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
COMPARison of Lumenless versus Stylet-driven Lead Systems in Left Bundle Branch Pacing - COMPARE LBBP
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Scientific title
COMPARison of procedural outcomes of Lumenless versus Stylet-driven Lead Systems in Left Bundle Branch Pacing - COMPARE LBBP
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Secondary ID [1]
311567
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Bradycardia
332937
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Heart failure
332938
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Pacemaker induced cardiomyopathy
332965
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Condition category
Condition code
Cardiovascular
329654
329654
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Left bundle branch pacing (LBBP) is a rapidly emerging pacing modality. Traditionally, lumenless fixed helix lead is used for LBBP delivered with a fixed curve or preshaped deflectable delivery catheter. However, it can also be done with stylet driven lead when used with appropriate delivery catheter. In this clinical trial one arm will receive lumen less lead and another will receive stylet driven lead for LBBP. No investigational therapy is involved as both methods are tested and currently in use.
Intervention arm will receive stylet driven lead system. LBBP will be performed with stylet driven lead delivered to target location through a delivery catheter. A pre-shaped delivery catheter (such as CPS Locator 3D sheth) will be used which is standard of care. Left bundle capture will be confirmed by paced RBBB morphology, V6-R wave peak time, V6-V1 inter peak interval, transition from nonselective to selective left bundle or left ventricular septal capture.
Procedure will be performed once and confirmation of left bundle branch capture will be considered acute success. Usual procedural duration is ~1 hour. Procedure will be performed by experienced cardiac electrophysiologist specialised in left bundle branch pacing.
Another cardiac electrophysiologist will be independently responsible for validating the left bundle branch capture and independent team of cardiac physiologists will be responsible for collecting data regarding procedure start, end and electrocardiographic parameters.
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Intervention code [1]
328022
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Treatment: Devices
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Comparator / control treatment
Lumenless lead for LBBP
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Control group
Active
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Outcomes
Primary outcome [1]
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Acute implant success rate
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Assessment method [1]
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Successful capture of left bundle branch as indicated by paced RBBB morphology, V6 RWPT, V6-V1 inter-peak interval and transition from nonselective to selective left bundle or left ventricular septal capture during procedure. This will be determined during the procedure by observing the transition on surface ECG in cardiac electrophysiology laboratory.
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Timepoint [1]
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At implant
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Secondary outcome [1]
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Terminal r/R' wave in lead V1 - Right Bundle Branch Block morphology in lead V1
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Assessment method [1]
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On surface electrocardiogram in cardiac electrophysiology laboratory
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Timepoint [1]
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At implant
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Secondary outcome [2]
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Transition from non-selective to selective LBBP or non-selective LBBP to left ventricular myocardial capture during decreasing pacing output
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Assessment method [2]
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On surface ECG in cardiac electrophysiology laboratory
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Timepoint [2]
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At implant
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Secondary outcome [3]
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Abrupt shortening of stimulus to R wave peak time in V6 ECG lead (V6RWPT) by 10 ms or more during implantation
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Assessment method [3]
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On surface ECG in cardiac electrophysiology laboratory
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Timepoint [3]
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At implant
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Secondary outcome [4]
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V6RWPT < 75ms or < 80ms in patients with preexisting left bundle branch block
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Assessment method [4]
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On surface ECG in cardiac electrophysiology laboratory
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Timepoint [4]
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At implant
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Secondary outcome [5]
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An interpeak interval (V1RWPT - V6RWPT) > 33ms
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Assessment method [5]
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On surface ECG in cardiac electrophysiology laboratory
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Timepoint [5]
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At implant
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Secondary outcome [6]
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Implant related complications
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Assessment method [6]
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Number of patients with major and minor complications related to the procedure (death, perforation, cardiac tamponade, lead dislodgment, loss of capture or need for reintervention). Lead dislodgement or loss of capture will be determined by interrogating the device predischarge or form review of device parameters on follow up. Cadiac perforation leading to tamponade and/or death are acute complications which will be diagnosed by echocardiography or fluoroscopy or CT scan predischarge. Source of the data will be above mentioned investigations.
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Timepoint [6]
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Immediate post procedure period
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Eligibility
Key inclusion criteria
a) Age: 18 years and above
b) Recipients of left bundle branch pacing therapy
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
a) Metallic tricuspid valve implant
b) Venous anatomy unsuitable for transvenous pacing - e.g venous stenosis, congenital malformation
b) Refuse to/unable to give consent
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by phone/fax/computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
17/11/2023
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Date of last participant enrolment
Anticipated
15/05/2024
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Actual
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Date of last data collection
Anticipated
31/05/2024
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Actual
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Sample size
Target
100
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Accrual to date
80
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Final
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Recruitment in Australia
Recruitment state(s)
ACT
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Address [1]
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Country [1]
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Primary sponsor type
Charities/Societies/Foundations
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Name
Canberra heart rhythm foundation
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Address
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Country
Australia
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Secondary sponsor category [1]
318006
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None
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Name [1]
318006
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Address [1]
318006
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Country [1]
318006
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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ACT Health Human Research Ethics Committee
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Ethics committee address [1]
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https://health.act.gov.au/act-health-system/research-data-and-publications/research/research-ethics-and-governance
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Ethics committee country [1]
314716
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Australia
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Date submitted for ethics approval [1]
314716
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19/10/2023
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Approval date [1]
314716
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16/11/2023
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Ethics approval number [1]
314716
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Summary
Brief summary
Left bundle branch pacing (LBBP) is rapidly emerging pacing therapy. Traditionally, lumenless fixed helix lead is used for LBBP which is delivered through a fixed curve or preshaped flexible curve delivery catheter. Left bundle area can also be captured with implantation of traditional stylet-driven leads delivered with the use of various delivery sheaths from different manufacturers. Currently, both techniques are in use; however, data regarding comparison of outcomes of these two different lead systems is limited. This trial aims at comparing the outcomes of these two different techniques of LBBP which are currently in use.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Rajeev Kumar Pathak
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Address
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Canberra heart rhythm, Suite 14, 2 Garran Pl, Garran, ACT-2605
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Country
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Australia
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Phone
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+61477653949
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Fax
132498
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Email
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[email protected]
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Contact person for public queries
Name
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Rajeev Kumar Pathak
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Address
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Canberra heart rhythm, Suite 14, 2 Garran Pl, Garran, ACT-2605
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Country
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Australia
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Phone
132499
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+61477653949
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Fax
132499
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Email
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[email protected]
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Contact person for scientific queries
Name
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Rajeev Kumar Pathak
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Address
132500
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Canberra heart rhythm, Suite 14, 2 Garran Pl, Garran, ACT-2605
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Country
132500
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Australia
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Phone
132500
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+61477653949
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Fax
132500
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Email
132500
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
21687
Study protocol
[email protected]
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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