Paced Dyssynchrony and Myocardial Perfusion IN apiCal Hcm (NCT04231032) | Clinical Trial Compass
TerminatedNot Applicable
Paced Dyssynchrony and Myocardial Perfusion IN apiCal Hcm
Stopped: Unable to recruit to target
United Kingdom11 participantsStarted 2021-06-02
Plain-language summary
Hypertrophic cardiomyopathy (HCM) is the most common inherited heart disease. A relatively common subgroup of HCM patients have apical HCM - a type of heart muscle disease that causes abnormal muscle thickening towards the tip (apex) of the heart. This can impair the heart's own blood flow through the thickened heart muscle. We think this is one of the causes for symptoms such as shortness of breath and chest pain. If medications are ineffective at treating symptoms, there are few further options available, limited to invasive heart surgery.
This study aims to determine if it is possible to improve the blood flow within by altering the settings of patients' permanent pacemakers, dynamic microvascular obstruction is an important cause of perfusion abnormalities in HCM and whether introducing localized dyssynchrony with ventricular pacing improves this. This phased study will include patients with apical HCM that already have implanted pacemaker devices to remove risks associated with device implantation.
The study may provide insights into novel mechanisms for symptoms in HCM and provide new methods for treating a patient group in whom therapeutic options can be extremely limited.
Who can participate
Age range18 Years
SexALL
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Inclusion criteria
✓. Male or female, \>18 years.
✓. HCM patients with apical HCM defined as apical hypertrophy with apical LV systolic obliteration and the presence of characteristic ECG changes. Participants with a mixed cardiac phenotype will be considered if they also meet these criteria and do not have resting outflow tract obstruction.
✓. A programmable intracardiac pacing device with a right atrial lead and an apically / low septal located right ventricular lead.
✓. Willing and able to provide informed consent.
Exclusion criteria
✕. Outflow tract obstruction \>50 mmHg at rest due to systolic anterior mitral movement.
✕. Evidence of high-grade heart block.
✕. Moderate or severe primary valvular disease.
✕. Unrevascularised, known, significant coronary disease: the significance of any known coronary disease will be determined after discussion with an independent clinician.
✕
What they're measuring
1
Myocardial perfusion mapping
Timeframe: Acute changes during the CMR scan on Visit 1 (day 1)