NCT07279870

Brief Summary

Study objective is to assess whether stimulation of the conduction system reduces cardiac decompensation events in patient follow-up, and how applicable this is in clinical practice and also to determine the impact of the studied interventions in terms of quality of life and cost-effectiveness for the treatment of patients with atrioventricular block. 1260 adult patients who are candidates for pacemaker implantation for the treatment of atrioventricular conduction disease will be randomised to stimulation of the conduction system or to the conventional stimulation.

Trial Health

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Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,260

participants targeted

Target at P75+ for not_applicable

Timeline
62mo left

Started Dec 2025

Longer than P75 for not_applicable

Geographic Reach
1 country

13 active sites

Status
not yet recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress7%
Dec 2025Jun 2031

First Submitted

Initial submission to the registry

December 1, 2025

Completed
11 days until next milestone

First Posted

Study publicly available on registry

December 12, 2025

Completed
8 days until next milestone

Study Start

First participant enrolled

December 20, 2025

Completed
5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2030

Expected
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2031

Last Updated

December 12, 2025

Status Verified

December 1, 2025

Enrollment Period

5 years

First QC Date

December 1, 2025

Last Update Submit

December 1, 2025

Conditions

Outcome Measures

Primary Outcomes (1)

  • Heart failure

    composite endponit of: number of HF events, HF hospitalizations and HF non-pharmacological interventions

    36 months after the PM implant

Secondary Outcomes (3)

  • number of HF events

    36 months after the PM implant

  • HF hospitalizations

    36 months after the PM implant

  • HF non-pharmacological interventions

    36 months after the PM implant

Study Arms (2)

Conduction System Pacing (CSP)

EXPERIMENTAL

CSP occurs at the left endocardic surface of the interventricular septum hence specifically designed delivery catheters are used to advance the ventricular lead across the septum until its left-sided edge, where the Left Bundle is located.

Procedure: Conduction System Pacing (CSP)

Conventional System Pacing/Right Ventricular (RV) Pacing

ACTIVE COMPARATOR

RV pacing delivered either at the RV apex or RV septum. RV pacing is delivered by single chamber or dual chamber pacemakers depending on patients' rhythm (sinus or AT/AF) according to well-established clinical practice as described in the EHRA recommendtions

Procedure: Right Ventricular (RV) Pacing

Interventions

CSP occurs at the left endocardic surface of the interventricular septum hence specifically designed delivery catheters are used to advance the ventricular lead across the septum until its left-sided edge, where the Left Bundle is located. To determine whether CSP has been achieved, a standard 12-lead electrocardiogram (ECG) is continuously recorded.

Conduction System Pacing (CSP)

RV pacing delivered either at the RV apex or RV septum. RV pacing is delivered by single chamber or dual chamber pacemakers depending on patients' rhythm (sinus or AT/AF) according to well-established clinical practice as described in the EHRA recommendtions

Conventional System Pacing/Right Ventricular (RV) Pacing

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Adult patients with AV block in either sinus rhythm (SR) or permanent atrial tachycardia/atrial fibrillation (AT/AF), or with slow AV conduction during AT/AF, or undergoing AV node ablation + ventricular stimulation
  • male and female
  • acquired informed consent

You may not qualify if:

  • Class I indication to Implantable Cardioverter Defibrillator (ICD) or to Cardiac Resynchronization Therapy (CRT)
  • Ejection Fraction \< 35%
  • Life expectancy \< 2 years
  • Participation in another clinical trial which might impact on the study outcome
  • Pregnancy, except as "In the event of an ongoing pregnancy, the doctor and patient will jointly assess, on a case-by-case basis and in the best interests of the patient, whether to propose participation in the study (random assignment to one of the two stimulation techniques) or to proceed as per clinical practice (assignment to one of the two stimulation techniques by the doctor). A screening log file of all eligible patients will be recorded, detailing the reason/s for non-randomization."

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (13)

Azienda Ospedal iera "Card. G. Panico"

Bari, Italy

Location

Azienda Ospedaliero-Universitaria Policlinico "G. Rodolico -San Marco"

Catania, Italy

Location

Azienda Ospedalie ro-Universitaria di Ferrara

Ferrara, Italy

Location

ASST Grande Ospedale Metropolitano Niguarda

Milan, Italy

Location

Azienda Ospedaliero-Universitaria Maggiore della Carità di Novara

Novara, Italy

Location

Azienda Sanitaria locali di Asti Ospedale Cardinal Massaia

Novara, Italy

Location

Azienda Ospedaliero-Univeritaria di Palermo - Policlinico Giaccone

Palermo, Italy

Location

Azienda Ospedaliero-Universitaria di Parma

Parma, Italy

Location

Azienda Ospedaliera Santa Maria della Misericordia

Perugia, Italy

Location

Policlinico Casilino

Roma, Italy

Location

Ospedale di Rovigo Aulss 5 Polesana

Rovigo, Italy

Location

Città delle Salute e della Scienza di Torino. Dipartimento Cardiovascolare e Toracico

Torino, Italy

Location

APSS Trento - Ospedale S. Maria del Carmine di Rovereto

Trento, Italy

Location

MeSH Terms

Conditions

Atrioventricular Block

Condition Hierarchy (Ancestors)

Heart BlockArrhythmias, CardiacHeart DiseasesCardiovascular DiseasesCardiac Conduction System DiseasePathologic ProcessesPathological Conditions, Signs and Symptoms

Study Officials

  • Mauro Biffi, MD

    IRCCS AOUBO Policlinico di Sant'Orsola

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Susanna Maltoni, PharmD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

December 1, 2025

First Posted

December 12, 2025

Study Start

December 20, 2025

Primary Completion (Estimated)

December 31, 2030

Study Completion (Estimated)

June 30, 2031

Last Updated

December 12, 2025

Record last verified: 2025-12

Locations