Sick Sinus SyndromeVIPERSNCT01528657
Ventricular Pace Suppression Versus Intrinsic Rhythm Support Study
A study testing Ventricular Pace Suppression (Vps) and Intrinsic rhythm support (IRSplus) in people with Sick Sinus Syndrome, run by Biotronik SE & Co. KG at 20 sites in Italy.
Trial summary
The objective of this study is to intra-individually compare the performances of two pacemaker algorithms designed to reduce unnecessary right ventricular pacing: Intrinsic Rhythm Support Plus (IRSplus) and Ventricular Pace Suppression (VpS). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Sick Sinus Syndrome
- What is being tested?
- Ventricular Pace Suppression (Vps) and Intrinsic rhythm support (IRSplus)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 230 participants
- Where
- 20 sitesItaly
- Study dates
- Dec 2011to Aug 2015
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients over 18 years of age;
- Patient has proven informed consent;
- Subject with indication of dual chamber pacemaker due to Sinus Node Dysfunction;
- Subjects with a dual chamber pacemaker already implanted within six months from enrollment, provided that ventricular pacing percentage ≤ 40% and with the right ventricular lead in the apical position;
- Stable medical situation;
- Stable geographical situation;
Who cannot join
- Permanent or paroxysmal AV block ≥ II;
- Permanent Atrial fibrillation/Atrial flutter;
- Device Replacement;
- Patient with a poor echocardiographic window;
- Patient already implanted with the right ventricular lead not in the apical position;
- Subjects with a dual chamber pacemaker, implanted later than six months;
Show all 13Show fewer
- Subjects with a dual chamber pacemaker with ventricular pacing percentage ≥ 40%;
- Contraindication for DDD(R)-ADI(R) or DDD(R) pacing modes;
- VpS or IRSplus algorithm contraindications;
- Age < 18 years;
- Life expectancy < 12 months;
- Cardiac surgery planned within the FU period;
- Participation to another clinical investigation;
Trial locations and contacts
20 sites in 1 country.
20 sites in 1 country
Italy20 sites
A.O.U. Ospedali Riuniti di Ancona
Ancona
Ospedale Degli Infermi
Biella
Ospedale SS. Trinità
Borgomanero, Novara
P.O. F. Ferrari
Casarano, Lecce
Ospedale San Leonardo
Castellammare di Stabia, Napoli
A.O.U. Policlinico-Vittorio Emanuele
Catania
Ospedale S. Giuseppe
Empoli
Ospedale S.Antonio Abate
Gallarate, Varese
Osp. Civile F. Veneziale
Isernia
P.O. Vito Fazzi
Lecce
Ospedale Dell'Angelo
Mestre, Venezia
Ospedale Santa Croce
Moncalieri, Torino
A.O.R.N. dei Colli - PO "V. Monaldi"
Naples
Ospedale SS. Cosma e Damiano
Pescia, Pistoia
A.O. Destra Secchia
Pieve di Coriano, Mantova
A.O. Santa Maria Degli Angeli
Pordenone
A.O. San Carlo
Potenza
Ospedale Degli Infermi
Rimini
Ospedale Bolognini
Seriate, Bergamo
Ospedale SS. Giovanni e Paolo
Venezia
About this study
The objective of this study is to intra-individually compare the performances of two pacemaker algorithms designed to reduce unnecessary right ventricular pacing: Intrinsic Rhythm Support Plus (IRSplus) and Ventricular Pace Suppression (VpS). The study will compare ventricular pacing percentage, long-term atrio-ventricular conduction time, occurrences of atrial tachyarrhythmic events and atrial fibrillation burden percentage in patients implanted with a pacemaker for Sick Sinus Syndrome.
- Conditions
- Sick Sinus Syndrome
- Being tested
- Ventricular Pace Suppression (Vps), Intrinsic rhythm support (IRSplus)
- Keywords
- Sick Sinus Syndrome, Ventricular pacing, Minimal ventricular pacing, Ventricular pacing suppression, Intrinsic rhythm support, Long term AV
- Medical subject headings
- Sick Sinus Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Ventricular Pace Suppression (Vps)Other
Unnecessary ventricular pacing is avoided by promoting intrinsic conduction. In case of intrinsic conduction, the device switches from a DDD mode to an ADI mode.
Intrinsic rhythm support (IRSplus)Other
All parameters of the AV hysteresis functions are set in a way to maintain spontaneous AV conduction of the patient's heart as long as possible.
| Study group | Role | What they receive |
|---|---|---|
| Ventricular Pace Suppression (VpS) | Experimental | The function Ventricular Pace Suppression (VpS) is activated Receives: Other: Ventricular Pace Suppression (Vps) |
| Intrinsic Rhythm Support (IRSplus) | Experimental | The function Intrinsic Rhythm Support (IRSplus) is activated Receives: Other: Intrinsic rhythm support (IRSplus) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Ventricular pacing percentage
Measured: 6 months
Secondary outcomes (3)
Long-term atrio-ventricular conduction delay
Measured: 6 Months
Occurrence of atrial tachycardia or atrial fibrillation events
Measured: 6 Months
Burden of atrial fibrillation
Measured: 6 Months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Feb 2012 (estimated)
- Study startDec 2011
- Primary completionAug 2015
- Study completionAug 2015
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (12)Papers the sponsor has linked to this study.
- Other trials for Sick Sinus SyndromeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Enrolment
- 230 participants (actual)
Sponsor and investigators
- Lead sponsor
- Biotronik SE & Co. KG
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Alessandro Capucci, Principal investigator, A.O.U. Ospedali Riuniti, AnconaValeria Calvi, Principal investigator, A.O.U. Policlinico-Vittorio Emanuele, CataniaMarco Brieda, Principal investigator, A.O. Santa Maria degli Angeli, PordenoneEnnio Pisanò, Principal investigator, P.O. Vito Fazzi, LecceVittorio Giudici, Principal investigator, Ospedale Bolognini, Seriate
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01528657
- Sponsor's protocol ID
- BA098
- Acronym
- VIPERS
- Status last verified
- Oct 2015
- First submitted
- 6 Feb 2012
- Last updated
- 22 Oct 2015
- Results posted
- No
- Data monitoring committee
- No
Publications
Vassallo JA, Cassidy DM, Miller JM, Buxton AE, Marchlinski FE, Josephson ME. Left ventricular endocardial activation during right ventricular pacing: effect of underlying heart disease. J Am Coll Cardiol. 1986 Jun;7(6):1228-33. doi: 10.1016/s0735-1097(86)80140-1.
PubMed 3711479Prinzen FW, Peschar M. Relation between the pacing induced sequence of activation and left ventricular pump function in animals. Pacing Clin Electrophysiol. 2002 Apr;25(4 Pt 1):484-98. doi: 10.1046/j.1460-9592.2002.00484.x.
PubMed 11991375Prinzen FW, Augustijn CH, Arts T, Allessie MA, Reneman RS. Redistribution of myocardial fiber strain and blood flow by asynchronous activation. Am J Physiol. 1990 Aug;259(2 Pt 2):H300-8. doi: 10.1152/ajpheart.1990.259.2.H300.
PubMed 2386214Thambo JB, Bordachar P, Garrigue S, Lafitte S, Sanders P, Reuter S, Girardot R, Crepin D, Reant P, Roudaut R, Jais P, Haissaguerre M, Clementy J, Jimenez M. Detrimental ventricular remodeling in patients with congenital complete heart block and chronic right ventricular apical pacing. Circulation. 2004 Dec 21;110(25):3766-72. doi: 10.1161/01.CIR.0000150336.86033.8D. Epub 2004 Dec 6.
PubMed 15583083Kanzaki H, Bazaz R, Schwartzman D, Dohi K, Sade LE, Gorcsan J 3rd. A mechanism for immediate reduction in mitral regurgitation after cardiac resynchronization therapy: insights from mechanical activation strain mapping. J Am Coll Cardiol. 2004 Oct 19;44(8):1619-25. doi: 10.1016/j.jacc.2004.07.036.
PubMed 15489094Maurer G, Torres MA, Corday E, Haendchen RV, Meerbaum S. Two-dimensional echocardiographic contrast assessment of pacing-induced mitral regurgitation: relation to altered regional left ventricular function. J Am Coll Cardiol. 1984 Apr;3(4):986-91. doi: 10.1016/s0735-1097(84)80357-5.
PubMed 6707363Vanderheyden M, Goethals M, Anguera I, Nellens P, Andries E, Brugada J, Brugada P. Hemodynamic deterioration following radiofrequency ablation of the atrioventricular conduction system. Pacing Clin Electrophysiol. 1997 Oct;20(10 Pt 1):2422-8. doi: 10.1111/j.1540-8159.1997.tb06081.x.
PubMed 9358483Nielsen JC, Kristensen L, Andersen HR, Mortensen PT, Pedersen OL, Pedersen AK. A randomized comparison of atrial and dual-chamber pacing in 177 consecutive patients with sick sinus syndrome: echocardiographic and clinical outcome. J Am Coll Cardiol. 2003 Aug 20;42(4):614-23. doi: 10.1016/s0735-1097(03)00757-5.
PubMed 12932590Nielsen JC, Andersen HR, Thomsen PE, Thuesen L, Mortensen PT, Vesterlund T, Pedersen AK. Heart failure and echocardiographic changes during long-term follow-up of patients with sick sinus syndrome randomized to single-chamber atrial or ventricular pacing. Circulation. 1998 Mar 17;97(10):987-95. doi: 10.1161/01.cir.97.10.987.
PubMed 9529267Nahlawi M, Waligora M, Spies SM, Bonow RO, Kadish AH, Goldberger JJ. Left ventricular function during and after right ventricular pacing. J Am Coll Cardiol. 2004 Nov 2;44(9):1883-8. doi: 10.1016/j.jacc.2004.06.074.
PubMed 15519023Sweeney MO, Hellkamp AS, Ellenbogen KA, Greenspon AJ, Freedman RA, Lee KL, Lamas GA; MOde Selection Trial Investigators. Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction. Circulation. 2003 Jun 17;107(23):2932-7. doi: 10.1161/01.CIR.0000072769.17295.B1. Epub 2003 Jun 2.
PubMed 12782566Calvi V, Pisano EC, Brieda M, Melissano D, Castaldi B, Guastaferro C, Nigro G, Madalosso M, Orsida D, Rovai N, Gargaro A, Capucci A. Atrioventricular Interval Extension Is Highly Efficient in Preventing Unnecessary Right Ventricular Pacing in Sinus Node Disease: A Randomized Cross-Over Study Versus Dual- to Atrial Single-Chamber Mode Switch. JACC Clin Electrophysiol. 2017 May;3(5):482-490. doi: 10.1016/j.jacep.2016.11.011. Epub 2017 Feb 1.
PubMed 29759604
Study at a glance
From the registry record, last updated by the sponsor on 22 Oct 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Ventricular Pace Suppression Versus Intrinsic Rhythm Support Study
- ClinicalTrials.gov ID
- NCT01528657
- Acronym / sponsor ID
- VIPERS / BA098
- Conditions
- Sick Sinus Syndrome
- Keywords
- Sick Sinus Syndrome, Ventricular pacing, Minimal ventricular pacing, Ventricular pacing suppression, Intrinsic rhythm support, Long term AV
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 230 participants (actual)
- Lead sponsor
- Biotronik SE & Co. KGIndustry (pharma, biotech, devices)
- Study start
- Dec 2011
- Primary completion
- Aug 2015 (actual)
- Study completion
- Aug 2015 (actual)
- First posted
- 8 Feb 2012 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The objective of this study is to intra-individually compare the performances of two pacemaker algorithms designed to reduce unnecessary right ventricular pacing: Intrinsic Rhythm Support Plus (IRSplus) and Ventricular Pace Suppression (VpS). The study will compare ventricular pacing percentage, long-term atrio-ventricular conduction time, occurrences of atrial tachyarrhythmic events and atrial fibrillation burden percentage in patients implanted with a pacemaker for Sick Sinus Syndrome.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Ventricular Pace Suppression (VpS) | Experimental | Other: Ventricular Pace Suppression (Vps)The function Ventricular Pace Suppression (VpS) is activated |
| Intrinsic Rhythm Support (IRSplus) | Experimental | Other: Intrinsic rhythm support (IRSplus)The function Intrinsic Rhythm Support (IRSplus) is activated |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Patients over 18 years of age;
- Patient has proven informed consent;
- Subject with indication of dual chamber pacemaker due to Sinus Node Dysfunction;
- Subjects with a dual chamber pacemaker already implanted within six months from enrollment, provided that ventricular pacing percentage ≤ 40% and with the right ventricular lead in the apical position;
- Stable medical situation;
Key exclusion criteria (13 listed)
- Permanent or paroxysmal AV block ≥ II;
- Permanent Atrial fibrillation/Atrial flutter;
- Device Replacement;
- Patient with a poor echocardiographic window;
- Patient already implanted with the right ventricular lead not in the apical position;
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Ventricular Pace Suppression (Vps)Unnecessary ventricular pacing is avoided by promoting intrinsic conduction. In case of intrinsic conduction, the device switches from a DDD mode to an ADI mode. | Other | Ventricular Pace Suppression (VpS) |
| Intrinsic rhythm support (IRSplus)All parameters of the AV hysteresis functions are set in a way to maintain spontaneous AV conduction of the patient's heart as long as possible. | Other | Intrinsic Rhythm Support (IRSplus) |
Primary outcome
Ventricular pacing percentage
Time frame: 6 months
3 secondary outcomes
Long-term atrio-ventricular conduction delay
Time frame: 6 Months
Occurrence of atrial tachycardia or atrial fibrillation events
Time frame: 6 Months
Burden of atrial fibrillation
Time frame: 6 Months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Oct 2015.
- Background: PubMed 3711479Vassallo JA, Cassidy DM, Miller JM, Buxton AE, Marchlinski FE, Josephson ME. Left ventricular endocardial activation during right ventricular pacing: effect of underlying heart disease. J Am Coll Cardiol. 1986 Jun;7(6):1228-33. doi: 10.1016/s0735-1097(86)80140-1.
- Background: PubMed 11991375Prinzen FW, Peschar M. Relation between the pacing induced sequence of activation and left ventricular pump function in animals. Pacing Clin Electrophysiol. 2002 Apr;25(4 Pt 1):484-98. doi: 10.1046/j.1460-9592.2002.00484.x.
- Background: PubMed 2386214Prinzen FW, Augustijn CH, Arts T, Allessie MA, Reneman RS. Redistribution of myocardial fiber strain and blood flow by asynchronous activation. Am J Physiol. 1990 Aug;259(2 Pt 2):H300-8. doi: 10.1152/ajpheart.1990.259.2.H300.
- Background: PubMed 15583083Thambo JB, Bordachar P, Garrigue S, Lafitte S, Sanders P, Reuter S, Girardot R, Crepin D, Reant P, Roudaut R, Jais P, Haissaguerre M, Clementy J, Jimenez M. Detrimental ventricular remodeling in patients with congenital complete heart block and chronic right ventricular apical pacing. Circulation. 2004 Dec 21;110(25):3766-72. doi: 10.1161/01.CIR.0000150336.86033.8D. Epub 2004 Dec 6.
- Background: PubMed 15489094Kanzaki H, Bazaz R, Schwartzman D, Dohi K, Sade LE, Gorcsan J 3rd. A mechanism for immediate reduction in mitral regurgitation after cardiac resynchronization therapy: insights from mechanical activation strain mapping. J Am Coll Cardiol. 2004 Oct 19;44(8):1619-25. doi: 10.1016/j.jacc.2004.07.036.
- Background: PubMed 6707363Maurer G, Torres MA, Corday E, Haendchen RV, Meerbaum S. Two-dimensional echocardiographic contrast assessment of pacing-induced mitral regurgitation: relation to altered regional left ventricular function. J Am Coll Cardiol. 1984 Apr;3(4):986-91. doi: 10.1016/s0735-1097(84)80357-5.
- Background: PubMed 9358483Vanderheyden M, Goethals M, Anguera I, Nellens P, Andries E, Brugada J, Brugada P. Hemodynamic deterioration following radiofrequency ablation of the atrioventricular conduction system. Pacing Clin Electrophysiol. 1997 Oct;20(10 Pt 1):2422-8. doi: 10.1111/j.1540-8159.1997.tb06081.x.
- Background: PubMed 12932590Nielsen JC, Kristensen L, Andersen HR, Mortensen PT, Pedersen OL, Pedersen AK. A randomized comparison of atrial and dual-chamber pacing in 177 consecutive patients with sick sinus syndrome: echocardiographic and clinical outcome. J Am Coll Cardiol. 2003 Aug 20;42(4):614-23. doi: 10.1016/s0735-1097(03)00757-5.
- Background: PubMed 9529267Nielsen JC, Andersen HR, Thomsen PE, Thuesen L, Mortensen PT, Vesterlund T, Pedersen AK. Heart failure and echocardiographic changes during long-term follow-up of patients with sick sinus syndrome randomized to single-chamber atrial or ventricular pacing. Circulation. 1998 Mar 17;97(10):987-95. doi: 10.1161/01.cir.97.10.987.
- Background: PubMed 15519023Nahlawi M, Waligora M, Spies SM, Bonow RO, Kadish AH, Goldberger JJ. Left ventricular function during and after right ventricular pacing. J Am Coll Cardiol. 2004 Nov 2;44(9):1883-8. doi: 10.1016/j.jacc.2004.06.074.
- Background: PubMed 12782566Sweeney MO, Hellkamp AS, Ellenbogen KA, Greenspon AJ, Freedman RA, Lee KL, Lamas GA; MOde Selection Trial Investigators. Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction. Circulation. 2003 Jun 17;107(23):2932-7. doi: 10.1161/01.CIR.0000072769.17295.B1. Epub 2003 Jun 2.
- Derived from this study: PubMed 29759604Calvi V, Pisano EC, Brieda M, Melissano D, Castaldi B, Guastaferro C, Nigro G, Madalosso M, Orsida D, Rovai N, Gargaro A, Capucci A. Atrioventricular Interval Extension Is Highly Efficient in Preventing Unnecessary Right Ventricular Pacing in Sinus Node Disease: A Randomized Cross-Over Study Versus Dual- to Atrial Single-Chamber Mode Switch. JACC Clin Electrophysiol. 2017 May;3(5):482-490. doi: 10.1016/j.jacep.2016.11.011. Epub 2017 Feb 1.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Alessandro Capucci principal investigator
A.O.U. Ospedali Riuniti, Ancona
Valeria Calvi principal investigator
A.O.U. Policlinico-Vittorio Emanuele, Catania
Marco Brieda principal investigator
A.O. Santa Maria degli Angeli, Pordenone
20 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Ventricular Pace Suppression (Vps) and Intrinsic rhythm support (IRSplus) in people with Sick Sinus Syndrome, run by Biotronik SE & Co. KG at 20 sites in Italy.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 22 Oct 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 20 sites in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Ventricular pacing percentage (time frame: 6 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01528657, which also lists 12 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Oct 2015.