AzTrials
AzTrials

BradycardiaPROTECT-HFNCT05815745

"Physiological vs Right Ventricular Pacing Outcome Trial Evaluated for bradyCardia Treatment" (PROTECT-HF)

A study testing Pacemaker - Physiological pacing and Pacemaker - Right Ventricular pacing in people with Bradycardia and Pacing, run by Imperial College London at 45 sites in 3 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

The PROTECT-HF multi-centre randomised controlled trial will compare two different pacing approaches for treating patients with slow heart rates. In it the investigators will compare a long-standing standard approach for pacing; right ventricular pacing, with a new form of pacing, physiological pacing (His and Left… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Bradycardia, Pacing, Right Ventricular Pacing
What is being tested?
Pacemaker - Physiological pacing and Pacemaker - Right Ventricular pacing
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,600 participants
Where
45 sitesin 3 countries
Study dates
5 Jun 2023to 4 Jun 2031
Phase
Interventional
Are there results?
Not yet: the study is under way

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

  • 1. Adults aged over 18 with left ventricular ejection fraction >35% and one or more of the following guideline based ventricular pacing indications:
  • Permanent or intermittent 3rd degree AV block
  • Permanent or intermittent Mobitz type II AV block
  • First Degree AV block with a pacing indication
  • Slow chronic Atrial Fibrillation or Proposed AV node ablation
  • Bifascicular block with a pacing indication
  • Trifascicular block with a pacing indication
  • Wenckebach with a pacing indication

Who cannot join

  • Patients who are likely to only need occasional ventricular pacing, i.e. those with isolated sick sinus syndrome.
  • Pregnant women.
  • Unable to provide informed consent.
  • Those with comorbidity leading to a life expectancy <1year.

Trial locations and contacts

45 sites in 3 countries. Contact the study team or a site near you to ask about taking part.

45 sites in 3 countries

United Kingdom43 sites, 43 recruiting
  • Aberdeen Royal Infirmary

    Aberdeen

    Valerie Harris, valerie.harries@nhs.scot

    Dr Santhosh Raga

    Recruiting
  • Queen's Hospital

    Barking

    Katrina Frayna, katrina.frayna@nhs.net

    Dr Afzal Sohaib

    Recruiting
  • Good Hope Hospital

    Birmingham

    Daniel Lenton, daniel.lenton2@uhb.nhs.uk

    Dr Hossam Elsayed

    Recruiting
  • Queen Elizabeth Hospital

    Birmingham

    Sophia Duong, Sophia.DuongVu@uhb.nhs.uk

    Prof Francisco Levya

    Recruiting
  • University Hospital Dorset

    Bournemouth

    Tanith Changuion, Tanith.Changuion@uhd.nhs.uk

    Dr Girish Ganesha Babu

    Recruiting
  • Royal SUSSEX County Hospital

    Brighton

    Fiona Ingoldby, fiona.ingoldby@nhs.net

    Dr Susan Ellery

    Recruiting
  • Bristol Heart Institute

    Bristol

    Sheila Bell, sheila.bell@uhbw.nhs.uk

    Jessica Strange, jessica.strange@uhbw.nhs.uk

    Recruiting
  • Royal Papworth Hospital

    Cambridge

    Joanna Oliveira, j.oliveira@nhs.net

    Dr Sharad Agarwal

    Recruiting
  • St Richard's Hospital

    Chichester

    Katherine Nicholas, katherine.nicholas@nhs.net

    Dr Mark Tanner

    Recruiting
  • University Hospital Coventry

    Coventry

    Nigel Edwards, Nigel.Edwards@uhcw.nhs.uk

    Dr Michael Kuehl

    Recruiting
  • Croydon

    Croydon

    Jacqueline Adabie-Ankrah, jacquelineadabie-ankrah@nhs.net

    Dr Ravi Kamdar

    Recruiting
  • Royal Infirmary of Edinburgh

    Edinburgh

    Marie Callaghan, Marie.Callaghan@nhslothian.scot.nhs.uk

    Claire Hart, claire.hart@nhs.scot

    Recruiting
  • Victoria Hospital

    Fife Keith

    Sandra Pirie, sandra.pirie@nhs.scot

    Dr Jagdeep Singh

    Recruiting
  • Medway Maritime Hospital

    Gillingham

    Suzanne Williams, suzanne.williams49@nhs.net

    Dr Shaumik Adhya

    Recruiting
  • Wycombe Hospital

    High Wycombe

    Josephine Chaplin, josephine.chaplin@nhs.net

    Dr Norman Qureshi

    Recruiting
  • Forth Valley Royal Hospital

    Larbert

    Elaine Wilson, elaine.wilson13@nhs.scot

    Dr Gareth Padfield

    Recruiting
  • Leeds Teaching Hospital

    Leeds

    Marie Callaghan, marie.callaghan@nhslothian.scot.nhs.uk

    Dr Muzahir Tayebjee

    Recruiting
  • Glenfield Hospital

    Leicester

    Elizabeth Cox, elizabeth.a.cox@uhl-tr.nhs.uk

    Dr Mokhtar Ibrahim

    Recruiting
  • Liverpool Heart and Chest Hospital

    Liverpool

    Sharon Glynn, sharon.glynn@lhch.nhs.uk

    Dr Archana Rao

    Recruiting
  • Hammersmith Hospital

    London

    Nandita Kaza, n.kaza@imperial.ac.uk

    Recruiting
  • Kettering Hospital

    London

    Eva Kisakye, e.kisakye@nhs.net

    Dr Rachana Prasad

    Recruiting
  • King's College Hospital

    London

    Abigail Knighton, abigail.knighton@nhs.net

    Dr Paul Scott

    Recruiting
  • Royal Free London/ Barnet Hospital

    London

    Susana Ramos Vasquez

    susana.ramosvazquez@nhs.net

    Recruiting
  • St Bartholomew's Hospital

    London

    Ben Romano, ben.romano@nhs.net

    Dr Phil Moore

    Recruiting
  • Watford General Hospital

    London

    Mary James, mary.james8@nhs.net

    Dr Louisa Malcome Lawes

    Recruiting
  • James Cook Hospital

    Middlesbrough

    Beverly Atkinson, bevatkinson@nhs.net

    Dr Mike Chapman

    Recruiting
  • King's Mill Hospital

    Nottingham

    Rebecca Rudd, rebecca.rudd4@nhs.net

    Dr Sukh Bassi

    Recruiting
  • Nottingham City Hospital

    Nottingham

    Edelline Makondo, Edelline.Makondo@nuh.nhs.uk

    Dr Phil Moore

    Recruiting
  • John Radcliffe Hospital

    Oxford

    Katharine New, KATHARINE.NEW@OUH.NHS.UK

    Dr Julian Ormerod

    Recruiting
  • Derriford Hospital

    Plymouth

    Lorraine Madziva, lorraine.madziva1@nhs.net

    Dr Edward Davies

    Recruiting
  • Queen Alexandra Hospital

    Portsmouth

    Pedro Bragasardo, pedro.bragasardo@porthosp.nhs.uk

    Dr Senthil Kirubakaran

    Recruiting
  • Royal Berkshire

    Reading

    Mark Brunton, Mark.brunton@royalberkshire.nhs.uk

    Dr Jon Swinburn

    Recruiting
  • East Surrey

    Redhill

    Julie Houghton, julie.houghton15@nhs.net

    Dr Cheuk Chan

    Recruiting
  • Rotherham General Hospital

    Rotherham

    Rachel Walker, rachel.walker7@nhs.net

    Dr Simon Smith

    Recruiting
  • Northern General

    Sheffield

    Olivia Holmes, olivia.holmes3@nhs.net

    Dr Nigel Lewis

    Recruiting
  • Wexham Park Hospital

    Slough

    Victoria Ugochukwu, victoria.ugochukwu@nhs.net

    Dr Sofia Metaxa

    Recruiting
  • Southampton

    Southampton

    Lisa Fletcher, Lisa.Fletcher@uhs.nhs.uk

    Dr John Paisley

    Recruiting
  • Morriston Hospital

    Swansea

    Debbie Williams, Debbie.Williams8@wales.nhs.uk

    Dr Dewi Thomas

    Recruiting
  • Great Western

    Swindon

    Suzannah Pegler, suzannah.pegler1@nhs.net

    Dr Badri Chandrasekaran

    Recruiting
  • Musgrove Park Hospital

    Taunton

    Helen Mills, helen.mills@somersetft.nhs.uk

    Dr Guy Furniss

    Recruiting
  • Torbay Hospital

    Torquay

    Lisa Felmelden, lisa.felmeden@nhs.net

    Dr Lisa Yung

    Recruiting
  • UHS Worthing

    Worthing

    Samantha Margerison, samantha.margerison@nhs.net

    Dr Marian Bencat

    Recruiting
  • York Hospital

    York

    Julie Anderson, julie.anderson3@nhs.net

    Dr Chris Hayes

    Recruiting

Other trials in United Kingdom

Ireland1 site, 1 recruiting
  • Beacon Hospital

    Dublin

    Dr Cian Mangan, Cian.Mangan@beaconhospital.ie

    Prof Jonathan Lyne

    Recruiting

Other trials in Ireland

Slovenia1 site, 1 recruiting
  • Univerisity Medical Centre Ljubljana

    Ljubljana

    Dr David Zizek, david.zizek@kclj.si

    Dr David Zizek

    Recruiting

Other trials in Slovenia

About this study

Official title: Physiological vs Right Ventricular Pacing Outcome Trial Evaluated for bradyCardia Treatment

The PROTECT-HF multi-centre randomised controlled trial will compare two different pacing approaches for treating patients with slow heart rates. In it the investigators will compare a long-standing standard approach for pacing; right ventricular pacing, with a new form of pacing, physiological pacing (His and Left bundle area pacing) in 2600 patients.

Patients will be allocated at random to receive either right ventricular pacing or physiological pacing. Endpoint measurements will be undertaken at baseline, and at six-monthly intervals post-randomisation. Treatment allocation will be blinded to the endpoint assessor and the patient.

Read more

Recruitment and pacemaker implantation will be carried out at each participating centre. The primary analysis will be intention to treat. The investigators will also perform an on-treatment analysis.

2048 patients are needed to detect the expected effect size with 85% power. A total of 2600 patients will be recruited to allow for patient drop-out and crossover.

500-patient sub-study will assess within patient, and between groups, echocardiographic changes over a 24-month period to try and improve mechanistic understanding of PICM (Pacing Induced Cardiomyopathy).

Read the detailed description

Patients entering the study will attend for implantation of a pacemaker device and be randomised to either right ventricular pacing or physiological pacing.

Patients at sites participating in echo sub-study will be informed of and given opportunity to consent to echo sub-study, this will be optional to them, even if they have consented to the main study.

Being tested
Pacemaker - Physiological pacing, Pacemaker - Right Ventricular pacing
Medical subject headings
Bradycardia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Pacemaker - Physiological pacingDevice

    The approach for physiological pacing will be either His bundle pacing or left bundle pacing at the operator's discretion. If both of these are not achieved biventricular pacing will be performed.

  • Pacemaker - Right Ventricular pacingDevice

    Right ventricular pacing (apical or septal lead locations as per the implanting physicians' normal practice).

Study groups in NCT05815745
Study groupRoleWhat they receive
Right ventricular pacingActive comparatorRight ventricular pacing (apical or septal lead locations as per the implanting physicians' normal practice)
Receives: Device: Pacemaker - Right Ventricular pacing
Physiological pacingExperimentalThe approach for physiological pacing will be either His bundle pacing or left bundle pacing at the operator's discretion. If both of these are not achieved biventricular pacing will be performed.
Receives: Device: Pacemaker - Physiological pacing

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mortality

    Death, any cause

    Measured: From date of consent, until date of death from any cause, assessed up until 78 months.

  2. Heart Failure Morbidity

    Adjudicated unplanned heart failure acute care (hospital admissions or ambulatory diuretic therapy i.e. diuretic lounge visit).

    Measured: From date of consent, assessed up until 78 months, or death from any cause, whichever came first.

Secondary outcomes (10)
  1. Incidence of clinically indicated upgrade to conventional biventricular pacing (CRT device)

    Measured: From date of randomisation until the date of first documented incident of device upgrade, or death from any cause, whichever came first, assessed up to 78 months.

  2. Patient quality of life assessed via questionnaires (EQ-5D-5L) EQ-5D is the name of the instrument and is not an acronym.

    The EQ-5D-5L consists of 2 pages: the EQ-5D descriptive system and the EQ 'visual analogue scale' (EQ VAS).

    The descriptive system is made up of 5 sections: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems.

    A High score on the descriptive section means a worse health outcome. A Low score on the descriptive section means a better health outcome. A value set is required to convert the outcomes into scores.

    The EQ VAS records the patient's self-rated health on a vertical visual analogue scale, where the endpoints are labelled 'The best health you can imagine' and 'The worst health you can imagine'. The VAS can be used as a quantitative (numerical) measure of health outcome that reflect the patient's own judgement.

    A high score on the VAS means a better outcome. A low score on the VAS means a worse outcome.

    Measured: From date of consent, assessed up to 78 months or until death of any cause, whichever came first.

  3. Patient symptoms assessed on a scale of 0-100 monthly

    This questionnaire will be sent to participants on a monthly basis for the duration of the study, 78 months from one month post pacemaker implant until end of study (78 months) or death from any cause, whichever came first.

    Measured: From one month after device implant date, assessed up to 78 months or until death of any cause, whichever came first.

  4. Safety endpoints: Device infections (requiring device extraction), pacing thresholds, need for lead revision or reimplantation, generator change, haematoma and pneumothorax

    Measured: From device implant date, assessed up to 78 months or until death of any cause, whichever came first.

  5. Pacemaker derived endpoints: a) Atrial fibrillation (duration >6minutes) b) Ventricular arrhythmia incidence c) Daily patient activity (hours stratified by device vendor)

    Measured: From device implant date, assessed up to 78 months or until death of any cause, whichever came first.

  6. Patient quality of life assessed via questionnaires '36-Item Short Form Health Survey' (SF-36)

    A high score defines a more favourable health state. Range 0 to 100.

    Measured: From date of consent, assessed up to 78 months or until death of any cause, whichever came first.

  7. Echo Sub-Study Endpoint: Left Ventricular End Systolic Volume (LVESV) (>10mls) within group differences

    Within group differences of Left Ventricular End Systolic Volume (>10mls) for differences according to treatment allocation.

    Measured: From baseline echocardiogram (0 to 6 weeks post pacemaker implant) to follow-up echocardiogram (24±1 months post pacemaker implant).

  8. Echo Sub-Study Endpoint: Ejection Fraction (EF) within patient changes

    Within patient changes in Ejection Fraction will be assessed for differences according to treatment allocation.

    Measured: From baseline echocardiogram (0 to 6 weeks post pacemaker implant) to follow-up echocardiogram (24±1 months post pacemaker implant).

  9. Echo Sub-Study Endpoint: Left Ventricular End Systolic Volume (LVESV) (>10mls) within patient changes

    Within patient changes of Left Ventricular End Systolic Volume (>10mls) for differences according to treatment allocation

    Measured: From baseline echocardiogram (0 to 6 weeks post pacemaker implant) to follow-up echocardiogram (24±1 months post pacemaker implant).

  10. Echo Sub-Study Endpoint: Ejection Fraction (EF) within group differences

    Within group differences in Ejection Fraction will be assessed for differences according to treatment allocation.

    Measured: From baseline echocardiogram (0 to 6 weeks post pacemaker implant) to follow-up echocardiogram (24±1 months post pacemaker implant).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Apr 2023
  2. Study start5 Jun 2023
  3. Primary completion4 Jun 2031 (estimated)
  4. Study completion4 Jun 2031 (estimated)

Resources

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
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
2,600 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05815745
Sponsor's protocol ID
22HH7931
Acronym
PROTECT-HF
Status last verified
Jul 2026
First submitted
13 Feb 2023
Last updated
22 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Pacemaker - Physiological pacing and Pacemaker - Right Ventricular pacing in people with Bradycardia and Pacing, run by Imperial College London at 45 sites in 3 countries.

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 8 inclusion and 4 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: looking for participants now, as of the sponsor's last update on 22 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 45 sites in United Kingdom, Ireland, Slovenia. 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?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Zachary Whinnett (+447749576830, z.whinnett@imperial.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mortality (time frame: From date of consent, until date of death from any cause, assessed up until 78 months.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 Jul 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in