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Atrioventricular Block, Second and Third DegreePACE-4-TAVINCT05966675

Physiologic Cardiac Pacing to Prevent Left Ventricular Dysfunction Post TAVI

A study testing conduction system pacing and right ventricular or biventricular pacing in people with Atrioventricular Block, Second and Third Degree, run by Medical University of Silesia at 1 site in Poland.

Recruiting

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

Sites and contacts
Official record
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Trial summary

The study aims to compare permanent Conduction System Pacing (CSP) with the standard therapy - Right Ventricular Pacing (RVP) or Biventricular Pacing (BVP) - in preventing the development and progression of symptomatic Chronic Heart Failure (CHF) and improving survival in patients after Transcatheter Aortic Valve… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
conduction system pacing and right ventricular or biventricular pacing
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
500 participants
Where
1 sitePoland
Study dates
27 Feb 2024to Jun 2028
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

  • transcatheter aortic valve implantation (TAVI) in up to 30 days before qualification to pacemaker implantation
  • Fulfilled criteria for permanent pacemaker implantation according do 2021 ESC guidelines
  • Written informed consent
  • Age of at least 18 years

Who cannot join

  • Permanent pacemaker implantation before TAVI procedure
  • The occurrence of conduction disturbances more than 30 days after TAVI procedure
  • No written informed consent
  • Inability to obtain informed consent from participant
  • Predicted inability to obtain cooperation from patient during observation period

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Krzysztof S. Gołba, MD PhD contact

+48 (32)359-88-93

krzysztof.golba@gmail.com

Tomasz Soral, MD contact

tomasz.soral@gmail.com

Poland1 site, 1 recruiting
  • Medical University of Silesia in Katowice

    Katowice

    Krzysztof S. Gołba, MD PhD, k.golba@sum.edu.pl

    Tomasz Soral, MD, tomasz.soral@gmail.com

    Recruiting

Other trials in Poland

About this study

Official title: Physiologic Cardiac Pacing to Prevent Left Ventricular Dysfunction Post Transcatheter Aortic Valve Implantation

The study aims to compare permanent Conduction System Pacing (CSP) with the standard therapy - Right Ventricular Pacing (RVP) or Biventricular Pacing (BVP) - in preventing the development and progression of symptomatic Chronic Heart Failure (CHF) and improving survival in patients after Transcatheter Aortic Valve Implantation (TAVI).

Read the detailed description

A multicenter randomized controlled head-to-head trial was planned to compare the effects of permanent pacemaker implantation (PPMI) using CSP (study intervention) with currently standard therapy - RVP or BVP (control group). The study population will consist of patients hospitalized after TAVI complicated with high-degree persistent atrioventricular (AV) block or newly developed complex AV or intraventricular conduction disturbances, qualified for PPMI within 30 days after surgery, following the 2021 European Society of Cardiology (ESC) guidelines on cardiac pacing and cardiac resynchronization therapy.

Being tested
conduction system pacing, right ventricular or biventricular pacing
Keywords
Pacemaker, Transcatheter Aortic Valve Replacement, Conduction System Pacing (CSP), Atrioventricular Block, Congestive Heart Failure, Bradycardia
Medical subject headings
Atrioventricular Block, Neoplasm Metastasis, Heart Failure, Bradycardia

What participants receive

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

  • conduction system pacingDevice

    Implantation of cardiac implantable electronic device (CIED) with conduction system pacing (left bundle branch area pacing or his bundle pacing).

  • right ventricular or biventricular pacingDevice

    Implantation of cardiac implantable electronic device with right ventricular or biventricular pacing according to left ventricular ejection fraction and current ESC guidelines.

Study groups in NCT05966675
Study groupRoleWhat they receive
Conduction System PacingExperimentalPatients who receive Conduction System Pacing in form of Left Bundle Branch Area Pacing or His Bundle Pacing.
Receives: Device: conduction system pacing
Standard Pacing MethodActive comparatorPatients who receive currently standard pacing method with exact type of ventricular pacing depending upon left ventricular ejection fraction (LVEF): right ventricular pacing in case of LVEF >= 40% or biventricular pacing if LVEF is determined to be less than 40%, as per current ESC guidelines.
Receives: Device: right ventricular or biventricular pacing

What is being measured

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

  1. Heart Failure Hospitalization

    Hospitalization due to heart failure as a main reason

    Measured: 12 months

  2. All-cause death

    Death from any cause

    Measured: 12 months

Secondary outcomes (8)
  1. Change in exercise capacity

    Improvement or deterioration in exercise capacity assessed as a change of ≥1 New York Heart Association (NYHA) functional class or a change in 6-Minute Walk Test (6MWT) distance by 55m or more

    Measured: 24 months

  2. Response to Cardiac Resynchronization Therapy (CRT)

    Meeting the echocardiographic criteria of response to CRT defined as a decrease in Left Ventricular End Systolic Volume by ≥15% or an increase in Left Ventricular Ejection Fraction by ≥5% from the baseline values

    Measured: 24 months

  3. Pacing-Induced Cardiomyopathy (PICM)

    Pacing-related CHF meeting the echocardiographic criteria of PICM defined as a decrease in LVEF by >=10% to the absolute value of <50%

    Measured: 24 months

  4. Change in global longitudinal strain (GLS)

    An increase in GLS value of 20 absolute percentage points from baseline or an increase above -16%.

    Measured: 24 months

  5. Atrial Fibrillation (AF) episodes

    Occurrence of the first episode of AF in a patient with no previous history of atrial fibrillation (AF).

    Measured: 24 months

  6. Atrial High Rate Episodes (AHRE) in pacemaker recordings

    Occurrence or change of the burden of AHRE events in the records from the CIED.

    Measured: 24 months

  7. Change in the concentration of the N-terminal pro-brain natriuretic peptide (NT-proBNP)

    pl/mL

    Measured: 24 months

  8. Change in Quality of Life

    Assessed with Short Form Health Survey (SF-36): 0 to 100; low QoL to high QoL - better outcome.

    Measured: 24 months

Timeline

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

  1. First posted1 Aug 2023
  2. Study start27 Feb 2024
  3. Primary completionMay 2028 (estimated)
  4. Study completionJun 2028 (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
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
Patients will be randomized 1:1 to the intervention and control groups. In the control group, the type of ventricular pacing will depend on the left ventricular ejection fraction (LVEF): 1) RVP is planned in the group of patients with LVEF ≥40%, 2) BVP is planned in the group of patients with LVEF \<40%, following current ESC guidelines.
Masking
Single blind
Who is masked
Participant
Enrolment
500 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05966675
Sponsor's protocol ID
2022/ABM/03/00049
Acronym
PACE-4-TAVI
Status last verified
Jun 2025
First submitted
20 Jul 2023
Last updated
8 Jun 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auricchio A, Barbash IM, Barrabes JA, Boriani G, Braunschweig F, Brignole M, Burri H, Coats AJS, Deharo JC, Delgado V, Diller GP, Israel CW, Keren A, Knops RE, Kotecha D, Leclercq C, Merkely B, Starck C, Thylen I, Tolosana JM; ESC Scientific Document Group. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J. 2021 Sep 14;42(35):3427-3520. doi: 10.1093/eurheartj/ehab364. No abstract available.

    PubMed 34455430
  • Shimony A, Eisenberg MJ, Filion KB, Amit G. Beneficial effects of right ventricular non-apical vs. apical pacing: a systematic review and meta-analysis of randomized-controlled trials. Europace. 2012 Jan;14(1):81-91. doi: 10.1093/europace/eur240. Epub 2011 Jul 27.

    PubMed 21798880
  • Daubert JC, Ritter P, Le Breton H, Gras D, Leclercq C, Lazarus A, Mugica J, Mabo P, Cazeau S. Permanent left ventricular pacing with transvenous leads inserted into the coronary veins. Pacing Clin Electrophysiol. 1998 Jan;21(1 Pt 2):239-45. doi: 10.1111/j.1540-8159.1998.tb01096.x.

    PubMed 9474680
  • Dandamudi G, Vijayaraman P. How to perform permanent His bundle pacing in routine clinical practice. Heart Rhythm. 2016 Jun;13(6):1362-6. doi: 10.1016/j.hrthm.2016.03.040. Epub 2016 Mar 22. No abstract available.

    PubMed 27016475
  • Huang W, Chen X, Su L, Wu S, Xia X, Vijayaraman P. A beginner's guide to permanent left bundle branch pacing. Heart Rhythm. 2019 Dec;16(12):1791-1796. doi: 10.1016/j.hrthm.2019.06.016. Epub 2019 Jun 22. No abstract available.

    PubMed 31233818
  • Jastrzebski M, Moskal P, Bednarek A, Kielbasa G, Vijayaraman P, Czarnecka D. Programmed His Bundle Pacing: A Novel Maneuver for the Diagnosis of His Bundle Capture. Circ Arrhythm Electrophysiol. 2019 Feb;12(2):e007052. doi: 10.1161/CIRCEP.118.007052.

    PubMed 30707037
  • Jastrzebski M, Moskal P, Bednarek A, Kielbasa G, Kusiak A, Sondej T, Bednarski A, Vijayaraman P, Czarnecka D. Programmed deep septal stimulation: A novel maneuver for the diagnosis of left bundle branch capture during permanent pacing. J Cardiovasc Electrophysiol. 2020 Feb;31(2):485-493. doi: 10.1111/jce.14352. Epub 2020 Jan 20.

    PubMed 31930753
  • Nazif TM, Dizon JM, Hahn RT, Xu K, Babaliaros V, Douglas PS, El-Chami MF, Herrmann HC, Mack M, Makkar RR, Miller DC, Pichard A, Tuzcu EM, Szeto WY, Webb JG, Moses JW, Smith CR, Williams MR, Leon MB, Kodali SK; PARTNER Publications Office. Predictors and clinical outcomes of permanent pacemaker implantation after transcatheter aortic valve replacement: the PARTNER (Placement of AoRtic TraNscathetER Valves) trial and registry. JACC Cardiovasc Interv. 2015 Jan;8(1 Pt A):60-9. doi: 10.1016/j.jcin.2014.07.022.

    PubMed 25616819
  • Xi Z, Liu T, Liang J, Zhou YJ, Liu W. Impact of postprocedural permanent pacemaker implantation on clinical outcomes after transcatheter aortic valve replacement: a systematic review and meta-analysis. J Thorac Dis. 2019 Dec;11(12):5130-5139. doi: 10.21037/jtd.2019.12.02.

    PubMed 32030230
  • Xu S, Zhang E, Qian Z, Sun J, Zou F, Wang Y, Hou X, Zou J. Mid- to Long-Term Clinical and Echocardiographic Effects of Post-procedural Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis. Front Cardiovasc Med. 2022 Jun 28;9:911234. doi: 10.3389/fcvm.2022.911234. eCollection 2022.

    PubMed 35837611
  • Fadahunsi OO, Olowoyeye A, Ukaigwe A, Li Z, Vora AN, Vemulapalli S, Elgin E, Donato A. Incidence, Predictors, and Outcomes of Permanent Pacemaker Implantation Following Transcatheter Aortic Valve Replacement: Analysis From the U.S. Society of Thoracic Surgeons/American College of Cardiology TVT Registry. JACC Cardiovasc Interv. 2016 Nov 14;9(21):2189-2199. doi: 10.1016/j.jcin.2016.07.026.

    PubMed 27832844

Questions about this trial

What is this clinical trial studying?

A study testing conduction system pacing and right ventricular or biventricular pacing in people with Atrioventricular Block, Second and Third Degree, run by Medical University of Silesia at 1 site in Poland.

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 4 inclusion and 5 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 8 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Poland. 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 Krzysztof S. Gołba, MD PhD (+48 (32)359-88-93, krzysztof.golba@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Heart Failure Hospitalization (time frame: 12 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?

On the ClinicalTrials.gov record for NCT05966675, which also lists 11 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 8 Jun 2025.

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