Actively Recruiting
Randomised Investigation of Physiological, Conventional and Optimised Resynchronisation Therapy in Heart Failure With Prolonged QRS Duration (RIPCORD-CRT)
Led by Imperial College London · Updated on 2026-02-24
60
Participants Needed
1
Research Sites
N/A
Total Duration
On this page
Sponsors
I
Imperial College London
Lead Sponsor
I
Imperial College Healthcare NHS Trust
Collaborating Sponsor
AI-Summary
What this Trial Is About
Researchers are investigating which type of specialist pacemaker, known as cardiac resynchronisation therapy (CRT), works best for people with heart failure and electrical dyssynchrony, a delay in how the lower chambers of the heart beat together. The study compares three different pacing methods: conventional biventricular pacing (BVP), conduction system pacing (CSP), and left-bundle optimised CRT (LOT-CRT). The goal is to assess their effects on heart failure symptoms, heart rhythm problems, heart muscle strength, electrical activity, and overall heart function over six months. Participants will be randomly assigned to receive one of three types of CRT pacemakers during implantation: BVP, which is the current standard treatment involving leads placed in the right ventricular endocardium and left ventricular epicardium; CSP, which targets direct capture of the heart's conduction system with a single lead; or LOT-CRT, a hybrid approach combining conduction system pacing with a left ventricular epicardial lead. The study includes four hospital visits: screening, device implantation, and two follow-ups at 12 weeks and six months post-implantation. At two visits, participants undergo non-invasive electrical mapping and low-dose chest CT scans to evaluate how the heart responds electrically to the different pacing methods. During the trial, participants will use a smartphone app to record daily heart failure symptoms. Researchers will assess symptoms using a daily ordinal symptom score, monitor arrhythmias, and measure heart contractility from randomisation through six months after device implantation. They will also track outcomes such as hospitalisations, death rates, device therapy, heart function via echocardiograms, quality of life questionnaires, and physical activity levels. Safety monitoring continues up to 36 months post-implant. Total participation spans at least six months with extended follow-up for some outcomes.
CONDITIONS
Brief Title
Comparing Three Types of Specialist Pacemakers to Improve Heart Function and Reduce Rhythm Problems in Heart Failure
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Patients referred or scheduled for a cardiac resynchronisation therapy procedure (new implant or upgrade)
- Diagnosed with symptomatic heart failure classified as NYHA II to IV
- Left ventricular ejection fraction of 40% or less
- Prolonged QRS duration of 130 milliseconds or more with left bundle branch block ECG morphology, or very prolonged QRS duration over 150 milliseconds with non-left bundle branch block ECG
- Receiving optimal medical therapy for heart failure
You will not qualify if you...
- Unable to provide informed consent
- Under 18 years old
- Pregnant patients; female patients of childbearing age must have a negative urine BHCG test
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Your Study Journey
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Single-day procedure
Participants receive one of three types of specialist pacemakers implanted to improve heart function and reduce rhythm problems.
1 visit (in-person) for device implantation
Duration - 6 months post device implant
Participants are treated with the implanted cardiac resynchronisation therapy device and monitored for heart function and symptoms.
Regular follow-up visits during treatment period
Duration - Up to 36 months post device implant
Participants are monitored for long-term outcomes including symptom scores, hospitalizations, and device-related adverse events up to 36 months post implant.
Periodic visits for assessments and monitoring
Trial Site Locations
Total: 1 location
1
Hammersmith Hospital, Imperial College Healthcare NHS Trust
London, Greater London, United Kingdom, W12 0HS
Actively Recruiting
Research Team
J
Jack W Samways, MBChB, MRes, MRCP
How is the study designed?
Study Type
INTERVENTIONAL
Masking
DOUBLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
3
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