Comparing Physiological and Conventional Pacemaker Pacing to Prevent Heart Weakening in Adults with Atrioventricular Block

What this Trial Is About

This trial investigates two methods of pacemaker implantation for patients with atrioventricular block and slow heart rate bradycardia. The study compares conventional right ventricular pacing, which can sometimes reduce heart function causing pacemaker-induced cardiomyopathy PICM, with conduction system pacing that aims to preserve natural heart activation and potentially prevent PICM. The research follows patients clinically and with heart imaging for one year to evaluate outcomes. Participants will receive either a traditional pacemaker with the lead placed in the apex or septal area of the right ventricle, or pacing targeting the his bundle or left bundle branch to stimulate the hearts natural conduction system. The choice of electrode location and pacing method is randomized. Implantation parameters like sensing and pacing thresholds will be measured. Follow-up lasts one year after implantation. During the study, patients will undergo clinical exams, electrocardiograms, and echocardiograms to monitor heart function and pacing effects. Researchers will assess the incidence of pacemaker-induced heart disease over 12 months along with changes in heart volume, atrial fibrillation onset, heart failure hospitalizations, exercise capacity, quality of life, and safety events. The trial includes regular evaluations to compare the benefits and risks of both pacing techniques.

Physiological Pacing for AV Block to Prevent Pacemaker-induced Cardiomyopathy