Comparing three specialist pacemakers to improve heart pumping and reduce rhythm problems
Official title: Randomised Investigation of Physiological, Conventional and Optimised Resynchronisation Therapy in Heart Failure With Prolonged QRS Duration (RIPCORD-CRT)
Run by Imperial College London · NCT07430553 · Data updated 2026-11-12
This study will test three types of specialist pacemakers in people with heart failure and reduced ejection fraction to see which best improves symptoms and heart rhythms over six months.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 60 (estimated) |
| Sponsor | Imperial College London Academic / other |
| Locations | 1 site (London, Greater London) |
| Status | Recruiting |
| Started | November 12, 2025 |
| Main results expected | October 24, 2028 |
| Study ends | October 24, 2028 |
| Registry record updated | February 24, 2026 |
| Trial ID | NCT07430553 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Ideal candidates are adults with symptomatic heart failure (NYHA II–IV), reduced LVEF ≤40%, prolonged QRS with left bundle branch block or very prolonged QRS, who are referred for a CRT implant or upgrade and are on optimal medical therapy.
✕Probably not a fit
Patients without electrical dyssynchrony or with LVEF above 40%, as well as those who cannot consent, are pregnant, under 18, or unable to attend the required hospital visits, are unlikely to benefit from or be eligible for this study.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
The trial enrolls patients referred for cardiac resynchronisation therapy who have symptomatic heart failure, reduced LVEF, and electrical dyssynchrony. Participants will receive a CRT device implanted using one of three pacing methods—biventricular pacing (BVP), conduction system pacing (CSP), or left-bundle optimised CRT (LOT-CRT)—and attend four hospital visits over six months. Symptoms will be recorded daily via a smartphone app and investigators will collect clinical, electrical, and imaging measures to compare effects on heart function and rhythm events. Outcomes at six months will be compared across the three pacing strategies to determine differences in symptom relief, arrhythmia rates, and cardiac performance.
Why it matters
Potential benefit: If successful, the results could help clinicians choose the pacing method that most improves heart function, reduces rhythm problems, and eases symptoms for people with heart failure.
How similar studies have gone: Conventional biventricular CRT is an established therapy, while conduction system pacing and LOT-CRT are newer approaches with encouraging early results but limited large-scale outcome data.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: Patients referred/scheduled for a CRT procedure (new implant or upgrade) who have: * Symptomatic heart failure (NYHA II-IV) * Reduced ejection fraction (LVEF≤40%) * Prolonged QRS duration (≥130ms) and left bundle branch block ECG morphology or very prolonged QRS duration (\>150ms) and non-left bundle branch block ECG * Optimal medical therapy for HF Exclusion Criteria: * Unable to provide informed consent * \<18 years old * Pregnant patients (with female patients of childbearing age requiring a negative urine BHCG)
Where it's running
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Hammersmith Hospital, Imperial College Healthcare NHS Trust
London, Greater London, United Kingdom Recruiting
Study contacts
- Principal investigator: Zachary I Whinnett, MBBS, BMedSci, MRCP, PhD — Imperial College London
- Study coordinator: Jack W Samways, MBChB, MRes, MRCP
- Email: jsamways@ic.ac.uk
- Phone: +4420 331 33000
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.