Comparing three specialist pacemakers to improve heart pumping and reduce rhythm problems
Randomised Investigation of Physiological, Conventional and Optimised Resynchronisation Therapy in Heart Failure With Prolonged QRS Duration (RIPCORD-CRT)
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
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 60 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Imperial College London Academic / other |
| Locations | 1 site (London, Greater London) |
| Trial ID | NCT07430553 on ClinicalTrials.gov |
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.
Who should consider this trial
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.
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.
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 performed: 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.
Eligibility criteria
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 this trial is running
London, Greater London
- 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
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.