The main objective is to investigate mechanical alternans and MTWA in patients with heart failure caused by coronary artery disease to demonstrate a possible correlation between these two phenomena.
ID
Source
Brief title
Condition
- Heart failures
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Presence or absence of mechanical alternans and MTWA.
Secondary outcome
Differences in reduced or more preserved LVEF and the occurrence of the two
phenomena
Occurrence of ventricular tachyarrhythmic events
Influence of LV compliance on arrhythmogenesis of the infarction border zone.
Background summary
In patients with severe heart failure and aortic valve disease mechanical
alternans or pulsus alternans (a condition in which there is a beat-to-beat
oscillation in the strength of cardiac muscle at a constant heart rate) is
observed. The mechanisms linking mechanical to electrophysiological dysfunction
in heart failure are still under investigation, but impaired calcium cycling is
the most striking abnormality of failing myocytes, and is most responsible for
contractile dysfunction. Yet it remains unclear how this influences
susceptibility to arrhythmias. The MTWA is suggested as a risk marker to
identify high risk patients for potential VTEs but the underlying mechanism is
not completely understood. The aim of this study is to investigate this in a
clinical setting by measuring LV parameters using a PV loop conductance
catheter and generate TWA recording simultaneously to demonstrate a possible
correlation between these two phenomena in patients with ischemic heart failure
and find out if MTWA could turn into a more valuable risk stratifier. Our
hypothesis is that alternating changes in LV filling explain the
electrocardiogenesis of TWA by changing the position of the heart relative to
the body surface electrodes in an alternating way.
Study objective
The main objective is to investigate mechanical alternans and MTWA in patients
with heart failure caused by coronary artery disease to demonstrate a possible
correlation between these two phenomena.
Study design
Observational study
Study burden and risks
Positioning the condunctance catheter requires 30 seconds - 1 minute extra
fluoroscopy time. According to the advice of the radiation commitee, this
causes minor risk. The high resolution electrodes could cause skin reactions
such as irritation and itching. The standard procedure will be extended by 30
minutes maximally.
Meibergdreef 9
1105 AZ Amsterdam
NL
Meibergdreef 9
1105 AZ Amsterdam
NL
Listed location countries
Age
Inclusion criteria
Patients will be included if they are over 18 years and under 85 years and able to give informed consent. Patients with heart failure caused by coronary artery disease. LVEF * 35% measured by echocardiogram. Patients with an indication for electrophysiological examination.
Exclusion criteria
hemodynamically instable patients
age under 18 and over 85 years
heart failure not caused by coronary artery disease
severe co-morbidity
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL33244.018.10 |