Antonio Berruezo1,2,3, Markus Linhart4,5, Angelo Auricchio6, José Luis Zamorano7,8, Pilar Santamaria9, Roger Borràs4,5, Felip Burgos5,10, Josep Brugada4,5. 1. Institut Clínic de Malalties Cardiovasculars, Hospital Clinic, Universitat de Barcelona, calle Vilaroel 170, 08036, Barcelona, Catalonia, Spain. berruezo@clinic.ub.es. 2. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, calle Rosselò, 149-153, 08036, Barcelona, Spain. berruezo@clinic.ub.es. 3. CIBERCV, Instituto de Salud Carlos III, Ctra. Colmenar Viejo, km. 9,100, 28034, Madrid, Spain. berruezo@clinic.ub.es. 4. Institut Clínic de Malalties Cardiovasculars, Hospital Clinic, Universitat de Barcelona, calle Vilaroel 170, 08036, Barcelona, Catalonia, Spain. 5. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, calle Rosselò, 149-153, 08036, Barcelona, Spain. 6. Division of Cardiology, Fondazione Cardiocentro Ticino, Via Tesserete 48, 6900, Lugano, Switzerland. 7. CIBERCV, Instituto de Salud Carlos III, Ctra. Colmenar Viejo, km. 9,100, 28034, Madrid, Spain. 8. Hospital Ramón y Cajal de Madrid, Ctra. Colmenar Viejo, km. 9,100, 28034, Madrid, Spain. 9. Abbott Laboratories S.A., Av. de Burgos, 91, 28050, Madrid, Spain. 10. Servicio de Neumología Hospital Clínic, Universitat de Barcelona, calle Vilaroel 170, 08036, Barcelona, Spain.
Abstract
PURPOSE:Dual-chamber (DDD) pacing has been used for treatment of patients with hypertrophic obstructive cardiomyopathy (HOCM). Due to inconclusive results in prior trials, current guidelines assign DDD pacing a class IIb indication in selected patients. Prior observations indicate that lack of clinical improvement may result from suboptimal effect of DDD pacing with non-physiological AV intervals due to fusion of intrinsic and paced QRS complex. METHODS: The Triple Chamber Pacing in Hypertrophic Obstructive Cardiomyopathy Patients (TRICHAMPION) trial is a prospective, randomized, single-blinded, multicenter study to investigate the benefit of atrial synchronous biventricular pacing (CRT-P) in highly symptomatic HOCM patients with severe left ventricular outflow tract (LVOT) obstruction who are not candidates for ablative therapies. AV node ablation is used as key tool to optimize AV intervals in patients with QRS fusion. The primary endpoint is the percentage of patients with symptomatic improvement at 12 months, defined as improvement of New York Heart Association functional class, in the Minnesota Living with Heart Failure Questionnaire score and increased cardiopulmonary exercise endurance. CONCLUSIONS: The aim of the TRICHAMPION trial is to investigate the benefit of optimized atrial synchronous biventricular pacing in absence of QRS fusion in highly symptomatic HOCM patients with severe LVOT obstruction who are not candidates for ablative therapies.
RCT Entities:
PURPOSE: Dual-chamber (DDD) pacing has been used for treatment of patients with hypertrophic obstructive cardiomyopathy (HOCM). Due to inconclusive results in prior trials, current guidelines assign DDD pacing a class IIb indication in selected patients. Prior observations indicate that lack of clinical improvement may result from suboptimal effect of DDD pacing with non-physiological AV intervals due to fusion of intrinsic and paced QRS complex. METHODS: The Triple Chamber Pacing in Hypertrophic Obstructive CardiomyopathyPatients (TRICHAMPION) trial is a prospective, randomized, single-blinded, multicenter study to investigate the benefit of atrial synchronous biventricular pacing (CRT-P) in highly symptomatic HOCM patients with severe left ventricular outflow tract (LVOT) obstruction who are not candidates for ablative therapies. AV node ablation is used as key tool to optimize AV intervals in patients with QRS fusion. The primary endpoint is the percentage of patients with symptomatic improvement at 12 months, defined as improvement of New York Heart Association functional class, in the Minnesota Living with Heart Failure Questionnaire score and increased cardiopulmonary exercise endurance. CONCLUSIONS: The aim of the TRICHAMPION trial is to investigate the benefit of optimized atrial synchronous biventricular pacing in absence of QRS fusion in highly symptomatic HOCM patients with severe LVOT obstruction who are not candidates for ablative therapies.
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