Guideline-based Pacing Therapy for Reflex Syncope (SUP2)
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| ClinicalTrials.gov Identifier: NCT01509534 |
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Recruitment Status :
Completed
First Posted : January 13, 2012
Last Update Posted : July 29, 2015
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| Condition or disease |
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| Syncope |
Background Divergence of opinion exists regarding the efficacy of cardiac pacing in patients affected by different forms of reflex syncope.
Definitions.
Severe syncope is defined when:
- it is perceived by patient that it alters his/her quality of life, and
- is unpredictable because occurs without, or with very short prodromes < 10 sec (thus exposing patients to risk of trauma) or, if preceded by prodromes, syncope recurs despite appropriate therapies (CPM or drugs).
Recurrent syncopes: at least 2 episodes during the last year (including the index episode) or 3 episodes during the last 2 years (including the index episode).
Suspected (undetermined) reflex syncope: the suspicion of reflex syncope is based on a history of uncertain syncope in the absence of (i) severe structural heart disease, significant ECG abnormalities, or rhythm disturbances; (ii) orthostatic hypotension; and (iii) non-syncopal causes of transient loss of consciousness.
Study protocol
- The eligible patients undergo firstly carotid sinus massage (according to the method of symptoms); if a diagnosis of cardioinhibitory carotid sinus syndrome (CI-CSS) is made, a pacemaker is implanted and follow-up immediately starts.
- If the carotid sinus massage is negative or vasodepressor, the patients undergo tilt table testing (with nitroglycerin or clomipramine drug challenge); if a diagnosis of VASIS 2B form is made, a pacemaker is implanted and follow-up immediately starts.
- If tilt table testing is negative or a form different from VASIS 2B is induced, the patients undergo ILR implantation. If a diagnosis of asystolic reflex syncope is made, a pacemaker is implanted and follow-up immediately starts.
End-points End-point of the study is syncope recurrence after pacemaker (PM) implantation. Syncope is defined as complete transient loss of consciousness. Pre-syncope is counted but it is not an end-point.
Primary end-points:
- Comparison of the time to first syncopal recurrence in CI-CSS and CI-TTT pts with PM and in control patients with ILR.
- Intra-patient comparison of the syncope burden in the year before and in the year following PM implant in all patients receiving a PM (CCS, TTT and ILR groups). Index syncope is not counted.
Follow-up One year after PM implantation for all enrolled patients for burden of syncope end-points Until the study end for time to first syncope recurrence end-points. Thus, the study ends one year after the enrollment of the last patient.
Study size Based on the sample size calculation the study will stop when 700 patients are enrolled.
| Study Type : | Observational |
| Actual Enrollment : | 281 participants |
| Observational Model: | Cohort |
| Time Perspective: | Prospective |
| Official Title: | Guideline-based Pacing Therapy for Reflex Syncope |
| Study Start Date : | January 2012 |
| Actual Primary Completion Date : | July 2015 |
| Actual Study Completion Date : | July 2015 |
- syncope recurrence after PM implantation [ Time Frame: 1 year ]
- syncope burden after PM implantation [ Time Frame: 1 year ]
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| Ages Eligible for Study: | 40 Years and older (Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Probability Sample |
Inclusion Criteria:
- Patients affected by severe, recurrent, certain or suspected (undetermined) reflex syncopes, aged ≥ 40 years.
Exclusion Criteria:
- Reflex syncopes due to reversible causes, e.g., vasoactive drugs, concomitant diseases, etc
- Suspected of certain cardiac syncope
- Syncope caused by orthostatic hypotension
- Non-syncopal causes of transient loss of consciousness
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01509534
| Italy | |
| Ospedale Generale Regionale | |
| Bolzano, Italy | |
| AO di Rilievo Nazionale e di Alta Specializzazione Garibaldi | |
| Catania, Italy | |
| PO S. Giuseppe | |
| Empoli, Italy | |
| AO Careggi | |
| Firenze, Italy | |
| Nuovo Ospedale S. Giovanni di Dio | |
| Firenze, Italy | |
| Department of Cardiology, Ospedali del Tigullio | |
| Lavagna, Italy, 16033 | |
| Arcispedale S. Maria Nuova | |
| Reggio Emilia, Italy | |
| Ospedale SS. Annunziata | |
| Taranto, Italy | |
| Principal Investigator: | Michele Brignole, MD | Ospedali del Tigullio, Lavagna, Italy |
| Responsible Party: | Gruppo Italiano Multidisciplinare per lo Studio della Sincope |
| ClinicalTrials.gov Identifier: | NCT01509534 |
| Other Study ID Numbers: |
GIMSI-001-2011 |
| First Posted: | January 13, 2012 Key Record Dates |
| Last Update Posted: | July 29, 2015 |
| Last Verified: | July 2015 |
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pacemaker implantable loop recorder syncope |
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Syncope Syncope, Vasovagal Unconsciousness Consciousness Disorders Neurobehavioral Manifestations |
Neurologic Manifestations Nervous System Diseases Orthostatic Intolerance Primary Dysautonomias Autonomic Nervous System Diseases |