Long-term Outcomes of Conduction System Pacing: a National Multicenter Observational Study - NORMAND'HIS / STIMU'HIS

Study Overview
=================
Brief Summary
-----------------
This prospective multicenter registry will evaluate the long-term electrical, echocardiographic, and clinical outcomes of conduction system pacing (CSP). There is currently limited data in the literature regarding the long-term results and benefits of CSP. The long-term maintenance of conduction system (His bundle or Left Bundle Branch) capture and physiological ventricular activation is an essential prerequisite for the expected benefits of this technique. There is currently no prospective study evaluating the preservation of CSP during long-term follow-up. The design of the present study will allow reliable evaluation of CSP maintenance at 2 years follow-up. The prospective collection of electrical data (pacing thresholds, impedance, R wave sensing) during pacemaker follow-up visits will confirm thresholds stability over the long term. The incidence of atrial fibrillation episodes will also be precisely evaluated and will provide new information. Although pathophysiological studies have demonstrated less impairment of left atrial function with conduction system pacing, there is currently no data on the incidence of atrial fibrillation in patients implanted with a CSP pacemaker. Echocardiographic data will be prospectively collected in order to analyse the evolution of left ventricular ejection fraction (LVEF) after CSP. This systematic follow-up is rarely found in CSP studies, often retrospective, with significant missing echocardiographic data. The hypothesis is that patients benefiting from CSP will not develop the deleterious effects demonstrated with conventional right ventricular pacing, such as left ventricular dilation and LVEF impairment. Inter- and intraventricular asynchrony criteria will also be systematically evaluated during follow-up echocardiography.Finally, this prospective cohort will also systematically collect clinical follow-up data (hospitalizations for heart failure and NYHA stage).

Official Title
-----------------
Long-term Outcomes of Conduction System Pacing: a National Multicenter Observational Study - NORMAND'HIS / STIMU'HIS

Conditions
-----------------
Conduction System Pacing

Intervention / Treatment
-----------------
* Device: Conduction system pacing


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patient who had undergone conduction system pacing attempt Age > 18 yo Capacity to understand the nature of the study, legal ability and willingness to give informed consent Exclusion Criteria: Patient under guardianship, trusteeship, or legal protection. Pregnant woman (positive urine pregnancy test) or breastfeeding or lack of proven effective contraception (according to the WHO definition) or menopausal without confirmed diagnosis (non-medically induced amenorrhea for at least 12 months before the inclusion visit).

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: Conduction system pacing|Conduction system pacing (His Bundle Pacing or Left Bundle Branch Area Pacing)|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Freedom from major adverse events | Major adverse events are defined as follow : Lead revision (including infection and pacing threshold increase) Lead dislodgment Loss of conduction system pacing (i.e. loss of His Bundle Pacing or Left Bundle Branch area pacing according to standard definitions) Heart Failure Hospitalization Upgrade to BiVentricular pacing All cause mortality | 24 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| LVEF (%) |  | 24 months | 
| AF incidence |  | 24 months | 
| Heart Failure Hospitalization Incidence |  | 24 months | 
| CSP Threshold during pacemaker check (Volt @ ms) |  | 24 months | 
| Paced QRS width |  | 24 months | 
| Interventricular dyssynchrony parameters | Aortic pre-ejection time (ms) - Pulmonary pre-ejection time (ms) (echocardiography) | pre-discharged | 
| Intraventricular dyssynchrony parameters | Difference between the first and last left ventricular systolic peak using 2D speckle tracking (echocardiography) | pre-discharged |