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Trial registered on ANZCTR
Registration number
ACTRN12625000408482
Ethics application status
Approved
Date submitted
15/04/2025
Date registered
5/05/2025
Date last updated
5/05/2025
Date data sharing statement initially provided
5/05/2025
Type of registration
Prospectively registered
Titles & IDs
Public title
Optimal heart rates in patients with Cardiac Amyloidosis and pacemakers.
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Scientific title
Assess the quality of life for cardiac pacing augmented myocardial dynamics in patients with transthyretin cardiac amyloidosis
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Secondary ID [1]
314215
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None
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Universal Trial Number (UTN)
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Trial acronym
CAPACE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Amyloidosis
337117
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Condition category
Condition code
Cardiovascular
333537
333537
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0
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Other cardiovascular diseases
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Human Genetics and Inherited Disorders
333538
333538
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0
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Other human genetics and inherited disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Prospective pilot study of cardiac pacing augmented myocardial dynamics in patients with transthyretin cardiac amyloidosis. The study includes enrolment then two site study visits and a final phone call at 1 year. During the first visit a patient will undergo clinical assessment with physical examination, quality of life survey, 6 minute walk test, electrocardiogram (ECG), echocardiogram and cardiac magnetic resonance imaging (CMR) at three different pacing rates, assessing the cardiac response to each heart rate. Cardiac device pacing rate will then be set to the individually optimised pacing rates as per CMR for one month.
The second visit at one month will include brief physical examination, quality of life survey, 6 minute walk test, electrocardiogram (ECG), echocardiogram. Cardiac devices will be interrogated to confirm the heart rate paced during the prior intervention period and reprogrammed to their original settings.
Patients will receive a brief follow up phone call at 1 year.
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Intervention code [1]
330824
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Treatment: Devices
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Comparator / control treatment
Each participant is their own control
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Control group
Active
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Outcomes
Primary outcome [1]
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To assess the change in quality-of-life score with individually optimized CMR pacing rates in patients with cardiac amyloidosis from baseline to one month.
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Assessment method [1]
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Change in quality of Life score
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Timepoint [1]
341118
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One month post commencement of intervention
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Secondary outcome [1]
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To assess the change in cardiac output by CMR at different cardiac implantable electronic device pacing rates in patients with cardiac amyloidosis.
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Assessment method [1]
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Assessment of cardiac output via CMR
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Timepoint [1]
446339
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At time of acquisition of imaging (First study visit)
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Eligibility
Key inclusion criteria
• People who meet diagnostic criteria for transthyretin cardiac amyloidosis
• Cardiac implantable electronic device (pacemakers or defibrillator) which is MRI compatible.
• Underlying native heart rate of 60 beats per minute or less.
• Willingness to give written informed consent and willingness to participate to and comply with the study.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• Patients with any contraindications for CMR imaging including:
o Patients with previous allergy to gadolinium.
o Patients with a history of significant renal impairment (eGFR< 30ml/min/1.73m2).
o Patients who are medically unstable.
o Patients with claustrophobia.
o Cardiac pacemakers or implantable cardioverter defibrillator not deemed to be MRI compatible.
o Pregnancy or lactating.
o Orbital foreign bodies from metal injury to the eye.
o Intracranial metal clips.
o Non-MRI compatible stapes implants.
o Programmable Hydrocephalus Shunts.
o Large metal implants.
• Patients with a history of a psychological illness or condition such as to interfere with the patient's ability to understand the requirements of the study.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
19/05/2025
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
25
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
27783
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St Vincent's Hospital (Darlinghurst) - Darlinghurst
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Recruitment postcode(s) [1]
43972
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2010 - Darlinghurst
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Funding & Sponsors
Funding source category [1]
318732
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Hospital
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Name [1]
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St Vincent's Hospital Sydney
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Address [1]
318732
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Country [1]
318732
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Australia
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Primary sponsor type
Hospital
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Name
St Vincent's Hospital Sydney
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Address
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Country
Australia
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Secondary sponsor category [1]
321338
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None
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Name [1]
321338
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Address [1]
321338
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Country [1]
321338
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
317345
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St Vincent’s Hospital Human Research Ethics Committee
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Ethics committee address [1]
317345
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https://svhs.org.au/home/research-education/research-office
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Ethics committee country [1]
317345
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Australia
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Date submitted for ethics approval [1]
317345
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07/11/2024
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Approval date [1]
317345
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17/12/2024
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Ethics approval number [1]
317345
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2024/ETH02406
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Summary
Brief summary
Cardiac amyloidosis is a significant health issue associated with high rates of heart failure and heart rhythm issues, including the need for pacemaker devices. Up to 40% of patients with cardiac amyloidosis need a heart pacemaker at some point, but the best heart rate to set the pacemaker at is not established. In similar conditions, higher heart rate pacemaker settings have been shown to be safe but also improve heart function, symptoms and exercise tolerance. Heart MRI (magnetic resonance imaging) is a technique widely used to understand the mechanisms and changes in flow in many heart conditions and we believe this is the best technique available to study heart function in response to different heart rates. Unlike most medical imaging methods, MRI does not use radiation but instead used magnetic fields and radiofrequency waves to produce images of the internal structure of the human body. We propose to assess MRI findings of heart flow and function at three different pacing heart rates to determine which heart rate provides the best possible heart output.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Andrew Jabbour
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Address
140750
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St Vincent's Hospital Sydney, 390 Victoria St, Darlinghurst, 2010, NSW
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Country
140750
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Australia
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Phone
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+61 28038 1080
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Fax
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Email
140750
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[email protected]
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Contact person for public queries
Name
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Dr Natasha Gorrie
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Address
140751
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St Vincent's Hospital Sydney, 390 Victoria St, Darlinghurst, 2010, NSW
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Country
140751
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Australia
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Phone
140751
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+61 423173865
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Fax
140751
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Email
140751
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[email protected]
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Contact person for scientific queries
Name
140752
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Dr Natasha Gorrie
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Address
140752
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St Vincent's Hospital Sydney, 390 Victoria St, Darlinghurst, 2010, NSW
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Country
140752
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Australia
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Phone
140752
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+61 423173865
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Fax
140752
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Email
140752
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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