Heart failure & cardiomyopathiesRandomised controlled trial
Electromechanically Optimized Right Ventricular Pacing for Obstructive Hypertrophic Cardiomyopathy
- Randomised crossover trial
- multicentre
- blinded
- Bayesian ordinal mixed modelling
Patients blinded to allocation; symptom assessments self-administered
Authors' conclusion
In patients with oHCM, RVP delivered at electromechanically optimized AVD improves symptoms and exercise capacity.
Study context
- Population
- Patients with symptomatic obstructive HCM (resting or provoked LVOT gradient ≥30 mm Hg) with existing dual-chamber devicesrandomized
- Participants
- 60 patients
- Comparison
- Atrio-ventricular delay (AVD)-optimized right ventricular pacing (RVP) vs backup-only RVP
- Primary endpoint
- Symptoms by Kansas City Cardiomyopathy Questionnaire Clinical Summary Score
Primary result
KCCQ Clinical Summary Score
Difference
+4.5
95% CrI 1.3–8.1
As reported in the abstract
Secondary outcomes
| Outcome | OR (95% CrI) | |
|---|---|---|
| Daily symptom scores (ORBITA-app) · CrI; probability of benefit 0.969 | 1.29 (0.98–1.68) | |
| 0.512Odds ratio (log scale) |
| Outcome | difference (mm Hg) (95% CrI) | |
|---|---|---|
| LVOT gradient · CrI; probability of benefit 0.010 | −7.3 (−13.5 to −1.1) | |
| −20−10010Difference, mm Hg (linear scale) |
| Outcome | difference (mL/kg/min) (95% CrI) |
|---|---|
| Exercise capacity · CrI; probability of benefit 0.984 | +1.0 (0.1–2.0) |
B-type natriuretic peptide
- No effect on B-type natriuretic peptide (probability of benefit)
- 0.893
Safety
Ejection fraction
- EF preserved (probability of benefit)
- 0.409
Original publication
Electromechanically Optimized Right Ventricular Pacing for Obstructive Hypertrophic Cardiomyopathy. J Am Coll Cardiol. Published 31 August 2025. doi:10.1016/j.jacc.2025.08.050
Summarised from the published abstract; every number is checked against it