RecruitingNot ApplicableNCT07270536

Accelerated Pacing and Cardiac Filling Pressures During Exercise in Patients With Heart Failure With Preserved Ejection Fraction

The Impact of Accelerated Pacing and AV-delay Regulation on the Pulmonary Capillary Wedge Pressure During Exercise in Patients With HFpEF

Sponsor

Universitaire Ziekenhuizen KU Leuven

Enrollment

20 participants

Start Date

Dec 10, 2025

Study Type

INTERVENTIONAL

Conditions

HFpEF

Summary

What is HFpEF? In heart failure with preserved ejection fraction (HFpEF), the heart pumps well but struggles to relax and fill with blood between beats. This raises the pressure inside the heart, especially during physical activity, causing symptoms like shortness of breath and fatigue - even with light activities like walking or climbing stairs. What is this study about? Recent research suggests that a higher heart rate may help lower this elevated pressure. Many HFpEF patients already have a pacemaker. This study investigates whether simply increasing the pacemaker rate during light exercise can reduce the pressure in the heart. How does the study work? We wille measure heart pressures in 20 patients in rest and while cycling using a heart catheter and monitor their breathing. Throughout these measurements, we will gradually increase the pacemaker rate step by step. Why does this matter? If a higher pacemaker rate successfully lowers heart pressure, this could offer a simple, drug-free way to improve daily functioning and comfort for thousands of patients with HFpEF, justifying further long-term studies to evaluate effects beyond the immediate changes in heart pressures.

Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study is exploring whether temporarily speeding up the heart rate with a pacemaker during exercise can reduce the buildup of pressure in the heart's chambers in people with a type of heart failure where the heart pumps normally but is stiff (called HFpEF). This could point to new pacemaker-based treatments. **You may be eligible if...** - You are 18 or older - You have been diagnosed with heart failure with preserved ejection fraction (HFpEF) — meaning your heart squeezes normally but has trouble relaxing - You already have a pacemaker or defibrillator device implanted - You are stable enough to undergo an exercise test **You may NOT be eligible if...** - You have severe valve disease or other significant structural heart problems - You recently had a heart attack or unstable chest pain - You are unable to exercise on a bike or treadmill - You are pregnant Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

OTHERAccelerated pacing with AV-delay optimization during rest and light intensity cycling

Patients will undergo one resting and one exercise protocol (25 Watts). During each protocol, the pacemaker rate will be gradually increased in three stages: +20, +40, +60 bpm at rest and +10, +30, +50 bpm during exercise. At each stage, intracardiac pressures and shear-wave velocity will be measured. In a final fourth stage, the pacemaker rate returns to the level associated with the lowest filling pressure, after which blood oxygen levels and oxygen uptake are assessed to calculate cardiac output.

Locations(2)

Jessa Ziekenhuis Hasselt

Hasselt, Belgium

University Hospitals Leuven

Leuven, Belgium

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NCT07270536

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