Study Summary
This trial will evaluate the incidence of high degree or complete AVB in patients with new-onset persistent left bundle branch block following TAVI, and will also assess the usefulness of the Reveal LINQ ICM for detecting significant arrhythmias in these patients.
- Aortic Valve Stenosis
- Heart Block
Treatment Effectiveness
Effectiveness Progress
Study Objectives
2 Primary · 5 Secondary · Reporting Duration: Within the first 3 years following TAVI procedure
Trial Safety
Safety Progress
Trial Design
1 Treatment Group
Implantable loop recorders Reveal ICM LINQ®,
1 of 1
Experimental Treatment
80 Total Participants · 1 Treatment Group
Primary Treatment: Implantable loop recorders system Reveal ICM LINQ®, · No Placebo Group · N/A
Trial Logistics
Trial Timeline
Who is running the clinical trial?
Eligibility Criteria
Age 18+ · All Participants · 1 Total Inclusion Criteria
Mark “Yes” if the following statements are true for you:- Piazza, Nicoló, Peter de Jaegere, Carl Schultz, Anton E. Becker, Patrick W. Serruys, and Robert H. Anderson. 2008. “Anatomy of the Aortic Valvar Complex and Its Implications for Transcatheter Implantation of the Aortic Valve”. Circulation: Cardiovascular Interventions. Ovid Technologies (Wolters Kluwer Health). doi:10.1161/circinterventions.108.780858.
- Thompson, Richard, Andrew Mitchell, Mohamed Ahmed, Malcolm Towers, and Magdi Yacoub. 1979. “Conduction Defects in Aortic Valve Disease”. American Heart Journal. Elsevier BV. doi:10.1016/0002-8703(79)90313-2.
- El-Khally, Ziad, Bernard Thibault, Cezar Staniloae, Pierre Theroux, Marc Dubuc, Denis Roy, Peter Guerra, Laurent Macle, and Mario Talajic. 2004. “Prognostic Significance of Newly Acquired Bundle Branch Block After Aortic Valve Replacement”. The American Journal of Cardiology. Elsevier BV. doi:10.1016/j.amjcard.2004.06.055.
- CALVI, VALERIA, EUGLENA PUZZANGARA, GIUSI PAOLA PRUITI, SERGIO CONTI, ANGELO DI GRAZIA, GIAN PAOLO USSIA, DAVIDE CAPODANNO, and CORRADO TAMBURINO. 2009. “Early Conduction Disorders Following Percutaneous Aortic Valve Replacement”. Pacing and Clinical Electrophysiology. Wiley. doi:10.1111/j.1540-8159.2008.02298.x.
- Föppl, M., A. Hoffmann, F. W. Amann, J. Roth, P. Stulz, J. Hasse, E. Grádel, and D. Burckhardt. 1989. “Sudden Cardiac Death After Aortic Valve Surgery: Incidence and Concomitant Factors”. Clinical Cardiology. Wiley. doi:10.1002/clc.4960120405.
- van der Boon, Robert M., Rutger-Jan Nuis, Nicolas M. Van Mieghem, Luc Jordaens, Josep Rodés-Cabau, Ron T. van Domburg, Patrick W. Serruys, Robert H. Anderson, and Peter P. T. de Jaegere. 2012. “New Conduction Abnormalities After Tavi—frequency and Causes”. Nature Reviews Cardiology. Springer Science and Business Media LLC. doi:10.1038/nrcardio.2012.58.
- Leon, Martin B., Nicolo Piazza, Eugenia Nikolsky, Eugene H. Blackstone, Donald E. Cutlip, Arie Pieter Kappetein, Mitchell W. Krucoff, et al.. 2011. “Standardized Endpoint Definitions for Transcatheter Aortic Valve Implantation Clinical Trials”. Journal of the American College of Cardiology. Elsevier BV. doi:10.1016/j.jacc.2010.12.005.
- Dou, Jianhong, Ling Xia, Yu Zhang, Guofa Shou, Qing Wei, Feng Liu, and Stuart Crozier. 2008. “Mechanical Analysis of Congestive Heart Failure Caused by Bundle Branch Block Based on an Electromechanical Canine Heart Model”. Physics in Medicine and Biology. IOP Publishing. doi:10.1088/0031-9155/54/2/012.
- Piazza, Nicolo, Rutger-Jan Nuis, Apostolos Tzikas, Amber Otten, Yoshinobu Onuma, Hector García-García, Carl Schultz, et al.. 2010. “Persistent Conduction Abnormalities and Requirements for Pacemaking Six Months After Transcatheter Aortic Valve Implantation”. Eurointervention. Europa Digital & Publishing. doi:10.4244/eij30v6i4a80.
- Houthuizen, Patrick, Leen A.F.M. Van Garsse, Thomas T. Poels, Peter de Jaegere, Robert M.A. van der Boon, Ben M. Swinkels, Jurriën M. ten Berg, et al.. 2012. “Left Bundle-branch Block Induced by Transcatheter Aortic Valve Implantation Increases Risk of Death”. Circulation. Ovid Technologies (Wolters Kluwer Health). doi:10.1161/circulationaha.112.101055.
- Testa, Luca, Azeem Latib, Federico De Marco, Marco De Carlo, Mauro Agnifili, Roberto Adriano Latini, Anna Sonia Petronio, et al.. 2013. “Clinical Impact of Persistent Left Bundle-branch Block After Transcatheter Aortic Valve Implantation with Corevalve Revalving System”. Circulation. Ovid Technologies (Wolters Kluwer Health). doi:10.1161/circulationaha.112.001099.
- Urena, Marina, Michael Mok, Vicenç Serra, Eric Dumont, Luis Nombela-Franco, Robert DeLarochellière, Daniel Doyle, et al.. 2012. “Predictive Factors and Long-term Clinical Consequences of Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Implantation with a Balloon-expandable Valve”. Journal of the American College of Cardiology. Elsevier BV. doi:10.1016/j.jacc.2012.07.035.
- Moya, A., R. Garcia-Civera, F. Croci, C. Menozzi, J. Brugada, F. Ammirati, A. Del Rosso, et al.. 2011. “Diagnosis, Management, and Outcomes of Patients with Syncope and Bundle Branch Block”. European Heart Journal. Oxford University Press (OUP). doi:10.1093/eurheartj/ehr071.
- Krahn, Andrew D., George J. Klein, Raymond Yee, Teri Takle-Newhouse, and Caro Norris. 1999. “Use of an Extended Monitoring Strategy in Patients with Problematic Syncope”. Circulation. Ovid Technologies (Wolters Kluwer Health). doi:10.1161/01.cir.99.3.406.
- LOMBARDI, F, E CALOSSO, G MASCIOLI, E MARANGONI, A DONATO, S ROSSI, M PALA, F FOTI, and M LUNATI. 2005. “Utility of Implantable Loop Recorder (reveal Plus) in the Diagnosis of Unexplained Syncope”. Europace. Oxford University Press (OUP). doi:10.1016/j.eupc.2004.09.003.
- FURUKAWA, TOSHIYUKI, ROBERTO MAGGI, CRISTINA BERTOLONE, DANIELE FONTANA, and MICHELE BRIGNOLE. 2011. “Additional Diagnostic Value of Very Prolonged Observation by Implantable Loop Recorder in Patients with Unexplained Syncope”. Journal of Cardiovascular Electrophysiology. Wiley. doi:10.1111/j.1540-8167.2011.02133.x.
- Paruchuri, Vijayapraveena, Mehul Adhaduk, Naga V. Garikipati, Jonathan S. Steinberg, and Suneet Mittal. 2011. “Clinical Utility of a Novel Wireless Implantable Loop Recorder in the Evaluation of Patients with Unexplained Syncope”. Heart Rhythm. Elsevier BV. doi:10.1016/j.hrthm.2011.01.039.
- Krahn, Andrew D, George J Klein, Raymond Yee, Jeffrey S Hoch, and Allan C Skanes. 2003. “Cost Implications of Testing Strategy in Patients with Syncope”. Journal of the American College of Cardiology. Elsevier BV. doi:10.1016/s0735-1097(03)00659-4.
- Task Force members, M. Brignole, P. Vardas, E. Hoffman, H. Huikuri, A. Moya, R. Ricci, et al.. 2009. “Indications for the Use of Diagnostic Implantable and External ECG Loop Recorders”. Europace. Oxford University Press (OUP). doi:10.1093/europace/eup097.
- Crossley, George H., Andrew Boyle, Holly Vitense, Yanping Chang, and R. Hardwin Mead. 2011. “The CONNECT (clinical Evaluation of Remote Notification to Reduce Time to Clinical Decision) Trial”. Journal of the American College of Cardiology. Elsevier BV. doi:10.1016/j.jacc.2010.12.012.
- Kappetein, A. P., S. J. Head, P. Genereux, N. Piazza, N. M. van Mieghem, E. H. Blackstone, T. G. Brott, et al.. 2012. “Updated Standardized Endpoint Definitions for Transcatheter Aortic Valve Implantation: The Valve Academic Research Consortium-2 Consensus Document (VARC-2)”. European Journal of Cardio-thoracic Surgery. Oxford University Press (OUP). doi:10.1093/ejcts/ezs533.
- Surawicz, Borys, Rory Childers, Barbara J. Deal, and Leonard S. Gettes. 2009. “AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram”. Journal of the American College of Cardiology. Elsevier BV. doi:10.1016/j.jacc.2008.12.013.
- Epstein, Andrew E., John P. DiMarco, Kenneth A. Ellenbogen, N.A. Mark Estes III, Roger A. Freedman, Leonard S. Gettes, A. Marc Gillinov, et al.. 2013. “2012 ACCF/AHA/HRS Focused Update Incorporated into the ACCF/AHA/HRS 2008 Guidelines for Device-based Therapy of Cardiac Rhythm Abnormalities”. Circulation. Ovid Technologies (Wolters Kluwer Health). doi:10.1161/cir.0b013e318276ce9b.
- Goldberger, Jeffrey J., Michael E. Cain, Stefan H. Hohnloser, Alan H. Kadish, Bradley P. Knight, Michael S. Lauer, Barry J. Maron, et al.. 2008. “American Heart Association/american College of Cardiology Foundation/heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death”. Journal of the American College of Cardiology. Elsevier BV. doi:10.1016/j.jacc.2008.05.003.
- Muntané-Carol, Guillem, Marina Urena, Luis Nombela-Franco, Ignacio Amat-Santos, Neal Kleiman, Antonio Munoz-Garcia, Felipe Atienza, et al.. 2020. “Arrhythmic Burden in Patients with New-onset Persistent Left Bundle Branch Block After Transcatheter Aortic Valve Replacement: 2-year Results of the MARE Study”. EP Europace. Oxford University Press (OUP). doi:10.1093/europace/euaa213.
- Rodés-Cabau, Josep, Marina Urena, Luis Nombela-Franco, Ignacio Amat-Santos, Neal Kleiman, Antonio Munoz-Garcia, Felipe Atienza, et al.. 2018. “Arrhythmic Burden as Determined by Ambulatory Continuous Cardiac Monitoring in Patients with New-onset Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Replacement”. JACC: Cardiovascular Interventions. Elsevier BV. doi:10.1016/j.jcin.2018.04.016.
- Surawicz B, Childers R, Deal BJ, Gettes LS, Bailey JJ, Gorgels A, Hancock EW, Josephson M, Kligfield P, Kors JA, Macfarlane P, Mason JW, Mirvis DM, Okin P, Pahlm O, Rautaharju PM, van Herpen G, Wagner GS, Wellens H; American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; American College of Cardiology Foundation; Heart Rhythm Society. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part III: intraventricular conduction disturbances: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol. 2009 Mar 17;53(11):976-81. doi: 10.1016/j.jacc.2008.12.013. No abstract available.
- Krahn AD, Klein GJ, Yee R, Hoch JS, Skanes AC. Cost implications of testing strategy in patients with syncope: randomized assessment of syncope trial. J Am Coll Cardiol. 2003 Aug 6;42(3):495-501. doi: 10.1016/s0735-1097(03)00659-4.
- Piazza N, de Jaegere P, Schultz C, Becker AE, Serruys PW, Anderson RH. Anatomy of the aortic valvar complex and its implications for transcatheter implantation of the aortic valve. Circ Cardiovasc Interv. 2008 Aug;1(1):74-81. doi: 10.1161/CIRCINTERVENTIONS.108.780858. Erratum In: Circ Cardiovasc Interv. 2008 Oct;1(2):e1.
- Lombardi F, Calosso E, Mascioli G, Marangoni E, Donato A, Rossi S, Pala M, Foti F, Lunati M. Utility of implantable loop recorder (Reveal Plus) in the diagnosis of unexplained syncope. Europace. 2005 Jan;7(1):19-24. doi: 10.1016/j.eupc.2004.09.003.
- Piazza N, Nuis RJ, Tzikas A, Otten A, Onuma Y, Garcia-Garcia H, Schultz C, van Domburg R, van Es GA, van Geuns R, de Jaegere P, Serruys PW. Persistent conduction abnormalities and requirements for pacemaking six months after transcatheter aortic valve implantation. EuroIntervention. 2010 Sep;6(4):475-84. doi: 10.4244/EIJ30V6I4A80.
- Muntane-Carol G, Urena M, Nombela-Franco L, Amat-Santos I, Kleiman N, Munoz-Garcia A, Atienza F, Serra V, Deyell MW, Veiga-Fernandez G, Masson JB, Canadas-Godoy V, Himbert D, Castrodeza J, Elizaga J, Francisco Pascual J, Webb JG, de la Torre Hernandez JM, Asmarats L, Pelletier-Beaumont E, Philippon F, Rodes-Cabau J. Arrhythmic burden in patients with new-onset persistent left bundle branch block after transcatheter aortic valve replacement: 2-year results of the MARE study. Europace. 2021 Feb 5;23(2):254-263. doi: 10.1093/europace/euaa213.
- Rodes-Cabau J, Urena M, Nombela-Franco L, Amat-Santos I, Kleiman N, Munoz-Garcia A, Atienza F, Serra V, Deyell MW, Veiga-Fernandez G, Masson JB, Canadas-Godoy V, Himbert D, Castrodeza J, Elizaga J, Francisco Pascual J, Webb JG, de la Torre JM, Asmarats L, Pelletier-Beaumont E, Philippon F. Arrhythmic Burden as Determined by Ambulatory Continuous Cardiac Monitoring in Patients With New-Onset Persistent Left Bundle Branch Block Following Transcatheter Aortic Valve Replacement: The MARE Study. JACC Cardiovasc Interv. 2018 Aug 13;11(15):1495-1505. doi: 10.1016/j.jcin.2018.04.016. Epub 2018 Jul 18.
- Kappetein AP, Head SJ, Genereux P, Piazza N, van Mieghem NM, Blackstone EH, Brott TG, Cohen DJ, Cutlip DE, van Es GA, Hahn RT, Kirtane AJ, Krucoff MW, Kodali S, Mack MJ, Mehran R, Rodes-Cabau J, Vranckx P, Webb JG, Windecker S, Serruys PW, Leon MB; Valve Academic Research Consortium (VARC)-2. Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document (VARC-2). Eur J Cardiothorac Surg. 2012 Nov;42(5):S45-60. doi: 10.1093/ejcts/ezs533. Epub 2012 Oct 1.
- Foppl M, Hoffmann A, Amann FW, Roth J, Stulz P, Hasse J, Gradel E, Burckhardt D. Sudden cardiac death after aortic valve surgery: incidence and concomitant factors. Clin Cardiol. 1989 Apr;12(4):202-7. doi: 10.1002/clc.4960120405.
- Task Force members, Brignole M, Vardas P, Hoffman E, Huikuri H, Moya A, Ricci R, Sulke N, Wieling W; EHRA Scientific Documents Committee, Auricchio A, Lip GY, Almendral J, Kirchhof P, Aliot E, Gasparini M, Braunschweig F; Document Reviewers, Lip GY, Almendral J, Kirchhof P, Botto GL; EHRA Scientific Documents Committee. Indications for the use of diagnostic implantable and external ECG loop recorders. Europace. 2009 May;11(5):671-87. doi: 10.1093/europace/eup097. No abstract available. Erratum In: Europace. 2009 Jun;11(6):836.
- Krahn AD, Klein GJ, Yee R, Takle-Newhouse T, Norris C. Use of an extended monitoring strategy in patients with problematic syncope. Reveal Investigators. Circulation. 1999 Jan 26;99(3):406-10. doi: 10.1161/01.cir.99.3.406.
- Goldberger JJ, Cain ME, Hohnloser SH, Kadish AH, Knight BP, Lauer MS, Maron BJ, Page RL, Passman RS, Siscovick D, Siscovick D, Stevenson WG, Zipes DP; American Heart Association; American College of Cardiology Foundation; Heart Rhythm Society. American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society scientific statement on noninvasive risk stratification techniques for identifying patients at risk for sudden cardiac death: a scientific statement from the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention. Circulation. 2008 Sep 30;118(14):1497-1518. No abstract available.
- van der Boon RM, Nuis RJ, Van Mieghem NM, Jordaens L, Rodes-Cabau J, van Domburg RT, Serruys PW, Anderson RH, de Jaegere PP. New conduction abnormalities after TAVI--frequency and causes. Nat Rev Cardiol. 2012 May 1;9(8):454-63. doi: 10.1038/nrcardio.2012.58.
- Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA 3rd, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO; American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines; Heart Rhythm Society. 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation. 2013 Jan 22;127(3):e283-352. doi: 10.1161/CIR.0b013e318276ce9b. Epub 2012 Dec 19. No abstract available.
- Thompson R, Mitchell A, Ahmed M, Towers M, Yacoub M. Conduction defects in aortic valve disease. Am Heart J. 1979 Jul;98(1):3-10. doi: 10.1016/0002-8703(79)90313-2. No abstract available.
- Moya A, Garcia-Civera R, Croci F, Menozzi C, Brugada J, Ammirati F, Del Rosso A, Bellver-Navarro A, Garcia-Sacristan J, Bortnik M, Mont L, Ruiz-Granell R, Navarro X; Bradycardia detection in Bundle Branch Block (B4) study. Diagnosis, management, and outcomes of patients with syncope and bundle branch block. Eur Heart J. 2011 Jun;32(12):1535-41. doi: 10.1093/eurheartj/ehr071. Epub 2011 Mar 28.
- El-Khally Z, Thibault B, Staniloae C, Theroux P, Dubuc M, Roy D, Guerra P, Macle L, Talajic M. Prognostic significance of newly acquired bundle branch block after aortic valve replacement. Am J Cardiol. 2004 Oct 15;94(8):1008-11. doi: 10.1016/j.amjcard.2004.06.055.
- Urena M, Mok M, Serra V, Dumont E, Nombela-Franco L, DeLarochelliere R, Doyle D, Igual A, Larose E, Amat-Santos I, Cote M, Cuellar H, Pibarot P, de Jaegere P, Philippon F, Garcia del Blanco B, Rodes-Cabau J. Predictive factors and long-term clinical consequences of persistent left bundle branch block following transcatheter aortic valve implantation with a balloon-expandable valve. J Am Coll Cardiol. 2012 Oct 30;60(18):1743-52. doi: 10.1016/j.jacc.2012.07.035. Epub 2012 Oct 3.
- Task Force members; Brignole M, Vardas P, Hoffman E, Huikuri H, Moya A, Ricci R, Sulke N, Wieling W; EHRA Scientific Documents Committee; Auricchio A, Lip GY, Almendral J, Kirchhof P, Aliot E, Gasparini M, Braunschweig F; Document Reviewers; Lip GY, Almendral J, Kirchhof P, Botto GL; EHRA Scientific Documents Committee. Indications for the use of diagnostic implantable and external ECG loop recorders. Europace. 2009 May;11(5):671-87. doi: 10.1093/europace/eup097. No abstract available. Erratum In: Europace. 2009 Jun;11(6):836.
- Josep Rodes-Cabau 2014. "Ambulatory Electrocardiographic Monitoring for the Detection of High-Degree Atrio-Ventricular Block in Patients With New-onset PeRsistent LEft Bundle Branch Block After Transcatheter Aortic Valve Implantation. The "MARE" Study". ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT02153307.
Frequently Asked Questions
What is the aggregate participation rate in this investigation?
"Affirmative. The clinical trial registry, clinicialtrials.gov, indicates that recruitment for this study is ongoing and has been since it was initially posted on January 1st 2014. 80 patients are needed to be recruited from a single medical centre." - Anonymous Online Contributor
Is this clinical research actively recruiting participants?
"The clinical trial in question is actively seeking participants, having been uploaded to clinicaltrials.gov on January 1st 2014 and last edited September 20th 2021." - Anonymous Online Contributor