NCT05257772: EMORI-HCM

Electromechanically Optimised Right Ventricular Pacing In Hypertrophic Cardiomyopathy (EMORI-HCM)

Active, enrolled NA Last updated 11 May 2025

What this trial tests

NA trial testing AV Delay Optimised RV Pacing in Hypertrophic Cardiomyopathy in 60 participants. Participants enrolled and being followed up; not accepting new ones.

Timeline

14 March 2022

Primary endpoint
16 May 2025

16 May 2025

Quick facts

Lead sponsor	Imperial College London
Phase	NA
Status	Active, enrolled
Study type	INTERVENTIONAL
Allocation	randomized
Design	crossover
Masking	double
Primary purpose	treatment
Enrollment	60
Start date	14 March 2022
Primary completion	16 May 2025
Estimated completion	16 May 2025
Sites	1 location across United Kingdom

Drugs / interventions tested

• AV Delay Optimised RV Pacing

Conditions studied

• Hypertrophic Cardiomyopathy — all drugs for Hypertrophic Cardiomyopathy →
• Hypertrophic Obstructive Cardiomyopathy — all drugs for Hypertrophic Obstructive Cardiomyopathy →

Sponsor

Imperial College London

Who can join

Adults 18 to 100, any sex, with Hypertrophic Cardiomyopathy or Hypertrophic Obstructive Cardiomyopathy. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Hypertrophic Obstructive Cardiomyopathy (HOCM) is an inherited cardiac condition which causes the heart muscle to become abnormally thick causing obstruction of blood flow in the heart. This causes debilitating symptoms including shortness of breath, blackouts and chest pain. Current treatments are not ideal as the medication is often poorly tolerated or ineffective.

People with HOCM can often have an Implantable Cardioverter Defibrillator (ICD) to shock them out of dangerous arrhythmias. ICD's can also be used as pacemakers and are a promising treatment option, since they can alter the sequence of the heart muscle contraction thereby relieving the obstruction to the blood flow, making it easier for the heart to pump.

The study will recruit patients who already have an ICD/pacemaker or who are scheduled to have an ICD / pacemaker implanted. For patients who are due to have a device implanted high precision haemodynamic, echocardiographic and electrical measurement techniques will be used to assess whether adjusting the position of the pacing lead (at the time of implant) can bring about changes in LVOT gradient and blood pressure. These patients with a new device and also patients who already have a device in situ will then go on to have atrioventricular delay (AV Delay) optimisation so we can assess what the optimum AV delay should be programmed at in order to bring about the most improvement in LVOT gradient and blood pressure.

Patients will then be recruited into a medium term double blinded randomised crossover study. They will have optimum RV pacing settings turned on for 3 months. They will then return and be crossed over and have optimum RV pacing turned off for a further 3 months. The primary outcome will be to see if optimum RV pacing being turned on is effective in improving symptoms and quality of life.

Publications & conference data

2 peer-reviewed publications reference this trial (live from Europe PMC):

1. High-Precision Hemodynamic and Echocardiographic Assessment of Pacing in Obstructive Hypertrophic Cardiomyopathy.
   Mohal JS, Shun-Shin MJ, Chiew K, Miyazawa AA, et al · · 2025 · cited 2× · PMID 40838531 · DOI 10.1111/pace.70024
2. Electromechanically Optimized Right Ventricular Pacing for Obstructive Hypertrophic Cardiomyopathy: The EMORI-HCM Trial.
   Mohal JS, Whinnett ZI, Mohiddin SA, Malcolmson J, et al · · 2026 · cited 1× · PMID 40892619 · DOI 10.1016/j.jacc.2025.08.050