Trust at the forefront of international heart failure research

Great Western Hospitals NHS Foundation Trust has played a leading global role in a major clinical trial aimed at improving treatment for patients with heart failure. 

The CSPOT study, which opened in 2021, investigated whether a new combination of pacemaker therapies could help the heart beat in a more coordinated and effective way.

The trial focused on patients with heart failure, a common condition that causes breathlessness, tiredness, and reduced ability to perform everyday activities. It is also a significant cause of death in the UK and worldwide.

In recent years, treatment has improved significantly with the use of new medications and pacemakers. The CSPOT study explored whether combining two established therapies, conduction system pacing and cardiac resynchronisation, could lead to even better outcomes for patients.

Conduction system pacing works by improving the speed at which electrical impulses travel around the heart, allowing it to pump more like a healthy heart. Cardiac resynchronisation involves placing three leads in the heart to correct electrical delays, helping it beat more efficiently. The CSPOT trial studied the impact of combining these two approaches in patients with poor heart function.

The Trust was the first site in the world to recruit a patient into the CSPOT study when it launched in 2021 and went on to become one of the top recruiting sites globally, exceeding its local target by 71 percent.

The study concluded in 2023/24, with patients showing measurable improvements in heart function and electrical activation. Many also reported reduced symptoms and better quality of life compared to standard pacing treatments. The improvement in heart function was much greater than typically seen with conventional methods.

The success of the trial was made possible by the dedication of the hospital’s research and cardiology teams, the support of scientific partners at Medtronic, and the willingness of patients to participate in this advanced study.

Pictured alongside the success of the CSPOT trial are Principal Investigator and Consultant Cardiologist Dr Paul Foley and Clinical Research Assistant Joe Stevens, who were instrumental in delivering the study at the Trust.

This achievement reflects the broader impact of the Research and Innovation team at the Trust. Over the past few months, from January 2025 to March 2025, the team has seen a high level of research activity, with 270 new participants recruited across 115 active clinical studies and the launch of 11 new studies. These include research led by local principal investigators in specialties such as cardiology, anaesthetics, paediatrics, rheumatology, trauma and orthopaedics, sexual health, and the emergency department.

The CSPOT trial is just one example of how clinical research at the Trust is making a real difference locally, nationally, and globally.