Catheter Ablation of Atrial Fibrillation Versus Atrioventricular Nodal Ablation with Conduction System Pacing in Persistent Atrial Fibrillation and Heart Failure

What this Trial Is About

Researchers are comparing two treatment strategies for patients aged 60 and older with persistent atrial fibrillation and heart failure who are eligible for atrial fibrillation ablation. The study aims to evaluate whether conduction system pacing combined with atrioventricular nodal ablation CSPAVNA is better or as effective as atrial fibrillation ablation by pulmonary vein isolation PVI in reducing mortality and hospitalizations. This prospective, randomized, open-label trial is conducted in multiple centers across Europe and plans to enroll 220 participants over four years. Participants will be randomly assigned to one of two groups. One group will undergo catheter ablation of atrial fibrillation, including pulmonary vein isolation using techniques chosen by the investigator. The other group will receive conduction system pacing, either His bundle pacing or left bundle branch area pacing, combined with catheter ablation of the atrioventricular node. Both interventions are conducted as procedures with specialized devices and catheter techniques. During the study, participants will be monitored for up to four years with evaluations including quality of life assessments, heart function measurements such as left ventricular ejection fraction, and tracking of complications and heart failure class. Researchers will assess mortality, cardiovascular and heart failure hospitalizations, and cost-effectiveness of the treatments. The study involves regular follow-up visits to gather clinical data and monitor health status.

Atrial Fibrillation Ablation Versus Atrioventricular Nodal Ablation with Conduction System Pacing in Heart Failure