Actively Recruiting

Phase Not Applicable
Age: 18Years +
All Genders
NCT06833138

Atrioventricular Node Ablation and Conduction System Pacing in Patients With Well Controlled Permanent Atrial Fibrillation (AF), Heart Failure and Preserved Ejection Fraction: Heart Rate Regularization Versus Medical Rate Control

Led by French Cardiology Society · Updated on 2025-09-22

266

Participants Needed

15

Research Sites

224 weeks

Total Duration

On this page

Sponsors

F

French Cardiology Society

Lead Sponsor

M

Medtronic France SAS

Collaborating Sponsor

AI-Summary

What this Trial Is About

The goal of this clinical trial is to assess the clinical efficacy of physiological pacing combined with atrioventricular node ablation, in patients with Heart Failure with preserved Ejection Fraction (HFpEF) and well controlled permanent atrial fibrillation.The main question it aims to answer is that heart rate regularization added to physiological pacing - preventing the deleterious effect of right ventricular apical pacing - would reduce mortality and heart failure hospitalizations. Researchers will compare physiological pacing combined with atrioventricular node ablation (intervention arm) versus optimal pharmacological therapy (control arm) to see if physiological pacing combined with atrioventricular node ablation reduce time to the composite of all-cause mortality or hospitalization due to heart failure or intravenous diuretics (time frame 24 months). Participants will : * Be randomized in intervention arm or control arm. * Visit the clinic 3 months, 12 months and 24 months after the randomization for checkups and tests.

CONDITIONS

Official Title

Atrioventricular Node Ablation and Conduction System Pacing in Patients With Well Controlled Permanent Atrial Fibrillation (AF), Heart Failure and Preserved Ejection Fraction: Heart Rate Regularization Versus Medical Rate Control

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Permanent atrial fibrillation lasting more than 6 months
  • Left Ventricular Ejection Fraction of 50% or higher
  • At least one heart failure hospitalization in the previous year
  • New York Heart Association (NYHA) score of 2 or higher
  • At least one criterion related to diastolic dysfunction: E/e' ratio over 9, or elevated left ventricular mass, or elevated NT pro BNP or BNP levels
  • Narrow QRS duration of 120 ms or less
  • Average heart rate of 110 beats per minute or less on 24-hour Holter monitoring
  • Age over 18 years
  • Ability to understand and give informed consent
  • Coverage by social insurance
  • Effective contraception and negative pregnancy test for women of childbearing age
Not Eligible

You will not qualify if you...

  • Eligible for atrial fibrillation catheter ablation
  • Life expectancy less than 12 months
  • Severe chronic kidney disease with estimated glomerular filtration rate 20 ml/1.73 m2 or less
  • Severe respiratory disease such as severe COPD with Gold stage 3 or higher, or chronic oxygen therapy
  • Class III obesity with body mass index 40 or higher
  • Confirmed or suspected infiltrative cardiomyopathy (e.g., amyloidosis, sarcoidosis, Fabry disease)
  • Obstructive hypertrophic cardiomyopathy
  • Previously implanted cardiac devices such as pacemaker or defibrillator
  • Other indications for pacemaker implantation
  • Indication for implantable cardioverter-defibrillator
  • Being ambulatory less than 50% of the time
  • Pregnant or breastfeeding women

AI-Screening

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Trial Site Locations

Total: 15 locations

1

OLV Aalst

Aalst, Belgium, 9300

Not Yet Recruiting

2

UZ Leuven

Leuven, Belgium, 3000

Not Yet Recruiting

3

Clinique St Pierre Ottignies

Ottignies-Louvain-la-Neuve, Belgium, 1340

Not Yet Recruiting

4

CHRU de Brest - Hôpital de la Cavale Blanche

Brest, France, 29200

Not Yet Recruiting

5

CHRU de Caen

Caen, France, 14000

Not Yet Recruiting

6

CHRU de Tours - Trousseau

Chambray-lès-Tours, France, 37170

Not Yet Recruiting

7

CHU Grenoble Alpes

Grenoble, France, 38043

Not Yet Recruiting

8

Groupe Hospitalier La Rochelle-Ré-Aunis

La Rochelle, France, 17019

Not Yet Recruiting

9

CHRU Lille

Lille, France, 59000

Not Yet Recruiting

10

GHICL Allome - Hôpital St Philibert

Lomme, France, 59462

Not Yet Recruiting

11

Clinique Millenaire

Montpellier, France, 34000

Not Yet Recruiting

12

CHU de Nantes - Hôpital Nord Laennec

Nantes, France, 44093

Not Yet Recruiting

13

CHU de Bordeaux - Hôpital Cardiologique du Haut-Lévèque

Pessac, France, 33604

Not Yet Recruiting

14

CHU Poitiers

Poitiers, France, 86021

Actively Recruiting

15

CHU de Rouen

Rouen, France, 76000

Not Yet Recruiting

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Research Team

T

Tessa BERGOT, MSc

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

SINGLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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