Randomized Study Comparing Left Bundle Branch Area Pacing and Right Ventricular Pacing After AV Node Ablation in Adults With Atrial Fibrillation and Preserved Heart Function

What this Trial Is About

Researchers are evaluating two pacing methodsleft bundle branch area LBBA pacing and right ventricular RV pacingin patients with atrial fibrillation who have preserved left ventricular function. This study aims to compare the effects of these pacing techniques after AV node ablation, focusing on clinical, functional, and electrical heart outcomes. The main question is whether RV pacing causes more pacing-induced cardiomyopathy, defined as a significant decline in heart function, compared to LBBA pacing. Secondary goals include assessing procedural safety, heart function, quality of life, and functional capacity. Participants will undergo either LBBA pacemaker implantation or RV apical pacemaker implantation before AV node ablation. This is a randomized, single-blind trial where patients are assigned to one of these two procedures. Both methods involve device implantation prior to the scheduled AV node ablation, which is performed independently of the study. The study follows patients for 36 months to observe long-term effects and safety. During the study, patients will be monitored for changes in heart function using echocardiography and other clinical assessments. Researchers will measure outcomes such as left and right ventricular function, heart strain, serum biomarkers, quality of life through a validated questionnaire, walking distance, mortality, and rehospitalizations related to heart failure, pacemaker issues, or arrhythmias. Safety outcomes and stroke events will also be tracked. This comprehensive follow-up lasts three years to thoroughly evaluate the impact of the pacing methods.

AV Node Ablation and CONDUCTion System Pacing for Atrial Fibrillation With Preserved Left Ventricular Function