ABACUS: Catheter ablation of AF vs AVNA and CSP in persistent AF & HF

• Research type

  Research Study

• Full title

  Catheter ablation of atrial fibrillation versus atrioventricular nodal ablation with conduction system pacing in persistent atrial fibrillation and heart failure (ABACUS)

• IRAS ID

  346237

• Contact name

  Haran Burri

• Contact email

  haran.burri@hcuge.ch

• Sponsor organisation

  Cardiology Department, University Hospital of Geneva (HUG)

• ISRCTN Number

  ISRCTN65526476

• Clinicaltrials.gov Identifier

  NCT06207383

• Duration of Study in the UK

  4 years, 0 months, 0 days

• Research summary

  Atrial fibrillation (AF) impacts heart function by causing a loss of atrial contractile function, inducing tachycardiomyopathy, and deteriorating the cardiac pump function due to irregular and often short cycles. The coexistence of persistent AF with heart failure (HF) confers an adverse prognosis with an increased risk of hospitalization and death.
  Treatment strategies involve drugs to slow down heart rate or to maintain normal rhythm, catheter intervention to maintain normal rhythm (AF ablation by pulmonary vein isolation), or implantation of a pacemaker with catheter ablation of the atrioventricular node (AVNA) to allow the pacemaker to regulate the heart rate.
  Conduction system pacing (CSP) involves implanting the pacemaker lead directly into the heart's natural electrical conduction system, maintaining a close-to-normal contraction of the heart (which allows preservation of pump function).
  Although different treatment strategies have been evaluated in randomized controlled trials for patients with AF and HF, there are no published studies to date which randomize AF ablation to conduction system pacing(CSP) and atrioventricular nodal ablation (AVNA). To guide future management of these patients, this study compares a strategy of CSP+AVNA versus AF ablation by pulmonary vein isolation (PVI) in patients with persistent AF and HF.

• REC name

  South Central - Hampshire A Research Ethics Committee

• REC reference

  25/SC/0152

• Date of REC Opinion

  18 Jul 2025

• REC opinion

  Further Information Favourable Opinion