Atrioventricular Nodal Ablation Versus Pulmonary Vein Isolation - Patient Centred Decisions

NCT ID: NCT07059208

Last Updated: 2025-07-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

172 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-30

Study Completion Date

2031-09-30

Brief Summary

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The goal of this clinical trial is to compare two procedural approaches to managing atrial fibrillation. The main questions it aims to answer are:

Is AF ablation or pacemaker implant and AV nodal ablation a more effective treatment approach for patients with atrial fibrillation refractory to pharmacological treatment?

What effect do these differing treatment approaches have on patient's quality of life and mental health?

Participants will:

Be randomly allocated to one of the treatment approaches. Visit the clinic 2 months, 12 months and 24 months after their procedure for a checkup, questionnaires and repeat heart ultrasounds.

Detailed Description

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The goal of this trial is to compare the effectiveness and safety of pulmonary vein isolation compared with pacemaker implant and atrioventricular nodal ablation for patients with atrial fibrillation.

Patients who have been refractory to attempts at symptom control with pharmacological therapy will be eligible and will be randomised to one of the two approaches.

The primary outcome will be all cause rehospitalisation with secondary outcomes including procedural complications, echocardiographic measurements, patient reported outcomes, all cause mortality and rehospitalisation due to cardiovascular causes. These will be assessed over the 2 years following the index procedure.

The patient reported outcome measures will be the EQ5D, AF Effect on Quality of life score (AFEQT), Hospital anxiety and depression score (HADS) and Somatosensory amplification scale.

Conditions

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Atrial Fibrillation (AF)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Pulmonary vein isolation

Patients randomised to this arm would undergo catheter ablation targeted at achieving pulmonary vein isolation

Group Type ACTIVE_COMPARATOR

Pulmonary vein isolation

Intervention Type PROCEDURE

Patients randomised to this arm would undergo catheter ablation targeted at achieving pulmonary vein isolation

Pacemaker implant and atrioventricular nodal ablation

Patients randomised to this arm would undergo physiological pacing followed by atrioventricular nodal ablation

Group Type ACTIVE_COMPARATOR

Atrioventricular nodal ablation

Intervention Type PROCEDURE

Patients randomised to this arm would undergo physiological pacing followed by atrioventricular nodal ablation

Interventions

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Atrioventricular nodal ablation

Patients randomised to this arm would undergo physiological pacing followed by atrioventricular nodal ablation

Intervention Type PROCEDURE

Pulmonary vein isolation

Patients randomised to this arm would undergo catheter ablation targeted at achieving pulmonary vein isolation

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age greater than 65 years for patients with persistent atrial fibrillation or greater than 75 years for patients with paroxysmal atrial fibrillation.
* Unsuccessful trial of at least one pharmacological rate or rhythm control medication. This includes patients with medication refractory AF and/or intolerance to the medication(s).
* A resting ECG demonstrating AF with ventricular response rate \>70bpm on a pharmacological rate control medication, or \>90bpm while not on rate control medication.

Exclusion Criteria

* Previous pulmomary vein isolation, left atrial flutter ablation or atrioventricular node ablation.
* BMI \>40.
* Not suitable for pulmonary vein isolation and/or pacemaker implant on clinical grounds.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sunshine Coast Hospital and Health Service

OTHER

Sponsor Role lead

Responsible Party

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Matthew Tung

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Matthew Tung, MBBS

Role: CONTACT

+61752020000

Other Identifiers

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AVENUE PACE

Identifier Type: -

Identifier Source: org_study_id

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