Cardiac Resynchronisation Therapy and AV Nodal Ablation Trial in Atrial Fibrillation Patients (CAAN-AF)

Launched by UNIVERSITY OF ADELAIDE · Jan 27, 2012

Keywords

ClinConnect Summary

Background: Cardiac Resynchronization Therapy (CRT) is an established treatment in heart failure (HF) patients with ventricular dyssynchrony who remain in sinus rhythm. Available clinical data has shown inferior outcomes of CRT in HF patients with co-existent atrial fibrillation (AF), who comprise up to 27% of HF patients, and are over-represented in advanced HF classes. We hypothesize, based on the results of a systematic review we recently published in the Journal of the American College of Cardiology, that AV nodal ablation may improve survival, heart failure and functional outcomes in C...

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Eligibility criteria

• Inclusion Criteria:
• • Age ≥ 18 years old
• • Persistent (≥ 1 month) or permanent atrial fibrillation. Persistent AF will be where obtaining and maintaining sinus rhythm is deemed either not worthwhile, or to be ineffective in the long term, or where both the patient and physician accept the presence of AF, where rhythm control intervention is, by definition no longer pursued. Permanent AF is defined as atrial fibrillation where sinus rhythm cannot be restored.
• • NYHA class II , III or ambulatory class IV heart failure
• • Left Ventricular Ejection Fraction (LVEF) ≤ 35% by objective criteria such as echocardiography, or cardiac MRI
• • QRS duration on 12-lead ECG ≥ 120ms
• • Able and willing to comply with all pre-, post- and follow-up testing and requirements.
• Exclusion Criteria:
• • age \< 18 years
• • pregnancy
• • previous AV nodal ablation
• • Second or third degree AV block
• • Inability to provide informed consent
• • life expectancy less than 24 months due to co-morbid illness other than heart failure erg cancer, end-stage renal disease, liver failure
• • Paroxysmal Atrial Fibrillation that self terminates within 7 days