A randomized controlled trial of atrioventricular junction ablation and cardiac resynchronization therapy in patients with permanent atrial fibrillation and narrow QRS

European Heart Journal · RCT. Narrow-QRS permanent AF: ablation plus CRT beats rate-control drugs, 20% vs 38% A randomized controlled trial of atrioventricular junction ablation and cardiac resynchronization therapy in patients with permanent atrial fibrillation and narrow QRS 102 patients: Permanent AF, narrow QRS, prior HF hospitalization. Followed for median 16 months: AV ablation plus CRT vs Rate-control drugs. HR 0.38 (95% CI 0.18–0.81), P=0.013. Fewer HF deaths, hospitalizations or worsening HF. 36% relative reduction: Less AF symptoms and physical limitation at 1 year. Bottom line: First RCT evidence: ablation plus CRT may be preferred over drugs alone.