Cardiac resynchronization therapy with or without atrioventricular node ablation in atrial fibrillation: the CAAN-AF trial

European Heart Journal 2026 Open access

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Authors: P Sanders, Jonathan P. Ariyaratnam, Martin K. Stiles, Alexis Puvrez, Stephen J Nicholls, Walter P. Abhayaratna, Mark J. Perrin, J. Alison, Rajeev K. Pathak, Anand N. Ganesan, Vincent Paul, Stuart P Thomas
+31 more Gijo Thomas, Melissa E. Middeldorp, Elnaz Shahmohamadi, A Elliott, Robert Park, Haris M. Haqqani, Dean Boddington, Peter M. Kistler, Paul Martin, Raymond W Sy, Stephan Willems, Paul Stobie, Matthew Webber, Gerald Kaye, P. MacIntyre, Bobby John, Daniel Steven, Azlan Hussin, Suresh Singarayar, David Whalley, David O’Donnell, Nigel Lever, Rajiv Mahajan, Daniel Ninio, John Amerena, Adrian Esterman, D Chew, Matthew Worthley, AM Tonkin, Carmine Pasquale Cerrato, Jonathan M. Kalman
DOI: 10.1093/eurheartj/ehag206
Cited by: 3
References: 29

Abstract

BACKGROUND AND AIMS: Patients with heart failure with reduced ejection fraction (HFrEF) derive less benefit from cardiac resynchronization therapy (CRT) if they have coexisting atrial fibrillation (AF). Observational data suggest that atrioventricular node ablation (AVNA) may enhance CRT efficacy in this population. This trial aimed to evaluate the effect of AVNA compared with medical rate control therapy (MRCT) on CRT outcomes in patients with HFrEF and permanent AF. METHODS: The CAAN-AF trial was an international, prospective, multicentre, randomized controlled trial evaluating the impact of AVNA in patients with HFrEF, permanent AF, and CRT-defibrillators (CRT-D). Participants were randomly assigned (1:1) to AVNA or MRCT targeting a resting heart rate

Fields of Study & Subjects

Cardiac pacing and defibrillation studies Cardiac Arrhythmias and Treatments Atrial Fibrillation Management and Outcomes

Publication details

Journal / source
European Heart Journal
Publisher
Oxford University Press (OUP)
Volume
47
Issue
36
Pages
5128-5138
Publication date
2 April 2026
Language
EN