Heart failure & cardiomyopathiesRandomised controlled trial
Cardiac resynchronization therapy with or without atrioventricular node ablation in atrial fibrillation: the CAAN-AF trial
- Randomised controlled trial
- international
- prospective
- multicentre
- early termination for futility
- All participants received device optimization
Authors' conclusion
This randomized trial of patients with permanent AF and CRT-D found no evidence of a reduction in all-cause mortality and nonfatal heart failure events with AVNA compared with MRCT.
Study context
- Population
- Patients with heart failure with reduced ejection fraction (HFrEF), permanent atrial fibrillation (AF) and CRT-defibrillators (CRT-D)
- Participants
- 143 patients
- Comparison
- Atrioventricular node ablation (AVNA) vs medical rate control therapy (MRCT)
- AVNAn = 67
- MRCTn = 76reference
- Primary endpoint
- Composite of:
- All-cause mortality
- Nonfatal HF events
Primary result
As reported in the abstract
All-cause mortality and nonfatal HF events
No significant difference in the primary endpoint; events
47 vs. 46
IRR, primary endpoint
1.16 (95% CI 0.60-2.24)
Secondary outcomes
CV mortality
- OR, no significant difference
- 1.93 (95% CI 0.60-6.20)
Unplanned hospitalizations
- IRR, no significant difference
- 1.01 (95% CI 0.71-1.74)
Ventricular arrhythmias requiring device therapy
- IRR, no significant difference
- 0.68 (95% CI 0.17-2.63)
6MWD and SF-36 scores
- No significant differences
Original publication
Cardiac resynchronization therapy with or without atrioventricular node ablation in atrial fibrillation: the CAAN-AF trial. Eur Heart J. Published 16 April 2026. doi:10.1093/eurheartj/ehag206
Summarised from the published abstract; every number is checked against it