Arrhythmias & electrophysiologyRandomised controlled trial
Pacemaker-implantation and atrioventricular-node ablation vs pulmonary vein isolation for elderly patients with persistent atrial fibrillation: the ABLATE versus PACE trial
- Randomised controlled trial
- investigator-initiated
- multicentre
- open-label
Authors' conclusion
In elderly patients with persistent AF, PM+AVNA was associated with fewer primary endpoint events than PVI over a 12-month follow-up period.
Study context
- Population
- Patients aged ≥75 years with symptomatic persistent atrial fibrillation (AF) and normal LVEF
- Participants
- 196 patients · 12 centres
- Comparison
- PM+AVNA vs pulmonary-vein isolation (PVI)
- PM+AVNAn = 98
- PVIn = 98reference
- Primary endpoint
- Composite of:
- Hospitalisation for atrial arrhythmia or HF
- Outpatient electrical cardioversion
- Upgrade to CRT for LV dysfunction
- Follow-up
- 12 months
Primary result
As reported in the abstract
Hazard ratio
0.45
95% CI 0.27–0.74
P = 0.002
Events by treatment group
PM+AVNA vs PVI
HR 0.45 (95% CI 0.27–0.74); P = 0.002
Secondary outcomes
| Outcome | PM+AVNA | PVI |
|---|---|---|
| Total primary endpoint events | ||
| AF hospitalisations | 3 | 54 |
| Cardioversions | 1 | 19 |
| HF hospitalisations | 23 | 11 |
Mortality and quality of life
- Not statistically different
Safety
CV complications
- Not statistically different
Original publication
Pacemaker-implantation and atrioventricular-node ablation vs pulmonary vein isolation for elderly patients with persistent atrial fibrillation: the ABLATE versus PACE trial. Eur Heart J. Published 31 August 2026. doi:10.1093/eurheartj/ehag742
Summarised from the published abstract; every number is checked against it