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Catheter-based ablation to improve outcomes in patients with atrial fibrillation and heart failure with preserved ejection fraction: rationale and design of the CABA-HFPEF-DZHK27 trial

Aims Atrial fibrillation (AF) is common in heart failure (HF) and negatively impacts outcomes. The role of ablation-based rhythm control in patients with AF and HF with preserved (HFpEF) or mildly reduced ejection fraction (HFmrEF) is not known. The CABA-HFPEF-DZHK27 (CAtheter-Based Ablation of atri...

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Main Authors: Parwani, Abdul Shokor (Author) , Kääb, Stefan (Author) , Friede, Tim (Author) , Tilz, Roland Richard (Author) , Bauersachs, Johann (Author) , Frey, Norbert (Author) , Hindricks, Gerhard (Author) , Lewalter, Thorsten (Author) , Rienstra, Michiel (Author) , Rillig, Andreas (Author) , Scherr, Daniel (Author) , Steven, Daniel (Author) , Kirchhof, Paulus (Author) , Pieske, Burkert (Author)
Format: Article (Journal)
Language:English
Published: October 2024
In: European journal of heart failure
Year: 2024, Volume: 26, Issue: 10, Pages: 2203-2212
ISSN:1879-0844
DOI:10.1002/ejhf.3373
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1002/ejhf.3373
Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.3373
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Author Notes:Abdul S. Parwani, Stefan Kääb, Tim Friede, Roland Richard Tilz, Johann Bauersachs, Norbert Frey, Gerhard Hindricks, Thorsten Lewalter, Michiel Rienstra, Andreas Rillig, Daniel Scherr, Daniel Steven, Paulus Kirchhof, and Burkert Pieske
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Summary:Aims Atrial fibrillation (AF) is common in heart failure (HF) and negatively impacts outcomes. The role of ablation-based rhythm control in patients with AF and HF with preserved (HFpEF) or mildly reduced ejection fraction (HFmrEF) is not known. The CABA-HFPEF-DZHK27 (CAtheter-Based Ablation of atrial fibrillation compared to conventional treatment in patients with Heart Failure with Preserved Ejection Fraction) trial will determine whether early catheter ablation for AF can prevent adverse cardiovascular outcomes in patients with HFpEF or HFmrEF. Methods CABA-HFPEF-DZHK27 (NCT05508256) is an investigator-initiated, prospective, randomized, open, interventional multicentre strategy trial with blinded outcome assessment. Approximately 1548 patients with paroxysmal or persistent AF diagnosed within 24 months prior to enrolment and HFpEF or HFmrEF will be randomized to early catheter ablation within 4 weeks after randomization or to usual care. All patients receive anticoagulation, rate control, and HF management according to current guideline recommendations. Usual care can include rhythm control in symptomatic patients. Patients will be followed until the end of the trial for the primary outcome, a composite of cardiovascular death, stroke, and total unplanned hospitalizations for HF or acute coronary syndrome. The safety outcome comprises complications of catheter ablation and death. The trial is powered for a rate ratio of 0.75 (two-sided alpha = 0.05, 1-beta = 0.8). Conclusion CABA-HFPEF-DZHK27 will define the role of systematic and early catheter ablation in patients with AF and HFpEF or HFmrEF.
Item Description:Gesehen am 22.05.2025
Physical Description:Online Resource
ISSN:1879-0844
DOI:10.1002/ejhf.3373

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