Treating Atrial Fibrillation in Heart Failure With Preserved Ejection Fraction: Ablation or Medication
Key facts
- Where
- Halifax, Hamilton, London, and Montreal, CanadaSee the 4 sites
Where in Canada
- QEII HSCHalifax, CanadaTaking people
- Hamilton Health SciencesHamilton, CanadaTaking people
- London Health Sciences CentreLondon, CanadaTaking people
- Montreal Heart InstituteMontreal, CanadaTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Nova Scotia Health Authority
- Trial code
- NCT07272902
- Record updated
- 20 October 2026
- Original description
This study is testing two different ways of treating atrial fibrillation (AF) in people who also have heart failure with mildly reduced or preserved heart function. Patients will randomly be assigned to either rhythm control using catheter ablation or rate control using medicines. The pilot phase will determine if a larger study can be successfully carried out to see which approach better improves survival, reduces hospitalizations, and enhances quality of life.Read full original descriptionShow less
A Randomized Ablation-based Atrial Fibrillation Rhythm Control Versus Rate Control Trial in Patients With Heart Failure and Preserved Ejection Fraction (CABANA-RAFT HF): A Pilot Study
This study is testing two different ways of treating atrial fibrillation (AF) in people who also have heart failure with mildly reduced or preserved heart function. Patients will randomly be assigned to either rhythm control using catheter ablation or rate control using medicines. The pilot phase will determine if a larger study can be successfully carried out to see which approach better improves survival, reduces hospitalizations, and enhances quality of life.
Inclusion: Age ≥18 years; Diagnosis of atrial fibrillation (documented on Holter, rhythm strip, or ECG); New York Heart Association (NYHA) class II-III heart failure; Left ventricular ejection fraction (LVEF) >40%; Meet specific NT-proBNP criteria:; If HF hospitalization within 6 months prior to screening: NT-proBNP >200 pg/ml (if not in AF at screening) or >600 pg/ml (if in AF at screening); Otherwise: NT-proBNP >300 pg/ml (if not in AF at screening) or >900 pg/ml (if in AF at screening); On stable guideline-directed medical therapy for ≥1 month; On stable diuretic dose for ≥2 weeks; Suitable for either ablation-based rhythm control or rate control strategy.
Exclusion: Prior catheter ablation for atrial fibrillation; NYHA class IV heart failure; Rheumatic heart disease; Renal failure requiring dialysis; Complex congenital heart disease; Untreated thyroid disease; Acute coronary syndrome or coronary artery bypass surgery within 12 weeks; Other serious non-cardiovascular condition with life expectancy ≤1 year; Age <18 years; Permanent atrial fibrillation diagnosis; Moderate or severe mitral stenosis; Mechanical mitral valve; Severe aortic stenosis or severe aortic/mitral regurgitation; Contraindication to oral anticoagulation; Infiltrative cardiomyopathies; Participation in another clinical trial; Inability to provide informed consent.