Catheter ablation compared with medicines for atrial fibrillation in older adults
Compares catheter ablation with medicine-based care in older adults with atrial fibrillation.
Plain-language title generated from the registry record
Registry title: Catheter Ablation vs Conservative Care in Elderly Patients With Atrial Fibrillation
Key facts
- Where
- Linköping and Stockholm, SwedenSee the 2 sites
Where in Sweden
- Linkoping University HospitalLinköping, SwedenNot yet recruiting
- Karolinska University HospitalStockholm, SwedenTaking 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
- Karolinska University Hospital
- Trial code
- NCT07424690
- Record updated
- 8 October 2026
- Original description
ACE-AF is a multicenter randomized study in people aged 78 years and older with symptomatic atrial fibrillation (AF). AF is a common heart rhythm disorder in older adults and can cause reduced quality of life and lead to serious complications such as stroke and heart failure.Read full original descriptionShow less
Assessment of the Effect of Catheter Ablation on Elderly Population With Atrial Fibrillation; a Randomized Controlled Study; The ACE-AF Study
ACE-AF is a multicenter randomized study in people aged 78 years and older with symptomatic atrial fibrillation (AF). AF is a common heart rhythm disorder in older adults and can cause reduced quality of life and lead to serious complications such as stroke and heart failure.
The study compares two established treatment strategies:
1. Catheter ablation (an invasive procedure aimed at reducing AF by electrically isolating triggers in the heart, primarily through pulmonary vein isolation), and 2. Optimized medical therapy without AF ablation (medications for rate and/or rhythm control; AV node ablation with pacemaker may be used if clinically indicated according to routine care).
Participants are randomized 1:1 to one of these strategies. All participants will receive an implantable loop recorder (a small heart rhythm monitor placed under the skin) to continuously track heart rhythm and measure AF burden over time.
The study has two primary endpoints, tested with Holm-Bonferroni multiplicity control assessed over 24 months:
1. a composite of major clinical events (all-cause mortality, stroke, major bleeding, cardiac arrest, or hospitalization due to heart failure), and 2. patient-reported health-related quality of life (HRQoL), measured by the RAND-36 "General Health" domain.
ACE-AF will provide evidence to guide treatment decisions for very elderly patients with symptomatic AF and help identify which patients benefit most from an ablation-based strategy compared with optimized medical therapy.
Inclusion: Age ≥78 years; ECG-documented atrial fibrillation; AF type: paroxysmal, persistent, or longstanding persistent AF; Suitable candidate for catheter ablation according to ESC guidelines; Charlson's comorbidity index ≤7.
Exclusion: Left atrial (LA) dimension >55 mm, based on echocardiography within the previous year; Prior surgical or catheter AF ablation procedure, or prior AV-node (atrioventricular nodal) ablation; Acute coronary syndrome or coronary artery bypass surgery within the last 12 weeks; Severe valvular heart disease (per ESC definitions) or congenital heart disease; Medical condition likely to limit survival to <12 months; History of non-compliance with medical therapy; Contraindication to oral anticoagulation; AF due to a reversible cause; Unable or unwilling to provide informed consent; BMI <18 or >37 kg/m².