Long-term outcomes after pace and ablate treatment for permanent atrial fibrillation
Reviews past records of adults treated with pace and ablate for atrial fibrillation.
Plain-language title generated from the registry record
Registry title: Patient Selection and Long-Term Outcomes of Pace & Ablate Strategy in Atrial Fibrillation
Key facts
- Where
- Basel, Bern, and Geneva, SwitzerlandSee the 3 sites
Where in Switzerland
- University Hospital BaselBasel, SwitzerlandTaking people
- Inselspital Universitätsspital BernBern, SwitzerlandTaking people
- Geneva University HospitalsGeneva, SwitzerlandTaking 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
- Insel Gruppe AG, University Hospital Bern
- Trial code
- NCT07852221
- Record updated
- 1 October 2026
- Original description
Atrioventricular node ablation with permanent pacing (the "pace-and-ablate" strategy) controls ventricular rate in atrial fibrillation that has not responded to drug therapy or catheter ablation. Chronic right ventricular pacing, however, can cause pacing-induced cardiomyopathy (PICM), and it is not well established which patients are at risk and should therefore receive conduction system pacing or biventricular pacing instead.Read full original descriptionShow less
Patient Selection and Long-Term Outcomes in Patients With a Pace & Ablate Strategy for Interventional Rate Control in Symptomatic Permanent Atrial Fibrillation - A Retrospective Multicenter Analysis
Atrioventricular node ablation with permanent pacing (the "pace-and-ablate" strategy) controls ventricular rate in atrial fibrillation that has not responded to drug therapy or catheter ablation. Chronic right ventricular pacing, however, can cause pacing-induced cardiomyopathy (PICM), and it is not well established which patients are at risk and should therefore receive conduction system pacing or biventricular pacing instead.
REPACE is a multicentre retrospective cohort of consecutive patients who underwent atrioventricular node ablation from January 2011 onwards at five centres in Switzerland, the United Kingdom and Poland: Liverpool Heart and Chest Hospital, Inselspital Bern, University Hospital Basel, Geneva University Hospitals and the Silesian Centre for Heart Diseases, Zabrze. More than 2,000 patients ablated up to March 2024 have been included to date; patients ablated after that date at the participating centres are being added.
The study has three aims: to validate, in an independent multicentre population, a previously published risk model for pacing-induced cardiomyopathy; to describe the procedural technique and outcomes of atrioventricular node ablation across different health systems; and to estimate the health-economic impact of the pace-and-ablate strategy.
Pacing-induced cardiomyopathy is defined as an absolute reduction in left ventricular ejection fraction of at least 10 percentage points to a value below 50%. All potential endpoints are adjudicated by a clinical events committee blinded to the classification made at the site.
Inclusion: Age 18 years or older at the time of atrioventricular node ablation; Atrial fibrillation, undergoing atrioventricular node ablation with a permanent cardiac implantable electronic device already in situ or implanted as part of the pace-and-ablate strategy; Availability of baseline echocardiographic data, including left ventricular ejection fraction.
Exclusion: Documented refusal of the further use of health-related data; Note: cardiac resynchronisation therapy or conduction system pacing at baseline is not an eligibility exclusion. Such patients are included in the cohort and in the procedural and health-economic analyses, but are excluded from the validation of the pacing-induced cardiomyopathy risk model, in which a decline in left ventricular function would represent non-response to resynchronisation. No lower limit of baseline ejection fraction is applied.