ArticleESC heart failure2023
Conduction system pacing and atrioventricular node ablation in heart failure: The PACE-FIB study design.
Article in ESC heart failure, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 13 citations in OpenAlex.
- Cardiac implantable electronic devices in heart failure: needs, challenges, and real-world implementation.Heart failure reviews · 2026Review
- Procedural Management of Atrial Fibrillation in Older Patients.Reviews in cardiovascular medicine · 2026Review
- Preserved Ejection, Lost Rhythm: A Narrative Review of the Pathophysiology and Management of Heart Failure with Preserved Ejection Fraction and Concomitant Atrial Fibrillation.Journal of clinical medicine · 2026Review
- Left bundle branch area pacing prevails over His bundle pacing for heart failure patients undergoing atrioventricular node ablation in permanent atrial fibrillation: a network meta-analysis.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Review
- The Critical Role of Comorbidities in Managing Heart Failure with Preserved Ejection Fraction (HFpEF).ESC heart failure · 2025Article
- European Society of Cardiology (ESC) clinical consensus statement on indications for conduction system pacing, with special contribution of the European Heart Rhythm Association of the ESC and endorsed by the Asia Pacific Heart Rhythm Society, the Canadian Heart Rhythm Society, the Heart Rhythm Society, and the Latin American Heart Rhythm Society.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Transition to Advanced Heart Failure: From Identification to Improving Prognosis.Journal of cardiovascular development and disease · 2025Review
- Determining Good Candidates for Atrioventricular Junction Ablation and Device Therapy and Which Device to Implant.Arrhythmia & electrophysiology review · 2025Review
- Atrioventricular node ablation for atrial fibrillation in the era of conduction system pacing.European heart journal · 2024Review
- Review
- Is conduction system pacing a panacea for pacemaker therapy?Expert review of medical devices · 2024Review
- Conduction system pacing and atrioventricular node ablation in heart failure: The PACE-FIB study design.ESC heart failure · 2023Article
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 2 countries.
Funding
Abstract
aimsAtrial fibrillation (AF) worsens the prognosis of patients with heart failure (HF). Successful treatments are still very scarce for those with permanent AF and preserved (HFpEF) or mildly reduced (HFmrEF) ejection fraction. In this study, the long-term benefits and safety profile of heart rate regularization through left-bundle branch pacing (LBBP) and atrioventricular node ablation (AVNA) will be explored in comparison with pharmacological rate-control strategy. METHODS AND
resultsThe PACE-FIB trial is a multicentre, prospective, open-label, randomized (1:1) clinical study that will take place between March 2022 and February 2027. A total of 334 patients with HFpEF/HFmrEF and permanent AF will receive either LBBP followed by AVNA (intervention arm) or optimal pharmacological treatment for heart rate control according to European guideline recommendations (control arm). All patients will be followed up for a minimum of 36 months. The primary outcome measure will be the composite of all-cause mortality, HF hospitalization, and worsening HF at 36 months. Other secondary efficacy and safety outcome measures such as echocardiographic parameters, functional status, and treatment-related adverse events, among others, will be analysed too.
conclusionLBBP is a promising stimulation mode that may foster the clinical benefit of heart rate regularization through AV node ablation compared with pharmacological rate control. This is the first randomized trial specifically addressing the long-term efficacy and safety of this pace-and-ablate strategy in patients with HFpEF/HFmrEF and permanent AF.
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