{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:54:34Z","timestamp":1790744074896,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Catheter ablation is an established rhythm\u2010control strategy for atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF), while atrioventricular node ablation with cardiac resynchronization therapy (AVNA+CRT) is often used in older patients with advanced disease when durable rhythm control is less feasible. Comparative long\u2010term outcomes remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the TriNetX Research Network, we identified adults with HFrEF and AF from 2016 who underwent AF ablation or AVNA+CRT from 2016\u20132023 and 2016\u20132020 for the 2\u2010 and 5\u2010year analysis, respectively. Propensity score matching was performed separately using 58 prespecified covariates. Outcomes included embolic events (stroke\/systemic embolism), all\u2010cause mortality, heart failure (HF) hospitalization, and heart transplant\/left ventricular assist device (LVAD) implantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 2\u2010year cohort included 16,276 patients (2899 AVNA+CRT; 13,377 AF ablation); the 5\u2010year cohort included 7370 patients (1463 AVNA+CRT; 5907 AF Ablation). After matching, AVNA+CRT was associated with higher all\u2010cause mortality (RR 1.580, 95% CI 1.389\u20131.799), HF hospitalization (RR 1.106, 95% CI 1.040\u20131.176), and heart transplant\/LVAD implantation (RR 2.381, 95% CI 1.142\u20134.975), with no difference in embolic events at 2 years. At 5 years, AVNA+CRT remained associated with higher mortality (RR 1.350, 95% CI 1.198\u20131.522;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), while HF hospitalization, embolic events, and heart transplant\/LVAD implantation did not differ significantly.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a large propensity matched HFrEF\u2010AF cohort, AVNA+CRT was associated with higher mortality at 2 and 5 years than AF ablation, with excess HF hospitalization and transplant\/LVAD at 2 years, whereas HF hospitalization rates were similar at 5 years. Prospective studies are needed to refine patient selection in older, medically complex patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70423","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:55:12Z","timestamp":1790740512000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Outcomes of AV Node Ablation Plus CRT Compared to AF Catheter Ablation in Patients With AF and HFrEF"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5686-8819","authenticated-orcid":false,"given":"Abhiram","family":"Challa","sequence":"first","affiliation":[{"name":"Department of Cardiology Heart and Vascular Institute West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sittinun","family":"Thangjui","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart and Vascular Institute West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amro","family":"Taha","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart and Vascular Institute West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsh","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Medicine Geetanjali Medical College and Hospital  Udaipur Rajasthan India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tejasri","family":"Polana","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart and Vascular Institute West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Het","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Willis\u2010Knighton Health System  Shreveport Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saim","family":"Rana","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart and Vascular Institute West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angkawipa","family":"Trongtorsak","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natee","family":"Deepan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Schwartzman","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart and Vascular Institute West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart and Vascular Institute West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.018614"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.821306"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0735\u20101097(98)00297\u20106"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl\u20102019\u2010316219"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/HAE.0000000000000078"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv513"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12872\u2010023\u201003375\u20109"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.03.005"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccl.2019.01.002"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.04.093"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.033897"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2017.02.050"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1707855"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2306037"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae656"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735\u20101097(03)00338\u20103"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200103223441202"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1388\u20109842(00)00113\u20106"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab569"},{"key":"e_1_2_15_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013168"},{"key":"e_1_2_15_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.08.017"},{"key":"e_1_2_15_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.019406"},{"key":"e_1_2_15_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.113.000806"},{"key":"e_1_2_15_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehag206"},{"key":"e_1_2_15_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0708234"},{"key":"e_1_2_15_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_2_15_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hroo.2021.09.003"},{"key":"e_1_2_15_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2025.05.021"}],"container-title":["Pacing and Clinical Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.70423","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pace.70423","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.70423","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:55:13Z","timestamp":1790740513000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pace.70423"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":28,"alternative-id":["10.1111\/pace.70423"],"URL":"https:\/\/doi.org\/10.1111\/pace.70423","archive":["Portico"],"relation":{},"ISSN":["0147-8389","1540-8159"],"issn-type":[{"value":"0147-8389","type":"print"},{"value":"1540-8159","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"assertion":[{"value":"2026-05-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"pace.70423"}}