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CABANA: Catheter ablation effectively reduced AF
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American College of Cardiology 59th Annual Scientific Sessions
ATLANTA – Percutaneous left atrial catheter ablation may be more effective at the elimination of atrial fibrillation when compared to anti-arrhythmic therapy, according to new findings presented today.
The CABANA pilot study included 60 patients with recurrent symptomatic AF, two-thirds of whom had persistent or a long-standing AF. Thirty-one patients were randomly treated with either anti-arrhythmic drug therapy (87%) or heart rate drug therapy alone without the elimination of the arrhythmia (13%). The remaining 29 patients were randomly assigned to catheter ablation. The primary study endpoint was a reduction in total mortality. Secondary endpoints included decreases in total mortality, disabling stroke, serious bleeding and MI.
Accoridng to the results, 80% of the cohort had high blood pressure, 18% had diabetes, 35% had coronary artery disease and 36% had mild-to-moderate HF. Almost half had previous left atrial enlargement; 30% were previously assigned anti-arrhythmic therapy. Electrophysiologists created additional linear lesions in problem areas for 13 of 29 patients (45%) assigned to catheter ablation. When compared with antiarrhythmic drug therapy, catheter ablation more effectively prevented recurrent AF, the researchers reported.
Douglas L. Packer, MD, a cardiologist at the Mayo Clinic in Rochester, added that “late recurrent AF may diminish the overall effectiveness of ablation therapy.”
The CABANA pilot study, according to a press release, is one of the first to evaluate the possibility of catheter ablation for patients with advanced AF and underlying CV disease.
“This trial was designed to lay the foundation for a large, randomized controlled trial and establishes the feasibility and importance of conducting an extended pivotal trial critical for establishing long-term outcomes, mortality, quality of life, and cost of ablation and drug therapy for AF,” Packer said during his presentation.
The CABANA study is ongoing and is currently recruiting patients with a final enrollment goal of about 3,000 patients. – by Jennifer Southall
It is very important to mention that the researchers are just getting started. Not surprisingly, the results are much less impressive in terms of the superiority of ablation therapy.
– John Camm, MD
St. George's University of London
For more information:
- Parker DL. LBCTII. Presented at: American College of Cardiology 59th Annual Scientific Sessions; March 13-16, 2010; Atlanta.
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