October 14, 2019 – Mixed results from the CABANA trial have led to debate about whether catheter ablation is an effective treatment option that provides benefit to patients with atrial fibrillation.
A Cardiology Today cover story published online today discussing results from the CABANA trial includes perspectives from several atrial fibrillation (AF) experts across the U.S., including the DCRI’s Jonathan Piccini, MD, MHS.
The CABANA trial, which compared catheter ablation with drug therapy treatment to evaluate which option is better for patients with AF, culminated in inconclusive results. When compared with drug therapy, catheter ablation did not significantly reduce the risk of the primary endpoint, which included death, stroke, cardiac arrest, or major bleeding. The catheter ablation group did see lower all-cause mortality, but these results were not statistically significant. However, when examining the secondary endpoints for the study, the catheter ablation group had lower rates of death, cardiovascular hospitalization, and AF recurrence.
These mixed results have led to debate among clinicians about whether catheter ablation is an effective treatment option that provides benefit for patients with AF. In a conversation with Cardiology Today, Piccini said the results call for further studies in this area. “There are a lot of important findings from CABANA that have great relevance to our patients with AF,” he told Cardiology Today. “There are also some important findings that require further investigation.”
Many of the experts cited in the cover story emphasized that treatment for AF should not be approached with a one-size-fits-all mindset; instead, clinicians should take into account the patient’s goals and explain their options so the patient can help make an informed decision. For example, relatively young patients with minimal heart disease may be good candidates for catheter ablation, as the procedure can be helpful for symptom reduction.
Piccini suggests that catheter ablation should be considered when drug therapy fails, and for a small minority of patients who are concerned about the safety of taking antiarrhythmic drugs long-term.
To read more insights from Piccini and other AF experts, read the Cardiology Today story.