Ablation for Abnormalities
March 15th, 2019 marked a big day for the electrophysiology community as the first results for the landmark Catheter Ablation Versus Antiarrhythmic Drug Therapy for Atrial Fibrillation (CABANA) trial were published in JAMA. Atrial fibrillation (AF) is the most common type of arrhythmia. Those with AF often experience a quivering or irregular heartbeat, typically at a fast tempo, and have often been treated with drug therapy to restore the sinus rhythm. Within two papers, the authors, and researchers behind the trial were able to depict improved patient outcomes utilizing catheter ablation rather than existing drug therapies for both quality of life and for reducing recurrent atrial fibrillation. While no difference in the combined endpoint of death, disabling strokes, serious bleeding or cardiac arrest were noted between the ablation and the drug therapy patients (intention to treat), however, both quality of life was improved and recurrent AF was decreased.
“Ablation for atrial fibrillation had previously been shown to be associated with improved quality of life over drug therapy, but those early studies had limited sample sizes and short follow-up durations,” said UW Cardiologist Jeanne Poole, MD who led the research team’s investigation of recurrent arrhythmias Core Lab. Additionally, recurrent AF was reduced regardless of whether the pattern of AF was intermittent, or persistent. As the trial studied over 2,000 patients with an average follow-up duration of over four years, Dr. Poole believes the “CABANA [trial] led by Dr. Douglas Packer at the Mayo clinic, provides extraordinary new data that can help both physicians and patients make better-informed decisions”. The Quality of Life data, led by Dr. Dan Mark at Duke, provides newfound data showed that all patients improved QOL in the trial, though the patients treated with ablation improved more than the drug treatment group using two measures of QOL: the Atrial Fibrillation Effect on Quality of Life (AFEQT) and the Mayo AF-Specific Symptom Inventory (MAFSI).
For more on the results of the trial, check out UW Newsroom’s article on the publication, as well as the full published papers, Effect of Catheter Ablation vs Medical Therapy on Quality of Life Among Patients With Atrial Fibrillation, and Catheter Ablation for Atrial Fibrillation, on the JAMA website.
We thank Dr. Poole for her work on this groundbreaking trial, and are excited for the future of electrophysiology.