Surgery no better than medication at preventing serious complications of AF
Two new papers in the Journal of the American Medical Association discuss the effects of catheter ablation vs. drug therapy in the treatment of patients with atrial fibrillation. The articles report the outcomes of the Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation (CABANA) trial.
From November 2009 to April 2016, the trial enrolled more than 2,200 patients at sites across the United States, Canada, Europe, and Asia. Approximately one-half of the patients were randomized to the ablation procedure, while the others were assigned to drug therapy, though they could opt for ablation if their symptoms could not be controlled. Ultimately, about 27% of the drug therapy patients also ended up receiving ablation. After a median follow-up period of 48.5 months, the researchers concluded that catheter ablation appeared to be no more effective than drug therapies in preventing strokes, deaths, and other complications in patients with atrial fibrillation.
They noted, however, that ablation patient had greater symptom relief and long-term improvements in the quality life, compared with the drug therapy-only recipients. Douglas L. Packer, MD, a cardiologist and professor of medicine at Mayo Clinic, in Rochester, MN, and the study"s principal investigator, said: "When we examined the data according to the treatment actually received, the ablation group had significantly lower rates of death as well as the combination of death, disabling stroke, serious bleeding, or cardiac arrest compared with patients who only received drug therapy."
Source : NIH News Release (03/15/19)
ESC TV at EHRA 2019. Professor Joseph Kautzner summarized two points about fibrillation ablation session at EHRA 2019
1. Whether to continue anticoagulation drugs after ablation
2. Recommendations of CABANA Trial (Catheter ABlation vs Antiarrhythmic Drug Therapy in Atrial Fibrillation)