{"id":"056c981f541e","type":"article","url":"https://hartvaat.nl/2020/06/30/af-recidief-na-ablatie-versus-antiaritmica-in-cabana/","title":"AF-recidief na ablatie versus antiaritmica in CABANA","title_en":"Recurrence of Atrial Fibrillation After Catheter Ablation or Antiarrhythmic Drug Therapy in the CABANA Trial.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2020.04.065","source_url":"https://doi.org/10.1016/j.jacc.2020.04.065","authors":["Jeanne E Poole","Tristram D Bahnson","Kristi H Monahan","George Johnson","Hoss Rostami","Adam P Silverstein","Hussein R Al-Khalidi","Yves Rosenberg","Daniel B Mark","Kerry L Lee","Douglas L Packer"],"significance":6,"published":"2020-06-30","source_date":"2020-06-30","image":"","kennis":[],"congress":"","summary_en":"This CABANA analysis characterized patterns of AF recurrence after catheter ablation versus antiarrhythmic drugs, showing that while ablation delays recurrence, the long-term freedom from AF requires ongoing surveillance.","created":"2026-07-03T10:28:38Z","updated":"2026-07-03T13:27:48Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"CABANA analyse naar AF-recidief na katheterablatie versus antiaritmische medicatie.","abstract_original":"BACKGROUND: The CABANA (Catheter Ablation Versus Antiarrhythmic Drug Therapy for Atrial Fibrillation) trial randomized 2,204 patients with atrial fibrillation (AF) to catheter ablation or drug therapy. Analysis by intention-to-treat showed a nonsignificant 14% relative reduction in the primary outcome of death, disabling stroke, serious bleeding, or cardiac arrest. OBJECTIVES: The purpose of this study was to assess recurrence of AF in the CABANA trial. METHODS: The authors prospectively studied CABANA patients using a proprietary electrocardiogram recording monitor for symptom-activated and 24-h AF auto detection. The AF recurrence endpoint was any post-90-day blanking atrial tachyarrhythmias lasting 30 s or longer. Biannual 96-h Holter monitoring was used to assess AF burden. Patients who used the CABANA monitors and provided 90-day post-blanking recordings qualified for this analysis (n = 1,240; 56% of CABANA population). Treatment comparisons were performed using a modified intention-to-treat approach. RESULTS: Median age of the 1,240 patients was 68 years, 34.4% were women, and AF was paroxysmal in 43.0%. Over 60 months of follow-up, first recurrence of any symptomatic or asymptomatic AF (hazard ratio: 0.52; 95% confidence interval: 0.45 to 0.60; p < 0.001) or first symptomatic-only AF (hazard ratio: 0.49; 95% confidence interval: 0.39 to 0.61; p < 0.001) were both significantly reduced in the catheter ablation group. Baseline Holter AF burden in both treatment groups was 48%. At 12 months, AF burden in ablation patients averaged 6.3%, and in drug-therapy patients, 14.4%. AF burden was significantly less in catheter ablation compared with drug-therapy patients across the 5-year follow-up (p < 0.001). These findings were not sensitive to the baseline pattern of AF. CONCLUSIONS: Catheter ablation was effective in reducing recurrence of any AF by 48% and symptomatic AF by 51% compared with drug therapy over 5 years of follow-up. Furthermore, AF burden was also significantly reduced in catheter ablation patients, regardless of their baseline AF type. (Catheter Ablation vs Anti-arrhythmic Drug Therapy for Atrial Fibrillation Trial [CABANA]; NCT00911508)."}