# AF-recidief na ablatie versus antiaritmica in CABANA

*geplaatst 2020-06-30 · Atriumfibrilleren · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2020.04.065 · https://hartvaat.nl/2020/06/30/af-recidief-na-ablatie-versus-antiaritmica-in-cabana/*

CABANA analyse naar AF-recidief na katheterablatie versus antiaritmische medicatie.

## English: Recurrence of Atrial Fibrillation After Catheter Ablation or Antiarrhythmic Drug Therapy in the CABANA Trial.

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.

## Abstract (original, from the publication)

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).

Auteurs: 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

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2020.04.065. Bijgewerkt 2026-07-03T13:27:48Z. 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.