Stroke and mortality risk after atrial fibrillation ablation: lesson from the CABANA trial

Abstract The CABANA trial is a randomized controlled study comparing catheter ablation vs. conventional medical therapy in atrial fibrillation (AF) patients. The results of the study showed that catheter ablation did not have a significant reduction of strokes, deaths, serious bleeding, or cardiac arrest compared to medical therapy. However, a significant improvement in AF recurrences, quality of life, and symptom relief has been shown after catheter ablation compared to drug therapy. The mixed results of the study emphasized an active controversy in the cardiology community on the interpretation of the data and their use in current clinical practice. In this review, we summarized the principal controversy points of the trial describing the strengths and weaknesses of the study design and analysis.

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Preventive counseling with subsequent remote support does not further improve the quality of life after catheter ablation of atrial fibrillation

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.352 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

N Pogosova ◽

AI Ovchinnikova ◽

YM Yufereva ◽

OY Sokolova ◽

KV Davtyan ◽

...

Keyword(s):

Quality Of Life ◽

Atrial Fibrillation ◽

Catheter Ablation ◽

Physical Health ◽

Intervention Group ◽

Controlled Study ◽

Control Group ◽

Preventive Counseling ◽

Integral Component

Abstract Funding Acknowledgements Type of funding sources: None. Background Atrial fibrillation (AF) is associated with substantially reduced quality of life (QoL). Both catheter ablation (CA) and education have a potential to improve QoL in AF patients (pts). Purpose To assess the impact of preventive counseling with long-term support on QoL in pts after CA performed for paroxysmal AF. Methods A prospective randomized controlled study with 2 parallel groups of pts with paroxysmal AF after CA (radiofrequency or cryoablation). Pts were randomized (1:1) into 2 groups. Before discharge, both groups received 1 preventive counseling session with focus on their individual risk factors profile. After discharge pts from intervention group received biweekly preventive counseling via email for 3 months (6 sessions). Control group received usual care. QoL was assessed at baseline and at 12 months using SF-36 questionnaire. Results A total of 90 pts aged 35 to 80 years were enrolled (mean age, 57.4 ± 9.9 years, men, 52.2%). Both groups had a poor QoL at baseline, and both groups experienced improvement in the physical health component at 1 year, but the degree of this improvement in the intervention group was similar to the control (table). Conclusions Preventive counseling with remote support via email does not further improve QoL in AF pts after CA. Intervention group Control group P Integral component of physical health Baseline (points) mean ± SD 44.1 ± 7.9 40.2 ± 8.7 0.028 Mе (25%; 75%) 44.5 (38.7; 50.1) 38.6 (34.4; 47.1) At 12 months (points) mean ± SD 49.4 ± 6.0* 45.7 ± 7.7* 0.010 Ме (25%; 75%) 51.0 (45.2; 53.9) 46.3 (42.4; 50.6) Δ% after 12 months, Ме (25%; 75%) 11.8 (1.4; 32.7) 18.7 (-0.3; 30.4) n/s Integral component of mental health Baseline (points) mean ± SD 46.1 ± 9.0 45.0 ± 8.4 n/s Mе (25%; 75%) 47.8 (39.1; 53.9) 48.0 (37.2; 52.0) At 12 months (points) mean ± SD 48.2 ± 8.1 46.8 ± 8.7 n/s Ме (25%; 75%) 50.1 (46.1; 53.6) 48.0 (41.0; 54.3) Δ% after 12 months, Ме (25%; 75%) 3.6 (-10.8; 32.6) 8.9 (-15.6; 30.8) n/s * p <0.001 vs baseline

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