AF Ablation Misses Primary Endpoint to Reduce Morbidity and Mortality

Atrial fibrillation (AF) is common, with symptoms varying from disabling to asymptomatic. AF ablation decreases episodes of AF and improves quality of life, but does it reduce disabling strokes, major bleeding, cardiac arrest, and mortality? These constituted the primary composite endpoint of the partially industry-funded, controlled CABANA trial (NCT00911508), which enrolled 2204 patients either aged >65 or aged ≤65 with a CHA₂DS₂-VASc score of at least 1.

Participants were typical of AF patients (median age, 68; women, 37%; paroxysmal AF, 43%; persistent AF, 57%; median CHA₂DS₂-VASc score, 3.0). Of the 1108 randomized to catheter ablation, 91% received the intervention. Of the 1096 randomized to medical therapy, 27% crossed over to cathete…