Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-127 - Outcomes Among Racial And Ethnic Minorities Treated With Ablation Versus Medical Therapy In The Cabana Trial (ID 333)


Background: There are limited data on long-term treatment effect of ablation versus antiarrhythmic drug therapy in patients with AF as a function of race and ethnicity.
Objective: To assess outcomes of ablation versus drug therapy among North American Racial and Ethnic Minorities in the CABANA trial.
Methods: The CABANA trial randomized 2204 symptomatic patients with AF to ablation versus drug therapy with rate or rhythm control drugs. Race and ethnicity were determined by site investigators in conjunction with participants using pre-specified categories. Primary endpoint was a composite of death, disabling stroke, serious bleeding, or cardiac arrest. Comparisons were performed by intention-to-treat using Cox regression model. Racial and ethnic groups were categorized as minority (non-white race or Hispanic ethnicity) and non-minority.
Results: Of 1280 patients in this analysis, 146 were racial and ethnic minorities, 72/649(11.1%) in the ablation group and 74/631(11.7%) in the drug therapy group. Racial and ethnic minorities relative to non-minorities were younger, had more symptomatic HF, fewer prior cardioversions, and were more likely to have a history of hypertension, HF, and HFpEF. Among racial and ethnic minorities, the primary event occurred more frequently in the drug therapy vs. ablation group (HR 0.33, 95% CI 0.14 to 0.78) over median follow-up of 48.5 months. This difference was not seen in the non-minority subgroup. (see Figure).
Conclusion: Racial and ethnic minorities with AF treated with catheter ablation had better outcomes compared with those treated with anti-arrhythmic drug therapy.