Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-125 - Impact Of Atrial Fibrillation Type On The Qol-related Outcomes Of Ablation Versus Medical Therapy In The Cabana Trial (ID 927)


Background: Catheter ablation for atrial fibrillation (AF) is effective in treating patients for all AF subtypes and more favorably impacts quality of life (QOL) than drug therapy. Patients with persistent (Pers) or long-standing persistent (LSP) AF experience higher arrhythmia burden and more coexistent CV comorbidities that may negatively impact their QOL post ablation. Long-term data comparing ablation to drug therapy in relation to underlying AF type and QOL have not been previously evaluated.
Objective: Compare the impact of AF type on QOL outcomes of ablation versus drug therapy in patients with AF.
Methods: The CABANA trial randomized 2204 symptomatic patients with AF to ablation versus drug therapy. Pre-specified QOL end points were collected at baseline, 3, 12, 24, 36, 48 and 60 months using the Atrial Fibrillation Effect on Quality of Life (AFEQT) and the Mayo AF Symptom Inventory (MAFSI) frequency scores.
Results: Of 2203 patients, 946 had paroxysmal (PAF), 1042 had Pers and 215 presented with LSP. There were baseline differences among AF types in age, gender, HTN, LVH, CHF and NYHA Class. Patients with PAF reported higher adjusted AFEQT summary scores compared to those with Pers and LSP AF. The composite mean follow-up AFEQT summary and MAFSI frequency scores were more favorable comparing ablation vs drug therapy (Figure). All AF subtypes reported consistent improved adjusted MAFSI frequency scores with ablation compared to drug therapy. AFEQT results over time across AF subtypes were less consistent.
Conclusion: Ablation was significantly more effective than drug therapy for improving AF symptoms regardless of AF type in CABANA, although benefit was largest in those with PAF.