Arrhythmias & electrophysiologyRandomised controlled trial
Atrial Fibrillation Catheter Ablation vs Medical Therapy and Psychological Distress
- Randomised controlled trial
- 2 atrial fibrillation (AF) centres in Australia
Authors' conclusion
In this trial of participants with symptomatic AF, improvement in psychological symptoms of anxiety and depression was observed with catheter ablation, but not medical therapy.
Study context
- Population
- Symptomatic AF, Australia, June 2018–March 2021
- Participants
- 100 participants
- Comparison
- AF catheter ablation vs medical therapy
- Ablationn = 52
- Medical therapyn = 48reference
- Primary endpoint
- HADS score
- Follow-up
- 12 months
Primary result
Combined HADS score
Between-group difference
−4.17
95% CI −7.04 to −1.31
P = 0.005
By group
Ablation
7.6
SD 5.3
Medical therapy
11.8
SD 8.6
Ablation vs Medical therapy
between-group difference −4.17 (95% CI −7.04 to −1.31); P = 0.005
As reported in the abstract
Secondary outcomes
Severe psychological distress (HADS score >15) · 12 months · 12 months; 6 months P = .02
P = 0.01
6 months
| Outcome | Ablation | Medical therapy | P value |
|---|---|---|---|
| Combined HADS score · 6 months | 8.2 (SD 5.4) | 11.9 (SD 7.2) | P = 0.006 |
| Anxiety HADS score · 12 months · 12 months; 6 months P = .02 | 4.5 (SD 3.3) | 6.6 (SD 4.8) | P = 0.02 |
| 6 months | 4.7 [3.2] | 6.4 [3.9] | |
| Depression HADS score · 12 months · 12 months; 3 months P = .047; 6 months P = .004 | 3.1 (SD 2.6) | 5.2 (SD 3.9) | P = 0.004 |
| 3 months | 3.7 [2.6] | 5.2 [4.0] | |
| 6 months | 3.4 [2.7] | 5.5 [3.9] | |
| BDI-II score · 12 months · 12 months; 6 months P = .01 | 6.6 (SD 7.2) | 10.9 (SD 8.2) | P = 0.01 |
| 6 months | 7.2 [6.1] | 11.5 [9.0] | |
| AF burden | median 0% (IQR 0%–3.22%) | median 15.5% (IQR 1.0%–45.9%) | P < 0.001 |
Successful pulmonary vein isolation
- Achieved in all participants in the ablation group
Original publication
Atrial Fibrillation Catheter Ablation vs Medical Therapy and Psychological Distress. JAMA. Published 12 September 2023. doi:10.1001/jama.2023.14685
Summarised from the published abstract; every number is checked against it