Arrhythmias & electrophysiology
Regional differences in outcomes with ablation versus drug therapy for atrial fibrillation: Results from the CABANA trial
Authors' conclusion
In CABANA, primary outcome events occurred significantly more often in the NA group but assignment to ablation significantly reduced all-cause mortality in the non-NA group only.
Study context
- Population
- Patients with atrial fibrillation (AF) in the CABANA trial: 1,285 at 85 North American (NA) sites and 919 at 41 non-NA sitesNA 1,285
- Comparison
- AF ablation vs drug therapy, by geographic region
- Primary endpoint
- Composite of:
- Death
- Disabling stroke
- Serious bleeding
- Cardiac arrest
Methodological detailsprespecified regional analysis, international (10 countries)
- Prespecified regional analysis
- International (10 countries)
Primary result
As reported in the abstract
Primary composite endpoint by region · median 54.9 (NA) and 40.5 (non-NA) months
Estimate (95% CI)P value
NA vs non-NAevents 157 (12.2%) NAvs 33 (3.6%) non-NA
adjusted HR 2.18(1.48–3.21)
P < 0.001Ablation vs Drug therapyNA: 78vs 79 events
HR 0.91(0.66–1.24)
Ablation vs Drug therapynon-NA: 11vs 22 events
HR 0.51(0.25,1.05)
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| Death, by regionAblationvs Drug therapyNA: 53vs 51 deaths | 0.96 (0.65,1.42) | |
| Death, by regionAblationvs Drug therapynon-NA: 5vs 16 deaths | 0.32 (0.12,0.86) | |
| First AF recurrence, by regionAblationvs Drug therapyNA | 0.54 (0.46–0.63) | |
| First AF recurrence, by regionAblationvs Drug therapynon-NA | 0.44 (0.30–0.64) | |
| 0.10.31310Hazard ratio (log scale) |
- Death, by region: interaction P = .044
- First AF recurrence, by region: interaction P = .322
Original publication
Regional differences in outcomes with ablation versus drug therapy for atrial fibrillation: Results from the CABANA trial. Am Heart J. Published 1 February 2024. doi:10.
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