Arrhythmias & electrophysiology
The Interaction Between Atrial Fibrillation and Mitral Regurgitation: Insights from the CABANA Randomized Clinical Trial
Authors' conclusion
Catheter ablation was superior to pharmacological therapy in rhythm control and may reduce MR severity over time.
Study context
- Population
- CABANA patients with atrial fibrillation (AF) and available baseline echocardiography; 722 (52%) had mitral regurgitation (MR) (582 mild, 140 ≥moderate)65% of CABANA cohort
- Participants
- 1,423 patients
- Comparison
- Catheter ablation vs pharmacological therapy in AF with or without baseline MR
- Primary endpoint
- All-cause mortality and CV hospitalization (composite)
Methodological detailssub-analysis
- Sub-analysis
Primary result
As reported in the abstract
All-cause mortality and CV hospitalization, by MR
- MR presence or absence did not interact with randomization in its neutral effect on all-cause mortality and CV hospitalization
- p for interaction = 0.115
Secondary outcomes
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| AF recurrence | 0.56 (0.50–0.62) | P < 0.001 | |
| AF recurrence, baseline MRvs no MR | 1.46 (1.40–1.74) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
Functional status, by MR
- Benefit of ablation on functional status greater with MR than without
- P for interaction < 0.001
MR severity change (follow-up echocardiography, n = 248)
- Greater reduction in MR severity with ablation vs drug therapy
- P for interaction = 0.040
Original publication
The Interaction Between Atrial Fibrillation and Mitral Regurgitation: Insights from the CABANA Randomized Clinical Trial. Eur J Heart Fail. Published 21 April 2025. doi:10.
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