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General Medicine
Catheter ablation in atrial fibrillation
  1. Mark T Mills
  1. Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  1. Correspondence to Dr Mark T Mills, Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S5 7AU, UK; marktmills1{at}gmail.com

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EBM Verdict

EBM Verdict on: Effect of catheter ablation vs antiarrhythmic drug therapy on mortality, stroke, bleeding, and cardiac arrest among patients with atrial fibrillation: the CABANA Randomized Clinical Trial. JAMA 2019 Mar 15. doi: 10.1001/jama.2019.0693.

  • The Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation trial is the largest randomised trial to study the effects of catheter ablation on morbidity and mortality in atrial fibrillation (AF). Although catheter ablation can reduce AF recurrence and ameliorate the quality of life of patients with AF, the effect of the procedure on long-term clinical outcomes does not differ from that observed with optimal pharmacological therapy. These findings should facilitate shared decision making between patients and physicians.

Catheter ablation in atrial fibrillation is effective at restoring sinus rhythm. Until recently, the prognostic effects of ablation have been unknown. The recent Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation trial compared catheter ablation with medical therapy and assessed the effect on disabling stroke, death and quality of life.

Context

Atrial fibrillation (AF) is the most common cardiac rhythm disturbance, …

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