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Catheter ablation for atrial fibrillation no better than drug therapy for reducing death or disabling stroke, trial finds

BMJ 2019; 364 doi: (Published 18 March 2019) Cite this as: BMJ 2019;364:l1254
  1. Susan Mayor
  1. London, UK

Catheter ablation achieved no significant reduction in death, disabling stroke, serious bleeding, or cardiac arrest compared with drug treatment in patients with atrial fibrillation (AF) in a large randomised trial.1 But further results2 showed clinically significant improvements in symptoms and quality of life with ablation.

Antiarrhythmic drug therapy has been the primary treatment for AF for decades but limited effectiveness in some patients has led to the development of other strategies to maintain sinus rhythm, including ablation. Although effective in restoring sinus rhythm in AF, the effects of catheter ablation on long term mortality and stroke risk have been unclear.

The new international study, CABANA, randomised 2204 patients to either catheter ablation (pulmonary vein isolation with additional ablation procedures at …

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