Evidence map›Paper›PMID 32586583›Full record

Trial reportJournal of the American College of Cardiology2020

Recurrence of Atrial Fibrillation After Catheter Ablation or Antiarrhythmic Drug Therapy in the CABANA Trial.

Jeanne E Poole, Tristram D Bahnson, Kristi H Monahan, George Johnson, Hoss Rostami, Adam P Silverstein, Hussein R Al-Khalidi, Yves Rosenberg, Daniel B Mark, Kerry L Lee and 2 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American College of Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00911508 (Catheter Ablation vs Anti-arrhythmic Drug Therapy for Atrial Fibrillation Trial), which is not on this map. Cited by 142 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
142citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00911508 nacompletednot on this map

Catheter Ablation vs Anti-arrhythmic Drug Therapy for Atrial Fibrillation Trial

TypeinterventionalSponsorMayo ClinicRan2009 to 2017Enrolled2,204ConditionsAtrial Fibrillation, ArrhythmiaArmsLeft atrial ablation, Rate or Rhythm Control Therapy
3 · Its place in the literature

Who cites it

142 citing papers in PubMed, 10 syntheses or guidelines pooled it.

  1. Pooled it
  2. Impact of catheter ablation timing according to duration of atrial fibrillation history on arrhythmia recurrences and clinical outcomes: a meta-analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Pooled it
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  11. Cryoballoon ablation vs. antiarrhythmic drug therapy as initial treatment for persistent atrial fibrillation: the multicentre randomized CEPAF trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
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  12. Early recurrence of atrial tachyarrhythmia after catheter ablation and its associations with clinical outcomes, atrial fibrillation burden, and blanking period duration: a post hoc analysis of the CABANA trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
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  15. Association between comorbidity burden and outcomes of catheter ablation vs. medical therapy for atrial fibrillation: insights from the CABANA trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
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  19. Influence of atrial fibrillation type on outcomes of ablation vs. drug therapy: results from CABANA.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2022
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82 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Jeanne E PooleUniversity of Washington Medical Center, Seattle, Washington. Electronic address: jpoole@u.washington.edu.
Tristram D BahnsonDuke Clinical Research Institute, Duke University, Durham, North Carolina.
Kristi H MonahanMayo Clinic, Rochester, Minnesota.
George JohnsonSeattle Institute of Cardiac Research, Seattle, Washington.
Hoss RostamiDuke Clinical Research Institute, Duke University, Durham, North Carolina.
Adam P SilversteinDuke Clinical Research Institute, Duke University, Durham, North Carolina.
Hussein R Al-KhalidiDuke Clinical Research Institute, Duke University, Durham, North Carolina.
Yves RosenbergNational Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
Daniel B MarkDuke Clinical Research Institute, Duke University, Durham, North Carolina.
Kerry L LeeDuke Clinical Research Institute, Duke University, Durham, North Carolina.
Douglas L PackerMayo Clinic, Rochester, Minnesota.
CABANA Investigators and ECG Rhythm Core Lab

Funding

CABANA-AF TrialU01HL089786 · NHLBI · DUKE UNIVERSITY · PI AL-KHALIDI, HUSSEIN · 2009 to 2014
$10.7M
Catheter Ablation versus Antiarrythmic Drug Therapy for Atrial Fibrilllation TriaU01HL089709 · NHLBI · MAYO CLINIC ROCHESTER · PI PACKER, DOUGLAS L · 2009 to 2014
$4.4M
Cabana Image Analysis LabU01HL089645 · NHLBI · MAYO CLINIC ROCHESTER · PI ROBB, RICHARD A · 2009 to 2014
$1.6M
CABANA EQOL TrialU01HL089907 · NHLBI · DUKE UNIVERSITY · PI MARK, DANIEL B · 2009 to 2014
$1.3M
NHLBI NIH HHS U01 HL089645NHLBI NIH HHS U01 HL089709NHLBI NIH HHS U01 HL089786NHLBI NIH HHS U01 HL089907
6 · The paper itself

Abstract

backgroundThe CABANA (Catheter Ablation Versus Antiarrhythmic Drug Therapy for Atrial Fibrillation) trial randomized 2,204 patients with atrial fibrillation (AF) to catheter ablation or drug therapy. Analysis by intention-to-treat showed a nonsignificant 14% relative reduction in the primary outcome of death, disabling stroke, serious bleeding, or cardiac arrest.

objectivesThe purpose of this study was to assess recurrence of AF in the CABANA trial.

methodsThe authors prospectively studied CABANA patients using a proprietary electrocardiogram recording monitor for symptom-activated and 24-h AF auto detection. The AF recurrence endpoint was any post-90-day blanking atrial tachyarrhythmias lasting 30 s or longer. Biannual 96-h Holter monitoring was used to assess AF burden. Patients who used the CABANA monitors and provided 90-day post-blanking recordings qualified for this analysis (n = 1,240; 56% of CABANA population). Treatment comparisons were performed using a modified intention-to-treat approach.

resultsMedian age of the 1,240 patients was 68 years, 34.4% were women, and AF was paroxysmal in 43.0%. Over 60 months of follow-up, first recurrence of any symptomatic or asymptomatic AF (hazard ratio: 0.52; 95% confidence interval: 0.45 to 0.60; p < 0.001) or first symptomatic-only AF (hazard ratio: 0.49; 95% confidence interval: 0.39 to 0.61; p < 0.001) were both significantly reduced in the catheter ablation group. Baseline Holter AF burden in both treatment groups was 48%. At 12 months, AF burden in ablation patients averaged 6.3%, and in drug-therapy patients, 14.4%. AF burden was significantly less in catheter ablation compared with drug-therapy patients across the 5-year follow-up (p < 0.001). These findings were not sensitive to the baseline pattern of AF.

conclusionsCatheter ablation was effective in reducing recurrence of any AF by 48% and symptomatic AF by 51% compared with drug therapy over 5 years of follow-up. Furthermore, AF burden was also significantly reduced in catheter ablation patients, regardless of their baseline AF type. (Catheter Ablation vs Anti-arrhythmic Drug Therapy for Atrial Fibrillation Trial [CABANA]; NCT00911508).

Indexed as

Anti-Arrhythmia AgentsAtrial FibrillationCatheter AblationElectrocardiography, AmbulatoryAgedFemaleHumansIntention to Treat AnalysisMaleOutcome and Process Assessment, Health CareRecurrenceStrokeTimeAnti-Arrhythmia Agentsantiarrhythmic drug therapyatrial fibrillationcatheter ablationlong-standing persistent atrial fibrillationparoxysmal atrial fibrillationpersistent atrial fibrillationpulmonary vein isolation

Identifiers

PMID32586583
PMCPMC8064404

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.