Evidence map›Paper›PMID 38629286›Full record

Trial reportCirculation. Arrhythmia and electrophysiology2024

Prognostic Impact of Sinus Rhythm in Atrial Fibrillation Patients: Separating Rhythm Outcomes From Randomized Strategy Findings From the CABANA Trial.

T Jared Bunch, Jeanne E Poole, Adam P Silverstein, Kerry L Lee, Hussein R Al-Khalidi, Gerhard Hindricks, Alexander Romanov, Evgeny Pokushalov, Tristram D Bahnson, Melanie R Daniels and 4 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation. Arrhythmia and electrophysiology, 2024. 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 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
6.0field-weighted citation impact, top 3% of its field
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

9 citing papers in PubMed, 15 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Article
  5. Article
  6. Review
  7. Review
  8. Review
  9. Response to the letter by Blank et al. regarding the article: 'LINAC-Based STereotactic Arrhythmia Radioablation (STAR) for paroxysmal atrial fibrillation in elderly: a prospective phase II 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 · 2024
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 6 institutions in 3 countries.

T Jared BunchDivision of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City (T.J.B.).ORCID 0000-0001-5349-0136
Jeanne E PooleUniversity of Washington Medical Center, Seattle (J.E.P.).ORCID 0000-0002-8481-7389
Adam P SilversteinDuke Clinical Research Institute, Duke University, Durham, NC (A.P.S., K.L.L., H.R.A.-K., T.D.B., M.R.D., J.P.P., D.B.M.).ORCID 0000-0003-2013-5087
Kerry L LeeDuke Clinical Research Institute, Duke University, Durham, NC (A.P.S., K.L.L., H.R.A.-K., T.D.B., M.R.D., J.P.P., D.B.M.).
Hussein R Al-KhalidiDuke Clinical Research Institute, Duke University, Durham, NC (A.P.S., K.L.L., H.R.A.-K., T.D.B., M.R.D., J.P.P., D.B.M.).ORCID 0000-0003-1375-0487
Gerhard HindricksLeipzig Heart Center, Leipzig, DE (G.H.).ORCID 0000-0002-0132-0773
Alexander RomanovE. Meshalkin National Medical Research Center, Novosibirsk, Russian Federation (A.R.).ORCID 0000-0001-8206-2480
Evgeny PokushalovNovosibirsk State Medical University, Russian Federation (A.R., E.P.).ORCID 0000-0002-9494-4234
Tristram D BahnsonDuke Clinical Research Institute, Duke University, Durham, NC (A.P.S., K.L.L., H.R.A.-K., T.D.B., M.R.D., J.P.P., D.B.M.).ORCID 0000-0001-9001-506X
Melanie R DanielsDuke Clinical Research Institute, Duke University, Durham, NC (A.P.S., K.L.L., H.R.A.-K., T.D.B., M.R.D., J.P.P., D.B.M.).ORCID 0000-0003-4360-5635
Jonathan P PicciniDuke Clinical Research Institute, Duke University, Durham, NC (A.P.S., K.L.L., H.R.A.-K., T.D.B., M.R.D., J.P.P., D.B.M.).ORCID 0000-0003-0772-2404
Daniel B MarkDuke Clinical Research Institute, Duke University, Durham, NC (A.P.S., K.L.L., H.R.A.-K., T.D.B., M.R.D., J.P.P., D.B.M.).ORCID 0000-0001-6340-8087
Douglas L PackerIntermountain Heart Institute, Salt Lake City, UT (D.L.P.).
CABANA Investigators
Duke University · USNovosibirsk State Medical University · RUIntermountain Medical Center · USLeipzig Heart Institute · DETwitter (United States) · USUniversity of Washington Medical Center · US

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

backgroundClinically detected atrial fibrillation (AF) is associated with a significant increase in mortality and other adverse cardiovascular events. Since the advent of effective methods for AF rhythm control, investigators have attempted to determine how much these adverse prognostic AF effects could be mitigated by the restoration of sinus rhythm (SR) and whether the method used mattered.

methodsThe CABANA trial (Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation) randomized 2204 AF patients to ablation versus drug therapy, of which 1240 patients were monitored in follow-up using the CABANA ECG rhythm monitoring system. To assess the prognostic benefits of SR, we performed a prespecified analysis using Cox survival modeling with heart rhythm as a time-dependent variable and randomized treatment group as a stratification factor.

resultsIn the 1240 patient study cohort, 883 (71.2%) had documented AF at some point during their postblanking follow-up. Among the 883 patients, 671 (76.0%) experienced AF within the first year of postblanking follow-up, and 212 (24.0%) experienced their first AF after ≥1 year of postblanking follow-up. The primary CABANA end point (death, disabling stroke, serious bleeding, or cardiac arrest) occurred in 95 (10.8%) of the 883 patients with documented AF and in 29 (8.1%) of the 357 patients with no AF recorded during follow-up. In multivariable time-dependent analysis, the presence of SR (compared with non-SR) was associated with a significantly reduced risk of the primary end point (adjusted hazard ratio, 0.57 [95% CI, 0.38-0.85];

conclusionsIn patients in the CABANA trial with detailed long-term rhythm follow-up, increased time in SR was associated with a clinically consequential decrease in mortality and other adverse prognostic events. The predictive value of SR was independent of the therapeutic approach responsible for reducing the burden of detectable AF. REGISTRATION: URL: https://clinicaltrials.gov; Unique Identifier: NCT00911508.

Indexed as

Anti-Arrhythmia AgentsAtrial FibrillationCatheter AblationHeart RateAction PotentialsAgedElectrocardiography, AmbulatoryFemaleHumansMaleMiddle AgedPrognosisRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeAnti-Arrhythmia Agentsanti-arrythmia agentsatrial fibrillationcatheter ablationheart failuremortalitystroke

Identifiers

PMID38629286
PMCPMC13570665
OpenAlexW4394873621

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.