Trial reportBMC medicine2026
Effects of ablation versus drug therapy on clinical outcomes and quality of life by frailty status in atrial fibrillation: a post hoc analysis of the CABANA trial.
Trial report in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Atrial Fibrillation Risk Management and Emerging Therapies.Journal of clinical medicine · 2026Review
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundFrailty is highly prevalent in patients with atrial fibrillation (AF) and is associated with adverse outcomes compared with non-frail individuals. This study aimed to explore whether the effects of ablation versus drug therapy on clinical outcomes and quality of life (QoL) differ according to frailty status in patients with AF.
methodsThis is a post hoc analysis of the Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation (CABANA) trial. The frailty index (FI) was calculated using 30 items, with an FI ≥ 0.21 defined as frailty. The primary endpoint was a composite of death, disabling stroke, serious bleeding, or cardiac arrest. The secondary outcomes included all-cause death and heart failure (HF) hospitalization. QoL was assessed periodically over 60 months using the Mayo AF-Specific Symptom Inventory (MAFSI).
resultsIn this study, a total of 2189 and 2070 patients were included in the intention-to-treat (ITT) and per-protocol (PP) populations, respectively. Over a median follow-up of 1440 (IQR, 900-2880) days, 184 patients experienced the primary endpoint, 122 died, and 174 experienced HF hospitalizations. Compared with drug therapy, catheter ablation did not significantly reduce the risk of clinical outcomes, with no significant difference observed across frailty strata. Regarding QoL, patients with AF and frailty in the ablation group experienced significant improvement compared with those in the drug group: a mean difference among all follow-ups of - 1.58 (- 2.11 to - 1.06; P < 0.001) in the MAFSI frequency score and - 1.26 (- 1.69 to - 0.84, P < 0.001) in the MAFSI severity score. However, patients with AF and without frailty in the ablation group showed no significant QoL improvement compared with those in the drug group.
conclusionsThere is no significant difference in the effectiveness of reducing clinical outcomes of catheter ablation according to frailty status in patients with AF compared with drug therapy, while patients with AF and frailty could derive a higher QoL improvements from catheter ablation therapy. These findings highlight the potential role of catheter ablation in improving QoL for patients with AF and frailty.
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