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Despite mxed reactions among the cardiovascular community, the recently published Catheter ABlation vs ANtiarrhythmic Drug Therapy in Atrial Fibrillation (CABANA) trial should be considered positive, as it provides clear evidence that catheter ablation is a valuable option for treating patients with atrial fibrillation (AF). In CABANA, not only did catheter ablation reduce the AF burden and prolong time to first recurrence,1 but it also improved quality of life.2 Furthermore, and most importantly, it reduced all-cause mortality and cardiovascular hospitalizations (HR 0.83, 95% CI 0.74-0.93, p=0.001).1 What this means is that for every 15.6 patients randomized to catheter ablation, one death or cardiovascular hospitalization was prevented (number needed to treat [NNT] 15.6). This is an extremely informative and powerful endpoint, as it is used for showing the benefit of most interventions across the spectrum of cardiovascular disease (Figure 1). The fact that it is a secondary endpoint in CABANA does not reduce its importance.

revista portuguesa de cardiologia

Science deserves justice: The results of the CABANA trial are positive and support catheter ablation of atrial fibrillation for reducing mortality and hospitalizations