Association Between Sex and Treatment Outcomes of Atrial Fibrillation Ablation Versus Drug Therapy: Results From the CABANA Trial.

Published on Feb 16, 2021in Circulation23.603
· DOI :10.1161/CIRCULATIONAHA.120.051558
Andrea M. Russo23
Estimated H-index: 23
(Rowan University),
Emily P. Zeitler13
Estimated H-index: 13
(Dartmouth–Hitchcock Medical Center)
+ 8 AuthorsJeanne E. Poole50
Estimated H-index: 50
(University of Washington Medical Center)
Sources
Abstract
Background: Among patients with atrial fibrillation (AF), women are less likely to receive catheter ablation, and may have more complications and less durable results. Most information regarding se...
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#2Koichi InoueH-Index: 19
Last. Satoshi Shizuta (Kyoto University)H-Index: 26
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AIM The impact of sex differences on the clinical outcomes of radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) is controversial. We investigated the sex differences regarding the efficacy and clinical outcomes of RFCA of AF. METHODS AND RESULTS We conducted a large-scale, prospective, multicentre, observational study (Kansai Plus Atrial Fibrillation Registry). We enrolled 5010 consecutive patients who underwent an initial RFCA of AF at 26 centres (64 ± 10 years; non-paroxysmal...
6 CitationsSource
#1Jeanne E. Poole (University of Washington Medical Center)H-Index: 50
#2Tristram D. Bahnson (Duke University)H-Index: 24
Last. Mauri WilsonH-Index: 1
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Abstract Background The 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. Objectives The purpose of this study was to assess recurrence of AF in the CABANA trial. Methods The authors prospectively s...
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#1Hariharan SugumarH-Index: 8
#2Shane Nanayakkara (Monash University)H-Index: 13
Last. Peter M. KistlerH-Index: 60
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Abstract Background Female gender is associated with an increase in recurrence of atrial fibrillation (AF) following catheter ablation (CA). Although AF is more common in men, women make up a significant proportion with persistent AF (PsAF). Objective To determine if multiple ablation procedures improves arrhythmia outcomes in females with PsAF compared to men. Methods We performed a multicentre observational study to determine the long-term arrhythmia outcomes in patients undergoing more than o...
4 CitationsSource
#1Xiaocheng Cheng (CQMU: Chongqing Medical University)H-Index: 4
#2Qiongwen HuH-Index: 2
Last. Dongying Zhang (CQMU: Chongqing Medical University)H-Index: 7
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AIMS: The sex-related differences in the clinical outcomes of rhythm and safety after catheter ablation remain unclear. The purpose of this study was to compare the clinical outcomes of catheter ablation for atrial fibrillation (AF) in women and men. METHODS AND RESULTS: The Medline and EMBASE databases were searched for published articles up to December 2018. Studies that met our predefined inclusion criteria were included. The primary endpoints were freedom from AF/atrial tachycardia (AT) recu...
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#1Jim W. Cheung (NewYork–Presbyterian Hospital)H-Index: 19
#2Edward P. Cheng (NewYork–Presbyterian Hospital)H-Index: 3
Last. Luke K. Kim (NewYork–Presbyterian Hospital)H-Index: 20
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AIMS: Although catheter ablation has emerged as an important therapy for patients with symptomatic atrial fibrillation (AF), there are limited data on sex-based differences in outcomes. We sought to compare in-hospital outcomes and 30-day readmissions of women and men undergoing AF ablation. METHODS AND RESULTS: Using the United States Nationwide Readmissions Database, we analysed patients undergoing AF ablation between 2010 and 2014. Based on ICD-9-CM codes, we identified co-morbidities and out...
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#1Zain Ul Abideen Asad (University of Oklahoma Health Sciences Center)H-Index: 5
#2Ali Yousif (University of Oklahoma Health Sciences Center)H-Index: 2
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Background: Despite the publication of several randomized clinical trials comparing catheter ablation (CA) with medical therapy (MT) in patients with atrial fibrillation (AF), the superiority of on...
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Last. Xiaoxi Yao (Mayo Clinic)H-Index: 23
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AIMS: The Catheter Ablation vs. Antiarrhythmic Drug Therapy for Atrial Fibrillation (CABANA) trial aimed to assess the impact of ablation on morbidity and mortality. This observational study was conducted in parallel to CABANA to assess trial generalizability. METHODS AND RESULTS: Using a large US administrative database, we identified 183 760 patients with atrial fibrillation (AF) treated with ablation or medical therapy (antiarrhythmic or rate control drugs) between 1 August 2009 and 30 April ...
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#1Douglas L. Packer (Mayo Clinic)H-Index: 76
#2Daniel B. Mark (Duke University)H-Index: 136
Last. Kerry L. Lee (Duke University)H-Index: 139
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Importance Catheter ablation is effective in restoring sinus rhythm in atrial fibrillation (AF), but its effects on long-term mortality and stroke risk are uncertain. Objective To determine whether catheter ablation is more effective than conventional medical therapy for improving outcomes in AF. Design, Setting, and Participants The Catheter Ablation vs Antiarrhythmic Drug Therapy for Atrial Fibrillation trial is an investigator-initiated, open-label, multicenter, randomized trial involving 126...
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#1Claude S. Elayi (UK: University of Kentucky)H-Index: 19
#2Yousef Darrat (UK: University of Kentucky)H-Index: 8
Last. Gbolahan O. Ogunbayo (UK: University of Kentucky)H-Index: 11
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Purpose Catheter ablation (CA) is an effective treatment for atrial fibrillation (AF). The differences in complication rates and outcomes between women and men remain poorly studied. We aimed to study the sex differences in morbidity and mortality associated with CA in AF.
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#1Nazem Akoum (UW: University of Washington)H-Index: 25
#2Christian MahnkopfH-Index: 8
Last. Nassir F. Marrouche (UofU: University of Utah)H-Index: 63
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Aim: Age and female sex are associated with a higher risk of stroke in atrial fibrillation (AF). We sought to determine whether advancing age and female sex are associated with higher atrial fibrosis. Methods and results: We conducted an observational cohort study of patients with AF enrolled in the University of Utah AF Database and a non-AF control group who underwent late-gadolinium enhancement magnetic resonance imaging (LGE-MRI) for atrial fibrosis quantification. Participants with contra-i...
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#1M.N. Kim (Yonsei University)
#2Seng Chan You (Yonsei University)H-Index: 13
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Abstract null Background null Catheter ablation is more effective than antiarrhythmic drug therapy alone in patients with atrial fibrillation (AF). However, there are limited data on the outcomes of AF ablation according to sex. The purpose of this study was to evaluate gender differences in the actual outcomes after catheter ablation for atrial fibrillation. null Methods null Of 801,710 patients with AF in the Korean National Health Insurance Service database, we identified 9175 patients withou...
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#1Birgit Vogel (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 16
#2Mónica Acevedo (UC: Pontifical Catholic University of Chile)H-Index: 15
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Summary Cardiovascular disease is the leading cause of death in women. Decades of grassroots campaigns have helped to raise awareness about the impact of cardiovascular disease in women, and positive changes affecting women and their health have gained momentum. Despite these efforts, there has been stagnation in the overall reduction of cardiovascular disease burden for women in the past decade. Cardiovascular disease in women remains understudied, under-recognised, underdiagnosed, and undertre...
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#1Linh Ngo (UQ: University of Queensland)H-Index: 1
#2Anna Ali (University of Adelaide)H-Index: 8
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Aim Population studies that provide unbiased estimates of gender differences in risk of complications following catheter ablation of atrial fibrillation (AF) are sparse. We sought to evaluate the association of female gender and risk of complications following AF ablation in a nation-wide cohort. Methods and results We identified 35,211 patients (29.5% females) undergoing AF ablations from 2008-17 using national hospitalization data from Australia and New Zealand. The primary outcome was any pro...
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#1Tongjian Zhu (WHU: Wuhan University)H-Index: 2
#2Zhen Wang (WHU: Wuhan University)H-Index: 12
Last. Hong Jiang (WHU: Wuhan University)H-Index: 30
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Background: Studies have shown that pulsed field ablation (PFA) has excellent effectiveness and safety in pulmonary vein isolation (PVI). However, there are few reports about the application of PFA, especially the alternating current (AC) biphase PFA, in superior vena cava (SVC) isolation, and its effectiveness and safety are still unclear. Objective: To investigate the efficacy and safety of the AC biphase PFA for SVC isolation, and to provide evidence for the clinical use of PFA for SVC. Metho...
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