One of the most long-awaited trials in cardiology, the atrial fibrillation CABANA1 trial made its debut at the Heart Rhythm Society meeting (May 9-12) in Boston earlier this year. The trial has generated almost as much discussion as the sham-controlled ORBITA trial did at the American College of Cardiology meeting, ie, some are calling CABANA a “game-changer” while others say the results won't impact their practice.
Test your knowledge of the CABANA trial here and consider your own opinion of the results.
1. Which of the following questions did the CABANA trial address in patients with atrial fibrillation who are symptomatic?
A. Should left atrial appendage ligation be done at the time of cardiac surgery to reduce stroke and all-cause mortality?
B. Are rate and rhythm control equivalent strategies in reducing risk of death?
C. Is catheter-based ablation superior to rate/rhythm control for management of atrial fibrillation?
D. Which is more effective: lenient rate control (resting HR<110 beats/min) or strict rate control (resting HR<80 beats/min and HR during moderate exercise <110 beats per minute).
Please click below for answer and discussion.
1. Packer DL, Mark DB, Robb RA, et al. Catheter Ablation vs. Antiarrhythmic Drug Therapy For Atrial Fibrillation: The Results Of The Cabana Multicenter International Randomized Clinical Trial. Heart Rhythm Society (HRS) 2018 Scientific Sessions. Abstract B-LBCT01-05. Presented May 10, 2018.
2. Yao X, Gersh BJ, Holmes DR, et al. Association of surgical left appendage occlusion with subsequent stroke and mortality among patients undergoing cardiac surgery. JAMA. 2018;319:2116–2126.
3. The AFFIRM investigators. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med 2002; 347:1825-1833.
4. Van Gelder IC, Groenveld HF, Crijns HJGM, et al. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med 2010; 362:1363-1373.