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心房颤动消融术后的中风和死亡风险:来自CABANA试验的经验教训。

Stroke and mortality risk after atrial fibrillation ablation: lesson from the CABANA trial.

作者信息

Balla Cristina, Cappato Riccardo

机构信息

Cardiovascular Center, University of Ferrara, Ferrara, Italy.

Department of Biomedical Sciences, Humanitas Clinical & Research Center & Humanitas University, Milan, Italy.

出版信息

Eur Heart J Suppl. 2020 Nov 18;22(Suppl L):L38-L40. doi: 10.1093/eurheartj/suaa131. eCollection 2020 Nov.

Abstract

The CABANA trial is a randomized controlled study comparing catheter ablation vs. conventional medical therapy in atrial fibrillation (AF) patients. The results of the study showed that catheter ablation did not have a significant reduction of strokes, deaths, serious bleeding, or cardiac arrest compared to medical therapy. However, a significant improvement in AF recurrences, quality of life, and symptom relief has been shown after catheter ablation compared to drug therapy. The mixed results of the study emphasized an active controversy in the cardiology community on the interpretation of the data and their use in current clinical practice. In this review, we summarized the principal controversy points of the trial describing the strengths and weaknesses of the study design and analysis.

摘要

CABANA试验是一项随机对照研究,比较了心房颤动(AF)患者的导管消融术与传统药物治疗。研究结果表明,与药物治疗相比,导管消融术在降低中风、死亡、严重出血或心脏骤停方面没有显著效果。然而,与药物治疗相比,导管消融术后房颤复发、生活质量和症状缓解方面有显著改善。该研究的混合结果凸显了心脏病学界在数据解读及其在当前临床实践中的应用方面存在的积极争议。在本综述中,我们总结了该试验的主要争议点,描述了研究设计和分析的优缺点。

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本文引用的文献

1
CABANA trial: "beauty is in the eye of the beholder".CABANA 试验:“美在旁观者眼中”。
J Interv Card Electrophysiol. 2020 Jan;57(1):1-3. doi: 10.1007/s10840-019-00604-0. Epub 2019 Sep 6.

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