EP News: Clinical

      Zeitler et al (J Am Heart Assoc 2023;12:e027871, PMID 36688367) evaluated prespecified sex-related outcomes for ablation vs drug therapy in the CABANA trial. Symptoms were assessed over 60 months with the Mayo Atrial Fibrillation (AF)-Specific Symptom Inventory (MAFSI) frequency score, and quality of life (QOL) was assessed with the Atrial Fibrillation Effect on Quality of Life (AFEQT) summary and component scores. Women had lower baseline QOL scores than did men (mean AFEQT scores 55.9 and 65.6, respectively). Patients who had undergone ablation improved more than patients receiving drug therapy with similar treatment effect by sex: AFEQT 12-month mean adjusted treatment difference was 6.1 points for women and 4.9 points for men. Participants with baseline AFEQT summary scores <70 had greater QOL improvement, with a mean treatment difference at 12 months of 7.6 points for women and 6.4 points for men. The mean difference in MAFSI frequency score between women randomized to ablation vs drug therapy at 12 months was −2.5; for men, the difference was −1.3. The authors conclude that ablation resulted in more QOL improvement in both sexes, driven by improvements in those with lower baseline QOL. Ablation did not eliminate the AF-related QOL gap between women and men.
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