Reflections on CABANA Trial (Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation Trial)

Abstract

Atrial fibrillation has been consolidated in recent decades as a serious public health problem, considering its notorious increase in prevalence with aging combined with increased population survival. Data from the Framingham Heart Study indicate that, even in an optimal scenario of absence of classic risk factors for its occurrences, such as smoking, alcohol abuse, obesity, hypertension, diabetes, and heart disease, about 10% of individuals aged 80 or over and about 25% of those aged 90 or over will have atrial fibrillation. These rates substantially increase when added to single or combined risk factors. Despite its already well-known association with the occurrence of thromboembolic stroke, the presence of atrial fibrillation has been identified as an independent mortality risk factor in large population studies.