Catheter ablation significantly improved major clinical outcomes compared with drug thera- py among racial or ethnic minorities with atrial fibrillation (AF) enrolled in the CABANA trial, according to a study published in the Journal of the American College of Cardiology. In the trial, a total of 2,204 symptomatic patients with AF were randomly assigned to ablation or drug therapy, including rate and/or rhythm control drugs. Of 1,280 participants in North America, 127 (9.9%) were racial and ethnic minorities. The study in- vestigators found that racial and ethnic minor- ities were younger than non-minorities and had more symptomatic heart failure, hypertension, and ejection fraction less than 40%. Racial/ ethnic minorities treated with ablation had sig- nificant reductions in the primary end point (composite of death, disabling stroke, serious bleeding, or cardiac arrest) and in all-cause mor- tality (aHR, 0.32 and 0.28, respectively). In the ablation arm, primary event rates were similar in racial/ethnic-minority and non-minority partic- ipants (4-year Kaplan-Meier event rates, 12.3% vs 9.9%); however, a much higher event rate was seen in racial and ethnic minorities versus non- minority participants randomly assigned to drug therapy (27.4% vs 9.4%). “These findings should be a ‘call to action’ to ensure that all treatment options, including catheter ablation, are widely accessible to provide the highest quality of care for all patients with AF,” the author of an accom- panying editorial wrote.
