Effects of Ablation Versus Drug Therapy on Quality of Life by Sex in Atrial Fibrillation: Results From the CABANA Trial.

dc.contributor.author

Zeitler, Emily P

dc.contributor.author

Li, Yanhong

dc.contributor.author

Silverstein, Adam P

dc.contributor.author

Russo, Andrea M

dc.contributor.author

Poole, Jeanne E

dc.contributor.author

Daniels, Melanie R

dc.contributor.author

Al-Khalidi, Hussein R

dc.contributor.author

Lee, Kerry L

dc.contributor.author

Bahnson, Tristram D

dc.contributor.author

Anstrom, Kevin J

dc.contributor.author

Packer, Douglas L

dc.contributor.author

Mark, Daniel B

dc.contributor.author

CABANA Investigators

dc.date.accessioned

2024-06-06T14:46:35Z

dc.date.available

2024-06-06T14:46:35Z

dc.date.issued

2023-02

dc.description.abstract

Background Women with atrial fibrillation (AF) demonstrate more AF-related symptoms and worse quality of life (QOL). Whether increased use of ablation in women reduces sex-related QOL differences is unknown. Sex-related outcomes for ablation versus drug therapy was a prespecified analysis in the CABANA (Catheter Ablation Versus Antiarrhythmic Drug Therapy for Atrial Fibrillation) trial. Methods and Results Symptoms were assessed periodically over 60 months with the Mayo AF-Specific Symptom Inventory (MAFSI) frequency score, and QOL was assessed with the Atrial Fibrillation Effect on Quality of Life (AFEQT) summary and component scores. Women had lower baseline QOL scores than men (mean AFEQT scores 55.9 and 65.6, respectively). Ablation patients improved more than drug therapy patients with similar treatment effect by sex: AFEQT 12-month mean adjusted treatment difference in women 6.1 points (95% CI, 3.5-8.6) and men 4.9 points (95% CI, 3.0-6.9). 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 (95% CI, 4.3-10.9) and 6.4 points for men (95% CI, 3.3-9.4). The mean adjusted difference in MAFSI frequency score between women randomized to ablation versus drug therapy at 12 months was -2.5 (95% CI, -3.4 to -1.6); for men, the difference was -1.3 (95% CI, -2.0 to -0.6). Conclusions Compared with drug therapy for AF, ablation resulted in more QOL improvement in both sexes, primarily driven by improvements in those with lower baseline QOL. Ablation did not eliminate the AF-related QOL gap between women and men. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT00911508.

dc.identifier.issn

2047-9980

dc.identifier.issn

2047-9980

dc.identifier.uri

https://hdl.handle.net/10161/31118

dc.language

eng

dc.publisher

Ovid Technologies (Wolters Kluwer Health)

dc.relation.ispartof

Journal of the American Heart Association

dc.relation.isversionof

10.1161/jaha.122.027871

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

CABANA Investigators

dc.subject

Humans

dc.subject

Atrial Fibrillation

dc.subject

Anti-Arrhythmia Agents

dc.subject

Catheter Ablation

dc.subject

Treatment Outcome

dc.subject

Quality of Life

dc.subject

Female

dc.subject

Male

dc.subject

Surveys and Questionnaires

dc.title

Effects of Ablation Versus Drug Therapy on Quality of Life by Sex in Atrial Fibrillation: Results From the CABANA Trial.

dc.type

Journal article

duke.contributor.orcid

Silverstein, Adam P|0000-0003-2013-5087

duke.contributor.orcid

Al-Khalidi, Hussein R|0000-0003-1375-0487

duke.contributor.orcid

Bahnson, Tristram D|0000-0001-9001-506X

duke.contributor.orcid

Mark, Daniel B|0000-0001-6340-8087

pubs.begin-page

e027871

pubs.issue

3

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Staff

pubs.organisational-group

Basic Science Departments

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Institutes and Centers

pubs.organisational-group

Biostatistics & Bioinformatics

pubs.organisational-group

Medicine

pubs.organisational-group

Medicine, Cardiology

pubs.organisational-group

Duke Clinical Research Institute

pubs.organisational-group

Biostatistics & Bioinformatics, Division of Biostatistics

pubs.publication-status

Published

pubs.volume

12

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
20230123_JAHA.122.027871.pdf
Size:
1.03 MB
Format:
Adobe Portable Document Format
Description:
Published version