Afib Ablation Magic Bullet or Band Aid

The cabana trial is the biggest study for people with atrial fibrillation that comes and goes. And the concept of the study was, are medications better for treating atrial fibrillation or is ablation better?

This was a study to, to definitively show how superior ablation would be to medications. At least, from a non-electrophysiologists like me. Seemed to be the concept of the study. So, what they did is they had over 2000 people in the cabana trial, they were randomized either medications or ablation.

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This was a four-year trial. And what they found was that those people who were assigned to the medication arm of atrial fibrillation over 70% of them had recurrence of their atrial fibrillation in four years’ time. So over two out of three people, if they were only treated with medications or some of them, I think it was around the 20%, maybe it was 29% of people actually had ablation as well.

But the chances of them being free of a fib over four years was less than 30%. So, no ablation of course is a lot better than that. But how much. Better, was it? Well, it wasn’t dramatically better. I mean, it was improved. It went from about a 30% chance of having no AFib at four years to about a 48% chance of having no way for that.

It is a band-aid. It is only covering up the problem and not addressing the underlying issue. What are the causes of fib that we can change that can change the outcomes, change the likelihood that you’re going to have a failure with a fed medications or with ablation, or maybe even not need ablation at all?

These are the ones that are most prominently discussed in the research literature and are dressed in programs like ours, where we help people transform their health so they can get the best outcomes from a fib. So, the biggest one is unhealthy weight.

So, I’m just going to present this one study. It’s called the rest an F study and I; this was beautifully done. They took all, all the people in the study who had afib ablation. So, they all had a fab. They all met indications for atrial fibrillation ablation and them.

Looked at the people that were just treated with expert medical care. So, medications and ablations alone. And you can see that at four years, only 18% of people in the study were free of AFib after four years. So, these are, these are low numbers. I recognize this study was published in 2015. They had to do the data before that.

So this is really like, late two like 2000 7, 8, 9, 2010. Medical treatment for afib was better than that now. And you know, maybe this number now today would be more than. 50% or 40% or something like that. But at the time of the study that this is what they got, 18% of people were free of a fib.

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