News | Atrial Fibrillation | May 18, 2018

Atrial Fibrillation Burden Reduces Mortality, Hospitalization in CASTLE-AF Trial

Data from the CASTLE-AF trial showing lower mortality and hospitalizations in patients treated with ablation vs. medical therapy. #HRS2018

May 18, 2018 — Catheter ablation for atrial fibrillation (AF) in patients with heart failure in the CASTLE-AF Trial was associated with significant improvement in AF burden compared to medical therapy.[1] The study was presented at Heart Rhythm 2018, the Heart Rhythm Society’s 39th Annual Scientific Sessions.

The study for Afib ablation had a much lower rate of death from any cause, or hospitalization for worsening heart failure compared to medical therapy. From the data, researchers proposed the idea that lowering AF burden may be a major driver for lowing co-morbid complications that may result in death.

Researchers randomly assigned patients with symptomatic paroxysmal or persistent atrial fibrillation who had failed antiarrhythmic drug (AAD) treatment, had unacceptable side-effects, or who were unwilling to take AADs. They also had NYHA class II-IV heart failure, left ventricular ejection fraction  equal to or below 35 percent, and an implanted defibrillator. The patients were randomized to undergo either catheter ablation (n=179) or pharmacological treatment (rate or rhythm control) of AF (n=184), in addition to guidelines-based heart failure therapy. After the baseline visit patients were followed for up to five years. AF burden was assessed using the dual chamber or biventricular implantable defibrillators (ICDs) at follow ups.

At baseline, AF burden was similar in both treatment groups. At all subsequent follow-up visits, AF burden was significantly lower in the ablation group than in the medical group (Figure A, p<0.001, Wilcoxon rank sum test).

A trend for improvement of AF burden in the ablation group was also reflected by a significant intra-individual decrease from baseline to 12, 36, and 60 months follow-up visits (Figure B, p<0.001, sign test). In contrast there was no significant change in AF burden in the medical group.

The research was presented at HRS 2018 by Dr. Johannes Brachmann from Medical Klinik Klinikum Coburg, Germany, and Nassir Marrouche, M.D., FHRS, from the University of Utah Health Sciences Center, Division of Cardiology, Salt Lake City.

Read about related article "CASTLE-AF Study Results Indicate Catheter Ablation of Atrial Fibrillation as First-Line Treatment for Heart Failure Patients." This data was presented at the 2017 European Society of Cardiology (ESC). 

Find links to all the Heart Rhythm 2018 Late-breaking Studies



1. Nassir F. Marrouche, M.D., Johannes Brachmann, M.D., Dietrich Andresen, et al. Catheter Ablation for Atrial Fibrillation with Heart Failure. N Engl J Med 2018; 378:417-427. February 1, 2018. DOI: 10.1056/NEJMoa1707855


#HRS2018 #HRS18

Related Content

Noninvasive Radioablation Offers Long-term Benefits to High-risk Heart Arrhythmia Patients
News | Ablation Systems | September 17, 2019
September 17, 2019 — Treating high-risk heart patients with a single, high dose of radiation therapy can dramatically
Biosense Webster Announces Initial Results From First-in-Human QDOT-FAST Study
News | Ablation Systems | May 16, 2019
Johnson & Johnson Medical Devices Companies announced that Biosense Webster, Inc.’s QDot Micro catheter...
CardioFocus Announces Results From HeartLight X3 Ablation System Pivotal Study
News | Ablation Systems | May 16, 2019
CardioFocus Inc. announced the presentation of results from its pivotal confirmatory study evaluating the HeartLight X3...
New Global Consensus Statement Addresses Catheter Ablation of Ventricular Arrhythmias
News | Ablation Systems | May 14, 2019
The Heart Rhythm Society (HRS) in partnership with three other professional societies issued an international consensus...
Netherlands Hospital to Install State-of-the-Art MRI Ablation Center
News | Ablation Systems | May 13, 2019
Imricor announced the signing of a commercial agreement with the Haga Hospital in The Hague, Netherlands to outfit a...
A CyberHeart cardiac ablation radiotherapy treatment plan showing where the radiation beam will ablate for a noninvasive pulmonary vein isolation procedure. Varian acquires, buys, purchases Cyberheart.

A CyberHeart cardiac ablation radiotherapy treatment plan showing where the radiation beams will ablate for a noninvasive pulmonary vein isolation procedure to treat an arrhythmia.

Feature | Ablation Systems | May 10, 2019 | Dave Fornell, Editor
May 10, 2019 — Radiation oncology vendor Varian announced it acquired the start-up company CyberHeart, which has deve
Ablation Reduces Risk of Dementia in Patients With AFib and Carotid Artery Disease
News | Ablation Systems | May 08, 2019
Even though many medical practitioners may opt not to perform procedures on higher-risk patients, new research finds it...
CardioFocus Announces European CE Mark Approval Of HeartLight X3 System
News | Ablation Systems | April 16, 2019
CardioFocus Inc. announced the European CE Mark approval of the HeartLight X3 Endoscopic Ablation System.
First Patient Treated With QDot Micro Ablation Catheter
News | Ablation Systems | February 04, 2019
Biosense Webster has enrolled and treated the first patient in its U.S. Investigational Device Exemption (IDE) study...
Overlay Init