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

First Patient Treated in STELLAR Atrial Fibrillation IDE Study
News | Ablation Systems | November 30, 2018
Johnson & Johnson Medical Devices Companies announced that Biosense Webster Inc. has enrolled and treated the first...
FDA Approves Biosense Webster's Tag-Index Guided Ablation Software
Technology | Ablation Systems | October 09, 2018
Biosense Webster Inc. recently received approval from the U.S. Food and Drug Administration (FDA) for its Visitag...
Medtronic Cryoballoon Improves Quality of Life, Reduces Systems of Persistent Atrial Fibrillation
News | Ablation Systems | August 28, 2018
Medtronic plc announced new findings from the CRYO4PERSISTENT AF clinical trial demonstrating improved quality of life...
Thermedical Announces FDA IDE Approval for Clinical Study of Durablate Catheter
News | Ablation Systems | August 02, 2018
Thermedical announced that the U.S. Food and Drug Administration (FDA) has approved its Investigational Device...
Boston Scientific to Acquire Cryterion Medical Inc.
News | Ablation Systems | July 13, 2018
Boston Scientific Corp. recently announced a definitive agreement to acquire Cryterion Medical Inc., a privately-held...
Treating AFib With Ablation Reduces Mortality and Stroke
News | Ablation Systems | July 05, 2018
Using catheter-based ablation instead of medications alone reduces the risks of death and stroke in patients with the...
LuxCath Showcases OmniView Light-Guided Ablation Catheter at HRS 2018
News | Ablation Systems | May 22, 2018
LuxCath LLC showcased the next generation of its proprietary OmniView light-guided catheter ablation system at the 2018...
The Kardium Globe combined mapping and ablation catheter. The device has a distal multi-electrode array consisting of 16 ribs with 122 gold-plated electrodes. Ablation can be done with up to 24 electrodes simultaneously.  #HRS2018

The Kardium Globe combined mapping and ablation catheter. The device has a distal multi-electrode array consisting of 16 ribs with 122 gold-plated electrodes. Ablation can be done with up to 24 electrodes simultaneously. 

News | Ablation Systems | May 21, 2018
May 21, 2018 — Complete pulmonary vein isolation (PVI) was achieved in more than 99 percent of patients in a first-in
CardioFocus Announces Successful Live Case Featuring HeartLight X3 System
News | Ablation Systems | May 17, 2018
Medical device manufacturer CardioFocus Inc. announced a successful live case featuring its HeartLight X3 System during...
Imricor MRI-Guided Cardiac Ablation Study Results to Be Presented at HRS 2018
News | Ablation Systems | May 10, 2018
Results from the clinical study to evaluate Imricor’s Vision-MR Ablation Catheter for the treatment of atrial flutter...
Overlay Init