AF Ablation Latest: Whom to Treat and How Early to Intervene

This transcript has been edited for clarity.

Thomas M. Munger, MD: Hello. I'm Tom Munger, electrophysiologist and heart rhythm services chair at Mayo Clinic in Rochester, Minnesota, where my colleague, Dr Peter Noseworthy, also serves as an electrophysiologist. We're here to discuss the role of ablation in atrial fibrillation (AF).

AF is a very common arrhythmia that we deal with each day. It will affect over a quarter of the population ≥ 45 years of age and has been increasing in frequency dramatically over the past several decades.

Several recent trials have dealt with the topic of ablation in AF. Peter, I'd like to begin by asking you about CABANA, a large randomized trial completed here by Douglas Packer, for which you served as a co-author.

Peter A. Noseworthy, MD: It's nice to be with you today, Tom, and there's a ton to talk about. It's a very exciting time in electrophysiology. I think we have more trials over the past couple of years than we've had for the decade before, which has given us a lot to talk and think about.

The most awaited study in cardiac electrophysiology was indeed the CABANA trial. For a long time, we've been looking at surrogate endpoints like symptom control and burden, focused on that 30-second threshold at which we diagnose AF.