The CABANA-HF trial is an international, multicenter, randomized trial evaluating catheter ablation versus guideline-directed medical therapy for atrial fibrillation in HFpEF.
About the Trial
Heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) together affect approximately 1.2 million patients in the United States. These patients face a 25–60% event rate at five years, yet there are no completed randomized clinical trials evaluating AF ablation vs medical therapy in this high-risk population.
All participants receive contemporary guideline-directed medical therapy including SGLT2 inhibitors, MRAs, ARNI, and GLP1-RA alongside rhythm-control strategies.
With over 120 sites across 12 countries, CABANA-HF will generate evidence applicable to diverse patient populations worldwide.
Patients are randomized 1:1 to one of two treatment strategies, both anchored in contemporary guideline-directed medical therapy for HFpEF.
Catheter ablation of atrial fibrillation combined with comprehensive guideline-directed medical therapy for HFpEF. The ablation strategy targets pulmonary vein isolation with additional lesion sets at the operator's discretion.
Optimized guideline-directed medical therapy for HFpEF with rate or rhythm control for atrial fibrillation per current ACC/AHA/ESC guidelines. Crossover to ablation is permitted after a prespecified period if clinically indicated.
Composite of cardiovascular mortality or significant worsening heart failure events.
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