AATAC Trial: Ablation Vs. Amiodarone for Persistent Atrial Fibrillation in CHF

AATAC Trial, ablation, amiodarone, afib
Name of the Trial
AATAC
Title of the Trial
Ablation vs. amiodarone for Atrial Fibrillation in patients with CHF and an implanted device
Design
Multicenter, parallel-group, open-label, randomized controlled trial
Year of Publication
2016
Objective
To assess if AF ablation is superior to amiodarone in patients HFrEF (LVEF ≤40%) and persistent AF.
Number of Patients (N)
203
Inclusion Criteria
Patients with:
persistent AF,
dual-chamber ICD or CRT-D,
NYHA II to III, and LVEF <40% within the past 6 months
Duration of Follow up
24 months
Comparison groups
AF ablation (n=203) vs amiodarone (n=203)
Primary Outcomes
Atrial arrhythmia-free survival
70% vs 34% (p<0.001)
Key Secondary Outcomes
Unplanned hospitalization
31% vs 57%
RR 0.55, 95% CI 0.39-0.76, p<0.001

Death
8% vs 18%
RR 0.44, 95% CI -0.20 to 0.96, p=0.037

LVEF (change from baseline)
8.1 vs 4.0
p=0.02
Conclusion
In patients with NYHA II-III HFrEF and persistent AF, AF ablation was associated with a 36% absolute increase in AF-free survival.
Citation, article link
Di Biase et al. Circulation. 2016. 133(17):1637-1634.