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Updated: Feb 14, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

34.2K

Catheter Ablation versus Thoracoscopic Surgical Ablation in Long Standing Persistent Atrial Fibrillation (CASA-AF):

Habib Rehman Khan1,2,3, Ines Kralj-Hans1, Shouvik Haldar1,3

  • 1Royal Brompton and Harefield NHS Trust, London, UK.

Trials
|February 21, 2018
PubMed

Insights

This trial compares catheter ablation and thoracoscopic surgical ablation for persistent atrial fibrillation. Results will guide treatment choices for this common arrhythmia.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Atrial fibrillation is a prevalent arrhythmia increasing risks of heart failure, stroke, and mortality.
  • Current treatments focus on rate/rhythm control and stroke risk reduction.
  • Minimally invasive ablation techniques, including catheter and surgical approaches, offer alternative strategies.

Purpose of the Study:

  • To compare the effectiveness and safety of percutaneous catheter ablation versus thoracoscopic surgical ablation for long-standing persistent atrial fibrillation.
  • To evaluate the impact of these interventions on patients' quality of life.

Main Methods:

  • A prospective, multi-centre, randomized controlled trial (CASA-AF) involving 120 adults with symptomatic, long-standing, persistent atrial fibrillation.
  • Patients were randomized 1:1 to catheter ablation or thoracoscopic ablation.
  • Continuous rhythm monitoring using implantable loop recorders for 12 months, with primary endpoint of freedom from atrial fibrillation/atrial tachycardia.

Main Results:

  • The study is designed to provide comparative data on efficacy and safety.
  • Continuous monitoring via implantable loop recorders will offer detailed rhythm assessment.
  • Quality of life assessments will be conducted throughout the 12-month follow-up period.

Conclusions:

  • The CASA-AF trial will offer high-quality evidence on the comparative efficacy, safety, and cost-effectiveness of two key ablation strategies.
  • Findings will inform clinical decision-making for patients with long-standing persistent atrial fibrillation.
  • The study will also elucidate the effects on patient-reported quality of life.
Abstract

Keywords:
Catheter ablationImplantable loop recorderLeft atrial appendage exclusionLong-standing persistent atrial fibrillationRandomised clinical trialThoracoscopic surgical ablation

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