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Nachrichten, Termine, Experten
The Atrial Fibrillation Network (AFNET) launched the CABA-MiTRA-AFNET12-DZHK34 study. On September 21, 2026, the first participant was enrolled at the University Hospital Cologne.
Mitral valve regurgitation is the most common heart valve disease among older adults. Patients typically undergo catheter-based repair of the defective heart valve. Many of these patients also suffer from atrial fibrillation, a heart rhythm disorder that can be treated with medication and catheter ablation. The CABA-MiTRA-AFNET12-DZHK34 study now aims to determine whether patients with atrial fibrillation after mitral valve repair are better protected against strokes and other serious complications through ablation than they are with the standard drug treatment currently in use.
Atrial fibrillation, the most common cardiac arrhythmia, is associated with an increased risk of premature death, stroke, heart failure, and other serious complications. Early initiation of rhythm-control therapy has been shown to be beneficial in reducing the complications associated with atrial fibrillation (1).
Although atrial fibrillation ablation is a well-established technology, it is currently still used relatively rarely in older patients with comorbidities. To date, there have been only a few controlled studies on the efficacy and safety of catheter ablation for atrial fibrillation in older adults. In particular, atrial fibrillation ablation after repair of a mitral valve defect has not yet been studied.
CABA-MiTRA stands for Catheter Ablation for Atrial Fibrillation in Patients with Severe Mitral Regurgitation after Successful Transcatheter Mitral Valve Repair. AFNET Board Member Prof. Stephan Willems of Hamburg, who is leading the CABA-MiTRA-AFNET12-DZHK34 study together with three AFNET Steering Committee members – Prof. Lars Eckardt of Münster, Prof. Daniel Steven of Cologne, and Prof. Reza Wakili of Frankfurt – explains the background:
“Recent findings showed that catheter ablation provides better protection against complications of atrial fibrillation for patients with atrial fibrillation and certain comorbidities than the usual standard treatment. We now want to determine whether this also applies to the specific group of atrial fibrillation patients who have undergone mitral valve repair. To this end, the Atrial Fibrillation Competence Network (AFNET) launched the CABA-MiTRA-AFNET12-DZHK34 study and is now conducting it in collaboration with the German Center for Cardiovascular Research (DZHK).“
To answer the study’s research question, AFNET plans to enroll 956 patients who have atrial fibrillation and have undergone successful mitral valve repair within the past six months. Upon enrollment in the study, all participants will be randomly assigned to one of two equally sized groups, where they will receive either atrial fibrillation ablation or standard guideline-based medical treatment. Approximately 50 hospitals in Germany and Europe are expected to participate in the recruitment and treatment of study patients.
Co-Principal Investigator Prof. Wakili praised the excellent collaboration among all those involved: “CABA-MiTRA-AFNET12-DZHK34 is a team effort. Thanks to the tireless dedication of AFNET and the participating study centers, as well as the fruitful cooperation with the DZHK and our other partners, we have been able to successfully launch the study and enroll our first patient.”
Current data suggest that the complication-preventing effect of early atrial fibrillation ablation is due to a reduction in atrial fibrillation burden. To investigate this relationship, atrial fibrillation burden is also being quantitatively assessed as part of a substudy. To this end, participants at some study sites are being offered the option of having an event recorder implanted, which allows for the precise measurement of atrial fibrillation burden.
“Atrial fibrillation and mitral valve regurgitation frequently occur together in older adults. Not only are these two conditions linked by a complex pathophysiological interaction, but their prevalence is also expected to increase due to the aging population and other factors, such as obesity. Optimal treatment for this patient group is therefore becoming increasingly important,” explains co-principal investigator Prof. Steven.
Co-principal investigator Prof. Eckardt summarizes: “The results of the CABA-MiTRA-AFNET12-DZHK34 study have the potential to improve treatment for people with atrial fibrillation and mitral valve regurgitation. Our study thus has the potential to contribute to healthier aging in this population group, which is at increased risk for premature death, stroke, and heart failure.”
CABA-MiTRA-AFNET12-DZHK34 is an investigator-initiated trial that compares two approved treatment strategies in patients with atrial fibrillation and has no commercial interests. The study is sponsored by AFNET. Financial support for conducting the study is provided by the following partners: German Center for Cardiovascular Research (DZHK), German Heart Foundation, Abbott Medical, Boston Scientific, and Biosense Webster / Johnson & Johnson.
References
(1) Kirchhof P et al. Early rhythm control therapy in patients with atrial fibrillation. N Engl J Med 2020; 383:1305-1316. DOI: 10.1056/NEJMoa2019422
Registration: NCT07380932
About the Atrial Fibrillation NETwork (AFNET)
The Atrial Fibrillation NETwork is an interdisciplinary research network comprising scientists and physicians from hospitals and practices dedicated to improving the management of atrial fibrillation through coordinated research in Germany, Europe, and worldwide. Its main objective is to conduct high quality investigator-initiated clinical trials and registries on a national and international level as well as translational research projects. The AFNET continues the long-term activities of the network which has been funded by the German Federal Ministry of Research and Education over a decade. Since January 2015, specific projects and infrastructures of the AFNET are funded by the German Centre for Cardiovascular Research (DZHK), and some projects by EU research grants. AFNET has long expertise in the management of atrial fibrillation, but also provides support for work in other fields informing cardiovascular care. The results of 23 years of clinical and translational research improved the lives of patients with cardiovascular diseases and influenced treatment guidelines.
Press Contact
Angelika Leute, PhD
Phone: +49 202 2623395
a.leute@t-online.de
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