Evidence map›Paper›PMID 23812041›Full record

Observational studyClinical research in cardiology : official journal of the German Cardiac Society2013

Types and outcomes of cardioversion in patients admitted to hospital for atrial fibrillation: results of the German RHYTHM-AF Study.

Anselm K Gitt, Wenefrieda Smolka, Galin Michailov, Alexandra Bernhardt, David Pittrow, Thorsten Lewalter

Abstract readComparative StudyMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Clinical research in cardiology : official journal of the German Cardiac Society, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Observational
  5. Review
  6. Observational
  7. Article
  8. Observational
  9. Health-related quality of life changes in patients undergoing repeated catheter ablation for atrial fibrillation.Clinical research in cardiology : official journal of the German Cardiac Society · 2016
    Article
  10. Observational
  11. Atrial fibrillation and long-term sports practice: epidemiology and mechanisms.Clinical research in cardiology : official journal of the German Cardiac Society · 2015
    Review
  12. Review
  13. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Anselm K GittStiftung Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany, GittA@klilu.de.
Wenefrieda Smolka
Galin Michailov
Alexandra Bernhardt
David Pittrow
Thorsten Lewalter

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtrial fibrillation (AF) accounts for approximately one-third of hospitalizations for cardiac rhythm disturbances. Little is known about the characteristics of current use of cardioversion (CV) and its success rates in clinical practice in Germany.

methodsAs part of the international RHYTHM-AF Study, 655 consecutive patients with documented AF (mean age 68.3 ± 10.5 years, 64.9 % males) who were considered candidates for CV were prospectively enrolled in 22 German hospitals (21 academic/teaching and 1 non-teaching). CV was considered successful if sinus rhythm or atrial rhythm was obtained within 1 day after start of pharmacological CV (PCV) or if sinus rhythm was achieved and maintained for at least 10 min after electrical CV (ECV).

resultsPatients with AF considered for CV had ECG in 94.4 %, Holter ECG in 25.8 %, and transesophageal echocardiography (TEE) in 73.1 % of cases. They underwent ECV (after mean 16 h, range 4-48), in 65.3 % and PCV in 6.7 % of patients (amiodarone in 47.7 %, flecainide in 27.3 %, propafenone in 2.3 %) as first CV procedure. No CV was performed in 27.9 %, mainly due to spontaneous CV or pathologic TEE. Primary success rates were 86.7 % for electrical CV and 54.5 % for pharmacological CV. More patients in the ECV group compared to the PCV group received oral anticoagulation at discharge (79.2 vs. 59.1 %, p < 0.001), and at 60 days (77.5 vs. 56.8 %, p < 0.001). Further, at 60 days the proportion of patients in sinus rhythm was not different between groups (ECV 76.8 % vs. PCV 77.3 %).

conclusionsIn large academic centres in Germany, the preferred CV method is electrical, mainly due to its easy access and to its higher success rate for the initial restoration of sinus rhythm. Considering the limitations of the open-label, non-randomised study design, overall short-term success rates appeared higher after ECV compared to PCV during hospitalisation, but not after 60 days.

Indexed as

HospitalizationAgedAged, 80 and overAtrial FibrillationEchocardiography, TransesophagealElectric CountershockElectrocardiographyElectrocardiography, AmbulatoryFemaleFollow-Up StudiesGermanyHumansMaleMiddle AgedProspective StudiesTime Factors

Identifiers

PMID23812041

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.