Evidence map›Paper›PMID 29458408›Full record

ArticleTrials2018

Catheter Ablation versus Thoracoscopic Surgical Ablation in Long Standing Persistent Atrial Fibrillation (CASA-AF): study protocol for a randomised controlled trial.

Habib Rehman Khan, Ines Kralj-Hans, Shouvik Haldar, Toufan Bahrami, Jonathan Clague, Anthony De Souza, Darrel Francis, Wajid Hussain, Julian Jarman, David Gareth Jones and 10 more

Open access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
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

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Review
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

20 authors at 7 institutions in 2 countries.

Habib Rehman KhanRoyal Brompton and Harefield NHS Trust, London, UK.
Ines Kralj-HansRoyal Brompton and Harefield NHS Trust, London, UK.
Shouvik HaldarRoyal Brompton and Harefield NHS Trust, London, UK.
Toufan BahramiRoyal Brompton and Harefield NHS Trust, London, UK.
Jonathan ClagueRoyal Brompton and Harefield NHS Trust, London, UK.
Anthony De SouzaRoyal Brompton and Harefield NHS Trust, London, UK.
Darrel FrancisNational Heart and Lung Institute, Imperial College London, London, UK.
Wajid HussainRoyal Brompton and Harefield NHS Trust, London, UK.
Julian JarmanRoyal Brompton and Harefield NHS Trust, London, UK.
David Gareth JonesRoyal Brompton and Harefield NHS Trust, London, UK.
Neeraj MedirattaLiverpool Heart and Chest Hospital NHS Trust, Liverpool, UK.
Raad MohiaddinRoyal Brompton and Harefield NHS Trust, London, UK.
Tushar SalukheRoyal Brompton and Harefield NHS Trust, London, UK.
Simon JonesNew York University School of Medicine, New York, NY, USA.
Joanne LordSouthampton Health Technology Assessments Centre (SHTAC), University of Southampton, Southampton, UK.
Caroline MurphyKing's Clinical Trials Unit, Institute of Psychiatry, King's College London, London, UK.
Joanna KellyKing's Clinical Trials Unit, Institute of Psychiatry, King's College London, London, UK.
Vias MarkidesRoyal Brompton and Harefield NHS Trust, London, UK.
Dhiraj GuptaNational Heart and Lung Institute, Imperial College London, London, UK.
Tom WongRoyal Brompton and Harefield NHS Trust, London, UK. tom.wong@imperial.ac.uk.
Royal Brompton & Harefield NHS Foundation Trust · GBImperial College London · GBInstitute of Occupational Medicine · GBKing's College London · GBLiverpool Heart and Chest Hospital NHS Trust · GBNew York University · USUniversity of Southampton · GB

Funding

Efficacy and Mechanism Evaluation Programme 12/127/127Medical Research Council MC_PC_15107
6 · The paper itself

Abstract

backgroundAtrial fibrillation is the commonest arrhythmia which raises the risk of heart failure, thromboembolic stroke, morbidity and death. Pharmacological treatments of this condition are focused on heart rate control, rhythm control and reduction in risk of stroke. Selective ablation of cardiac tissues resulting in isolation of areas causing atrial fibrillation is another treatment strategy which can be delivered by two minimally invasive interventions: percutaneous catheter ablation and thoracoscopic surgical ablation. The main purpose of this trial is to compare the effectiveness and safety of these two interventions. METHODS/

designCatheter Ablation versus Thoracoscopic Surgical Ablation in Long Standing Persistent Atrial Fibrillation (CASA-AF) is a prospective, multi-centre, randomised controlled trial within three NHS tertiary cardiovascular centres specialising in treatment of atrial fibrillation. Eligible adults (n = 120) with symptomatic, long-standing, persistent atrial fibrillation will be randomly allocated to either catheter ablation or thoracoscopic ablation in a 1:1 ratio. Pre-determined lesion sets will be delivered in each treatment arm with confirmation of appropriate conduction block. All patients will have an implantable loop recorder (ILR) inserted subcutaneously immediately following ablation to enable continuous heart rhythm monitoring for at least 12 months. The devices will be programmed to detect episodes of atrial fibrillation and atrial tachycardia ≥ 30 s in duration. The patients will be followed for 12 months, completing appropriate clinical assessments and questionnaires every 3 months. The ILR data will be wirelessly transmitted daily and evaluated every month for the duration of the follow-up. The primary endpoint in the study is freedom from atrial fibrillation and atrial tachycardia at the end of the follow-up period. DISCUSSION: The CASA-AF Trial is a National Institute for Health Research-funded study that will provide first-class evidence on the comparative efficacy, safety and cost-effectiveness of thoracoscopic surgical ablation and conventional percutaneous catheter ablation for long-standing persistent atrial fibrillation. In addition, the results of the trial will provide information on the effects on patients' quality of life.

trial registrationISRCTN Registry, ISRCTN18250790 . Registered on 24 April 2015.

Indexed as

Randomized Controlled Trials as TopicAtrial FibrillationCatheter AblationCost-Benefit AnalysisData Interpretation, StatisticalHumansMulticenter Studies as TopicPostoperative CareProspective StudiesQuality-Adjusted Life YearsThoracoscopyCatheter ablationImplantable loop recorderLeft atrial appendage exclusionLong-standing persistent atrial fibrillationRandomised clinical trialThoracoscopic surgical ablation

Identifiers

PMID29458408
PMCPMC5819216
OpenAlexW2795218866

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.