Evidence map›Paper›PMID 29549512›Full record

SynthesisJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2018

Catheter ablation versus medical therapy for patients with persistent atrial fibrillation: a systematic review and meta-analysis of evidence from randomized controlled trials.

Chen Chen, Xinbin Zhou, Min Zhu, Shenjie Chen, Jie Chen, Hongwen Cai, Jin Dai, Xiaoming Xu, Wei Mao

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 pooled it
2.9field-weighted citation impact, top 8% 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

21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Article
  4. Proteolytic degradation of atrial sarcomere proteins underlies contractile defects in atrial fibrillation.American journal of physiology. Heart and circulatory physiology · 2024
    Article
  5. Observational
  6. Article
  7. Review
  8. Article
  9. Review
  10. Atrial Fibrillation: Rate Versus Rhythm Control.HCA healthcare journal of medicine · 2023
    Review
  11. Article
  12. Review
  13. Article
  14. Observational
  15. Article
  16. Article
  17. Observational
  18. Article
  19. Review
  20. 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

9 authors at 1 institution in 1 country.

Chen ChenDepartment of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Xinbin ZhouDepartment of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Min ZhuDepartment of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Shenjie ChenDepartment of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Jie ChenDepartment of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Hongwen CaiDepartment of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Jin DaiDepartment of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Xiaoming XuDepartment of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Wei MaoDepartment of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China. maoweilw@163.com.ORCID http://orcid.org/0000-0003-1994-2770
Zhejiang Chinese Medical University · CN

Funding

National Natural Science Foundation of China 81673706Natural Science Foundation of Zhejiang Province LQ17H290003zhejiang province key social development projects of major scientific and technological special projects 2015C0304
6 · The paper itself

Abstract

purposeThe superiority of catheter ablation (CA) for persistent (and long-standing persistent) atrial fibrillation (AF) is currently not well defined. We performed a meta-analysis of randomized controlled trials (RCTs) to assess the clinical outcomes of CA compared with medical therapy in persistent AF patients.

methodsWe systematically searched PubMed, EMBASE, the Cochrane Library, and clinicaltrials.gov for RCTs comparing CA with medical therapy in patients with persistent AF. For CA vs medical rhythm control, the primary outcome was freedom from atrial arrhythmia. For CA vs medical rate control, the primary outcome was the change in the left ventricular ejection fraction (LVEF).

resultsEight studies with a total of 809 patients were included in the final analysis. Compared with medical rhythm control, CA was superior in achieving freedom from atrial arrhythmia (RR 2.08, 95% CI [1.67, 2.58]; P < 0.00001). Similar result was found in CA arm without antiarrhythmic drug use after operation (RR 1.82, 95%CI [1.33, 2.49]; P = 0.0002). CA was also superior in reducing the probability of cardioversion (RR 0.59, 95%CI [0.46, 0.76]; P < 0.0001) and hospitalization (RR 0.54, 95%CI [0.39, 0.74]; P = 0.0002). Compared with the medical rate control in persistent AF patients with heart failure (HF), CA significantly improved the LVEF (MD 7.72, 95%CI [4.78, 10.67]; P < 0.00001) and reduced Minnesota Living with Heart Failure Questionnaire scores (MD 11.1395% CI [2.52-19.75]; P = 0.01).

conclusionsCA appeared to be superior to medical therapy in persistent AF patients and might be considered as a first-line therapy for some persistent AF patients especially for those with HF.

Indexed as

AdultAnti-Arrhythmia AgentsAtrial FibrillationCatheter AblationFemaleHumansMaleMiddle AgedPrognosisRandomized Controlled Trials as TopicRisk AssessmentTreatment OutcomeAnti-Arrhythmia AgentsCatheter ablationMedical therapyMeta-analysisPersistent atrial fibrillation

Identifiers

PMID29549512
OpenAlexW2789426606

What OpenQuestion holds

Textmetadata
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.