Evidence map›Paper›PMID 30404603›Full record

Observational studyBMC cardiovascular disorders2018

Resource use and clinical outcomes in patients with atrial fibrillation with ablation versus antiarrhythmic drug treatment.

Julian W E Jarman, Wajid Hussain, Tom Wong, Vias Markides, Jamie March, Laura Goldstein, Ray Liao, Iftekhar Kalsekar, Abhishek Chitnis, Rahul Khanna

Abstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC cardiovascular disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–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

12 citing papers in PubMed.

  1. Trial
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  12. MulticellularFrontiers in cardiovascular medicine · 2020
    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

10 authors.

Julian W E JarmanHeart Rhythm Centre, NIHR Cardiovascular Research Unit, The Royal Brompton Hospital, and National Heart and Lung Institute, Imperial College, London, UK.
Wajid HussainHeart Rhythm Centre, NIHR Cardiovascular Research Unit, The Royal Brompton Hospital, and National Heart and Lung Institute, Imperial College, London, UK.
Tom WongHeart Rhythm Centre, NIHR Cardiovascular Research Unit, The Royal Brompton Hospital, and National Heart and Lung Institute, Imperial College, London, UK.
Vias MarkidesHeart Rhythm Centre, NIHR Cardiovascular Research Unit, The Royal Brompton Hospital, and National Heart and Lung Institute, Imperial College, London, UK.
Jamie MarchFranchise Health Economics and Market Access, Johnson & Johnson, Irvine, CA, USA.
Laura GoldsteinFranchise Health Economics and Market Access, Johnson & Johnson, Irvine, CA, USA.
Ray LiaoJanssen R&D US, Raritan, NJ, USA.
Iftekhar KalsekarMedical Device Epidemiology, Johnson and Johnson, 410 George Street, New Brunswick, NJ, 08901, USA.
Abhishek ChitnisMedical Device Epidemiology, Johnson and Johnson, 410 George Street, New Brunswick, NJ, 08901, USA.
Rahul KhannaMedical Device Epidemiology, Johnson and Johnson, 410 George Street, New Brunswick, NJ, 08901, USA. rkhann14@its.jnj.com.ORCID 0000-0002-2478-1724

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe objective of our study was to compare resource use and clinical outcomes among atrial fibrillation (AF) patients who underwent catheter ablation versus antiarrhythmic drug (AAD) treatment.

methodsA retrospective cohort design using the Clinical Practice Research Data-Hospital Episode Statistics linkage data from England (2008-2013) was used. Patients undergoing catheter ablation treatment for AF were indexed to the date of first procedure. AAD patients with at least two different AAD drugs were indexed to the first fill of the second AAD. Patients were matched using 1:1 propensity matching. Primary endpoints including inpatient and outpatient visits were compared between ablation and AAD cohorts in the 4 months-1 year period after index. Secondary endpoints including heart failure, stroke, cardioversion, mortality, and a composite outcome were compared for the 4 months-3 years post-index period in the two groups. Cox-proportional hazards models were estimated for clinical outcomes comparison.

resultsA total of 558 patients were matched in the two groups for resource utilization comparison. The average number of cardiovascular (CV)-related outpatient visits in the 4-12 months post-index period were significantly lower in the ablation group versus the AAD group (1.76 vs 3.57, p < .0001). There was no significant difference in all-cause and CV-related inpatient visits and all-cause outpatient visits among the two groups. For secondary endpoints comparison, 615 matched patients in each group emerged. Ablation patients had 38% lower risk of heart failure (hazard ratio [HR] 0.62, p = 0.0318), 50% lower risk of mortality (HR 0.50, p = 0.0082), and 43% lower risk of experiencing a composite outcome (HR 0.57, p = 0.0009) as compared to AAD treatment cohort.

conclusionAF ablation was associated with significantly lower CV-related outpatient visits, and lower risk of heart failure and mortality versus AAD therapy.

Indexed as

Catheter AblationHealth ResourcesAgedAmbulatory CareAnti-Arrhythmia AgentsAtrial FibrillationEnglandFemaleHeart FailureHumansIschemic Attack, TransientLongitudinal StudiesMaleMiddle AgedPatient AdmissionRetrospective StudiesAnti-Arrhythmia AgentsAnti-arrhythmic drugsAtrial fibrillationCatheter ablation

Identifiers

PMID30404603
PMCPMC6223058

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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.