Evidence map›Paper›PMID 30646857›Full record

SynthesisBMC cardiovascular disorders2019

Catheter ablation for atrial fibrillation in heart failure with reduced ejection fraction: a systematic review and meta-analysis of randomized controlled trials.

Ahmed AlTurki, Riccardo Proietti, Ahmed Dawas, Hasan Alturki, Thao Huynh, Vidal Essebag

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC cardiovascular disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 5 pooled it
6.3field-weighted citation impact, top 3% 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

30 citing papers in PubMed, 5 syntheses or guidelines pooled it, 62 citations in OpenAlex.

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  20. One-Year Change in the HFrontiers in cardiovascular medicine · 2021
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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 at 3 institutions in 3 countries.

Ahmed AlTurkiDivision of Cardiology, McGill University Health Center, 1650 Cedar Ave, Room E5-200, Montreal, QC, H3G 1A4, Canada.ORCID 0000-0003-0593-9191
Riccardo ProiettiDepartment of Cardiac, Thoracic, and Vascular Sciences, Padua, Italy.
Ahmed DawasDivision of Cardiology, McGill University Health Center, 1650 Cedar Ave, Room E5-200, Montreal, QC, H3G 1A4, Canada.
Hasan AlturkiSchool of Medicine and Medical Science, University College, Dublin, Ireland.
Thao HuynhDivision of Cardiology, McGill University Health Center, 1650 Cedar Ave, Room E5-200, Montreal, QC, H3G 1A4, Canada.
Vidal EssebagDivision of Cardiology, McGill University Health Center, 1650 Cedar Ave, Room E5-200, Montreal, QC, H3G 1A4, Canada. vidal.essebag@mcgill.ca.
McGill University Health Centre · CAUniversity College Dublin · IEUniversity of Padua · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrevious randomized controlled trials (RCT)s showed similar outcomes in patients with atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) treated with anti-arrhythmic drugs (AAD) compared to rate control therapy. We sought to evaluate whether catheter ablation is superior to medical therapy in patients with AF and HFrEF.

methodsWe searched electronic databases for all RCTs that compared catheter ablation and medical therapy (with or without use of AAD). We used random-effects models to summarize the studies. The primary end-point was all-cause mortality. Secondary outcomes included heart failure-related hospitalizations and change in left ventricular ejection fraction (LVEF).

resultsWe retrieved and summarized 7 randomized controlled trials, enrolling 856 patients (429 in the catheter ablation arm and 427 in the medical therapy arm). Compared with medical therapy (including use of AAD), AF catheter ablation was associated with a significant reduction in mortality (risk ratio 0.50; 95% confidence interval [CI]: 0.34 to 0.74; P = 0.0005) and heart failure-related hospitalizations (risk ratio 0.56; 95% CI: 0.44 to 0.71; P < 0.0001). Furthermore, catheter ablation led to significant improvements in LVEF (weighted mean difference, 7.48; 95% CI: 3.71 to 11.26; P < 0.0001).

conclusionsCompared to medical therapy, including use of AAD, catheter ablation for AF was associated with a significant reduction in mortality and heart failure-related hospitalizations as well as an improvement in LVEF in patients with HFrEF. Larger trials are needed to confirm whether rhythm control with ablation is superior to rate control in patients with AF and heart failure.

Indexed as

Catheter AblationStroke VolumeVentricular Function, LeftAnti-Arrhythmia AgentsAtrial FibrillationDisease ProgressionHeart FailureHeart RateHumansRandomized Controlled Trials as TopicRecovery of FunctionRisk FactorsTreatment OutcomeAnti-Arrhythmia AgentsAtrial fibrillationCatheter ablationHeart failure

Identifiers

PMID30646857
PMCPMC6332840
OpenAlexW2913815352

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.