Evidence map›Paper›PMID 30701358›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2020

The impact of steerable sheaths on unblinded contact force during catheter ablation for atrial fibrillation.

Marc W Deyell, Glen Wen, Zachary Laksman, Matthew T Bennett, Santabhanu Chakrabarti, John A Yeung-Lai-Wah, Andrew D Krahn, Jason G Andrade

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 14% 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

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. The Impact of a Visualized Steerable Sheath on Radiofrequency Catheter Ablation for First-Time Atrial Fibrillation Ablation: A Prospective, Randomized, Single-Blind Study.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026
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  8. High efficiency single-catheter workflow for radiofrequency atrial fibrillation ablation in the QDOT catheter era.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024
    Article
  9. Evaluation of an Optimized Workflow for the Radiofrequency Catheter Ablation of Paroxysmal Atrial Fibrillation.Medical science monitor : international medical journal of experimental and clinical research · 2024
    Article
  10. 2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
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  15. Choice of Steerable Sheath Impacts Contact Force Stability During Pulmonary Vein Isolation.The Journal of innovations in cardiac rhythm management · 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

8 authors at 2 institutions in 1 country.

Marc W DeyellHeart Rhythm Services, Division of Cardiology, Department of Medicine, University of British Columbia, #211-1033 Davie Street, Vancouver, BC, V6E 1M7, Canada. mdeyell@providencehealth.bc.ca.ORCID http://orcid.org/0000-0001-8434-7076
Glen WenHeart Rhythm Services, Division of Cardiology, Department of Medicine, University of British Columbia, #211-1033 Davie Street, Vancouver, BC, V6E 1M7, Canada.
Zachary LaksmanHeart Rhythm Services, Division of Cardiology, Department of Medicine, University of British Columbia, #211-1033 Davie Street, Vancouver, BC, V6E 1M7, Canada.
Matthew T BennettHeart Rhythm Services, Division of Cardiology, Department of Medicine, University of British Columbia, #211-1033 Davie Street, Vancouver, BC, V6E 1M7, Canada.
Santabhanu ChakrabartiHeart Rhythm Services, Division of Cardiology, Department of Medicine, University of British Columbia, #211-1033 Davie Street, Vancouver, BC, V6E 1M7, Canada.
John A Yeung-Lai-WahHeart Rhythm Services, Division of Cardiology, Department of Medicine, University of British Columbia, #211-1033 Davie Street, Vancouver, BC, V6E 1M7, Canada.
Andrew D KrahnHeart Rhythm Services, Division of Cardiology, Department of Medicine, University of British Columbia, #211-1033 Davie Street, Vancouver, BC, V6E 1M7, Canada.
Jason G AndradeHeart Rhythm Services, Division of Cardiology, Department of Medicine, University of British Columbia, #211-1033 Davie Street, Vancouver, BC, V6E 1M7, Canada.
University of British Columbia · CAProvidence Health Care · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this study was to evaluate the impact of steerable sheaths on multiple contact force parameters during atrial fibrillation (AF) ablation. Steerable sheaths are commonly used during AF ablation, at an additional cost to standard fixed-curve sheaths. However, there is little data on their incremental value in the era of contact force-guided radiofrequency ablation.

methodsThis multi-center cohort study included consecutive patients undergoing index pulmonary vein (PV) isolation with a force-sensing catheter. Operators employed either only steerable or only fixed-curve sheaths. Operators targeted a force of 10-40 g for each ablation lesion. Automated ablation lesion assessment software with standardized settings was employed.

resultsOf 85 subjects, 52 and 33 underwent ablation with steerable and fixed-curve sheaths, respectively. The steerable sheath group showed significantly higher average and maximum forces, but predominantly for the right PVs. The proportion of lesions with ≥ 10% of time with less than 10 g of force was lower in the steerable sheath group (adjusted odds ratio 0.56, steerable vs. fixed; 95% confidence interval 0.35, 0.89, p = 0.01). Improved stability was seen in the posterior aspect of both PV pairs. The proportion of RF time-in-target (the proportion of RF time meeting lesion criteria) was not different between the two groups (p = 0.176).

conclusionsEven with contemporary contact force targets, steerable sheath use in AF ablation is associated with better average and maximum contact force and increased stability in comparison to fixed-curve sheaths.

Indexed as

Atrial FibrillationCatheter AblationEpicardial MappingEquipment DesignFemaleHumansMaleMiddle AgedPulmonary VeinsRetrospective StudiesAtrial fibrillationCatheter ablationContact forceSteerable sheath

Identifiers

PMID30701358
OpenAlexW2914486891

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.