Evidence map›Paper›PMID 30758702›Full record

Trial reportJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2019

Regional differences in patient characteristics and outcomes during uninterrupted anticoagulation with dabigatran versus warfarin in catheter ablation of atrial fibrillation: the RE-CIRCUIT study.

Stefan H Hohnloser, Hugh Calkins, Stephan Willems, Atul Verma, Richard Schilling, Ken Okumura, Matias Nordaby, Eva Kleine, Branislav Biss, Edward P Gerstenfeld and 1 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02348723 (Randomized Evaluation of Dabigatran Etexilate Compared to warfarIn in pulmonaRy Vein Ablation), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

NCT02348723 phase4completednot on this map

Randomized Evaluation of Dabigatran Etexilate Compared to warfarIn in pulmonaRy Vein Ablation: Assessment of an Uninterrupted periproCedUral alntIcoagulation sTrategy (The RE-CIRCUIT Trial)

TypeinterventionalSponsorBoehringer IngelheimRan2015 to 2016Enrolled678ConditionsAtrial FibrillationArmsWarfarin, Dabigatran Etexilate 150mg
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

11 authors.

Stefan H HohnloserDepartment of Cardiology, J. W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany. hohnloser@em.uni-frankfurt.de.
Hugh CalkinsElectrophysiology Laboratory and Arrhythmia Service, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Stephan WillemsDepartment of Cardiac Electrophysiology, University of Hamburg, Hamburg, Germany.
Atul VermaDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
Richard SchillingCardiac and Cardiology Research Department, St. Bartholomew's Hospital, London, UK.
Ken OkumuraDivision of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, Kumamoto, Japan.
Matias NordabyTA Cardiology Medicine, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany.
Eva KleineBiostatistics + Data Sciences, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany.
Branislav BissDepartment of Clinical Operations, Boehringer Ingelheim RCV, Vienna, Austria.
Edward P GerstenfeldCardiac Electrophysiology and Arrhythmia Service, University of California, San Francisco, CA, USA.
RE-CIRCUIT® investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo describe regional differences in patient characteristics, ablation procedures, and bleeding events in the RE-CIRCUIT study. RE-CIRCUIT was a prospective, multicenter study that captured data from different regions, providing an opportunity to understand the practices followed in various regions. The incidence of major bleeding events (MBEs) was significantly lower with uninterrupted dabigatran versus uninterrupted warfarin.

methodsPatients were randomized to receive dabigatran 150 mg twice daily or warfarin. Ablation was performed with uninterrupted anticoagulation for 8 weeks after the procedure. Regions were Western Europe, Eastern Europe, North America, and Asia.

resultsOf 704 patients screened across 104 sites, 635 underwent catheter ablation (dabigatran, 317; warfarin, 318). Patient characteristics were different across various regions. Patients from North America had the highest prevalence of atrial flutter (33%), coronary artery disease (29%), diabetes mellitus (18%), and previous myocardial infarction (9%). Hypertension was most prevalent in Eastern Europe (75%), as was congestive heart failure (40% vs 2% in Western Europe). Pulmonary vein isolation alone was the preferred technique used in most patients (86% in North America and 75-83% elsewhere) and radio frequency was the preferred energy source. The major outcome measure, incidence of MBEs during and up to 2 months after the procedure, was consistently lower with uninterrupted dabigatran versus warfarin, irrespective of regions and their procedural differences, and different ablation techniques utilized.

conclusionsThis analysis shows that the benefits of dabigatran over a vitamin K antagonist in patients undergoing atrial fibrillation ablation are consistent across all geographic regions studied.

trial registrationNCT02348723 (https://clinicaltrials.gov/ct2/show/NCT02348723).

Indexed as

AgedAnticoagulantsAsiaAtrial FibrillationCatheter AblationComorbidityDabigatranEuropeFemaleHumansMaleMiddle AgedNorth AmericaProspective StudiesWarfarinAnticoagulantsDabigatranWarfarinAblationAnticoagulationAtrial fibrillationDabigatranRegional differenceWarfarin

Identifiers

PMID30758702
PMCPMC6660508

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Registered trials

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.