Evidence map›Paper›PMID 31269029›Full record

Trial reportPloS one2019

Online webinar training to analyse complex atrial fibrillation maps: A randomized trial.

João Mesquita, Natasha Maniar, Tina Baykaner, Albert J Rogers, Mark Swerdlow, Mahmood I Alhusseini, Fatemah Shenasa, Catarina Brizido, Daniel Matos, Pedro Freitas and 8 more

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 32% 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

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. 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

18 authors at 4 institutions in 3 countries.

João MesquitaDepartment of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Gaia, Portugal.ORCID 0000-0001-6965-4457
Natasha ManiarStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, United States of America.ORCID 0000-0002-7490-3718
Tina BaykanerStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, United States of America.
Albert J RogersStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, United States of America.
Mark SwerdlowStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, United States of America.
Mahmood I AlhusseiniStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, United States of America.
Fatemah ShenasaStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, United States of America.
Catarina BrizidoDepartment of Cardiology, Centro Hospitalar de Lisboa Ocidental-Hospital de Santa Cruz, Carnaxide, Portugal.
Daniel MatosDepartment of Cardiology, Centro Hospitalar de Lisboa Ocidental-Hospital de Santa Cruz, Carnaxide, Portugal.
Pedro FreitasDepartment of Cardiology, Centro Hospitalar de Lisboa Ocidental-Hospital de Santa Cruz, Carnaxide, Portugal.
Ana Rita SantosDepartment of Internal Medicine, Centro Hospitalar de Lisboa Ocidental-Hospital de São Francisco Xavier, Lisboa, Portugal.
Gustavo RodriguesDepartment of Cardiology, Centro Hospitalar de Lisboa Ocidental-Hospital de Santa Cruz, Carnaxide, Portugal.
Claudia SilvaDepartment of Cardiology, Centro Hospitalar de Lisboa Ocidental-Hospital de Santa Cruz, Carnaxide, Portugal.
Miguel RodrigoStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, United States of America.
Yan DongDepartment of Cardiovascular Medicine, Stanford University, Stanford, California, United States of America.
Paul CloptonStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, United States of America.
António M FerreiraDepartment of Cardiology, Centro Hospitalar de Lisboa Ocidental-Hospital de Santa Cruz, Carnaxide, Portugal.
Sanjiv M NarayanStanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, United States of America.
Cardiovascular Institute of the South · USHospital de Santa Cruz · PTCentro Hospitalar de Lisboa Ocidental · PTStanford University · US

Funding

Novel Atrial Fibrillation Phenotypes Defined by Functional-Anatomical, Machine-Learned ClassificationsF32HL144101 · NHLBI · STANFORD UNIVERSITY · PI ROGERS, ALBERT JOSEPH · 2018 to 2019
$130k
NHLBI NIH HHS F32 HL144101
6 · The paper itself

Abstract

backgroundSpecific tools have been recently developed to map atrial fibrillation (AF) and help guide ablation. However, when used in clinical practice, panoramic AF maps generated from multipolar intracardiac electrograms have yielded conflicting results between centers, likely due to their complexity and steep learning curve, thus limiting the proper assessment of its clinical impact.

objectivesThe main purpose of this trial was to assess the impact of online training on the identification of AF driver sites where ablation terminated persistent AF, through a standardized training program. Extending this concept to mobile health was defined as a secondary objective.

methodsAn online database of panoramic AF movies was generated from a multicenter registry of patients in whom targeted ablation terminated non-paroxysmal AF, using a freely available method (Kuklik et al-method A) and a commercial one (RhythmView-method B). Cardiology Fellows naive to AF mapping were enrolled and randomized to training vs no training (control). All participants evaluated an initial set of movies to identify sites of AF termination. Participants randomized to training evaluated a second set of movies in which they received feedback on their answers. Both groups re-evaluated the initial set to assess the impact of training. This concept was then migrated to a smartphone application (App).

results12 individuals (median age of 30 years (IQR 28-32), 6 females) read 480 AF maps. Baseline identification of AF termination sites by ablation was poor (40%±12% vs 42%±11%, P = 0.78), but similar for both mapping methods (P = 0.68). Training improved accuracy for both methods A (P = 0.001) and B (p = 0.012); whereas controls showed no change in accuracy (P = NS). The Smartphone App accessed AF maps from multiple systems on the cloud to recreate this training environment.

conclusionDigital online training improved interpretation of panoramic AF maps in previously inexperienced clinicians. Combining online clinical data, smartphone apps and other digital resources provides a powerful, scalable approach for training in novel techniques in electrophysiology.

Indexed as

Atrial FibrillationCardiac ElectrophysiologyCatheter AblationEducation, Medical, ContinuingElectrophysiologic Techniques, CardiacMobile ApplicationsRegistriesSmartphoneVideo RecordingAdultAgedFemaleHumansMaleMiddle Aged

Identifiers

PMID31269029
PMCPMC6609132
OpenAlexW2954270916

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.