SynthesisJACC. Clinical electrophysiology2019
Meta-Analysis of Randomized Controlled Trials of Atrial Fibrillation Ablation With Pulmonary Vein Isolation Versus Without.
Synthesis in JACC. Clinical electrophysiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled 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.
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.
Who cites it
24 citing papers in PubMed, 4 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Guideline
- 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2024Guideline
- Temporal Trends and Lesion Sets for Persistent Atrial Fibrillation Ablation: A Meta-Analysis With Trial Sequential Analysis and Meta-Regression.Circulation. Arrhythmia and electrophysiology · 2023Pooled it
- Comparing efficacy and safety in catheter ablation strategies for atrial fibrillation: a network meta-analysis.BMC medicine · 2022Pooled it
- First-in-human experience and one-year outcomes using a novel conformal pulsed-field ablation balloon catheter for pulmonary vein isolation in paroxysmal atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Prophylactic cavotricuspid isthmus ablation in addition to pulmonary vein isolation is associated with improved recurrence-free survival in patients aged > 70 years with paroxysmal atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Temporal Changes in Nonlinear Heart Rate Variability Following Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation.Acta Cardiologica Sinica · 2026Article
- A case of superior vena cava reentrant atrial tachycardia after pulmonary vein isolation with pentaspline pulsed field ablation.HeartRhythm case reports · 2026Article
- Relationship Between Complex Signal Identification and Non-Pulmonary Vein Foci.Journal of arrhythmia · 2025Article
- Prospective validation of SURPOINT index for creating atrial scar using Magnetic Resonance Imaging.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 · 2025Article
- Advances in Atrial Fibrillation Management: A Guide for General Internists.Journal of clinical medicine · 2024Review
- Electrophysiological characteristics of pulmonary vein conduction recovery after radiofrequency ablation of atrial fibrillation.Scientific reports · 2024Article
- Case report of persistent atrial fibrillation with durably isolated pulmonary veins: what's next?European heart journal. Case reports · 2024Article
- Comparison of voltages between atria: differences in sinus rhythm and atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024Article
- Chinese Guidelines for the Diagnosis and Management of Atrial Fibrillation.Journal of geriatric cardiology : JGC · 2024Article
- Emerging Tools and Techniques for Catheter Ablation of Cardiac Arrhythmias: A 2024 Update.The Journal of innovations in cardiac rhythm management · 2024Article
- Information theory-based direct causality measure to assess cardiac fibrillation dynamics.Journal of the Royal Society, Interface · 2023Article
- Tic-Tac: A Translational Approach in Mechanisms Associated with Irregular Heartbeat and Sinus Rhythm Restoration in Atrial Fibrillation Patients.International journal of molecular sciences · 2023Review
- Comparing the efficacy of catheter ablation strategies for persistent atrial fibrillation: a Bayesian analysis of randomized controlled trials.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2023Review
- Arrhythmia mechanism dependent pulmonary vein ablation in paroxysmal atrial fibrillation.Frontiers in physiology · 2023Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
Abstract
objectivesThis meta-analysis examined the ability of pulmonary vein isolation (PVI) to prevent atrial fibrillation in randomized controlled trials (RCTs) in which the patients not receiving PVI nevertheless underwent a procedure.
backgroundPVI is a commonly used procedure for the treatment of atrial fibrillation (AF), and its efficacy has usually been judged against therapy with anti-arrhythmic drugs in open-label trials. There have been several RCTs of AF ablation in which both arms received an ablation, but the difference between the treatment arms was inclusion or omission of PVI. These trials of an ablation strategy with PVI versus an ablation strategy without PVI may provide a more rigorous method for evaluating the efficacy of PVI.
methodsMedline and Cochrane databases were searched for RCTs comparing ablation including PVI with ablation excluding PVI. The primary efficacy endpoint was freedom from atrial fibrillation (AF) and atrial tachycardia at 12 months. A random-effects meta-analysis was performed using the restricted maximum likelihood estimator.
resultsOverall, 6 studies (n = 610) met inclusion criteria. AF recurrence was significantly lower with an ablation including PVI than an ablation without PVI (RR: 0.54; 95% confidence interval [CI]: 0.33 to 0.89; p = 0.0147; I
conclusionsIn RCTs where both arms received an ablation, and therefore an expectation amongst patients and doctors of benefit, being randomized to PVI had a striking effect, reducing AF recurrence by a half.
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Identifiers
What OpenQuestion holds
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.