Evidence map›Paper›PMID 31894385›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2020

Atrial fibrillation ablation in adults with congenital heart disease on uninterrupted oral anticoagulation is safe and efficient.

Marc Kottmaier, Ariela Baur, Sarah Lund, Felix Bourier, Tilko Reents, Verena Semmler, Martha Telishevska, Florian Berger, Katharina Koch-Büttner, Carsten Lennerz and 9 more

Abstract read
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In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
0.7field-weighted citation impact, top 27% 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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Guideline
  2. Guideline
  3. The impact of catheter ablation in congenital heart disease and atrial fibrillation: An updated meta-analysis.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Article
  4. Review
  5. Anti-thrombotic strategies in patients with atrial fibrillation undergoing PCI.Clinical research in cardiology : official journal of the German Cardiac Society · 2021
    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

19 authors at 1 institution in 1 country.

Marc KottmaierDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany. kottmaier@dhm.mhn.de.
Ariela BaurDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Sarah LundDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Felix BourierDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Tilko ReentsDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Verena SemmlerDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Martha TelishevskaDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Florian BergerDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Katharina Koch-BüttnerDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Carsten LennerzDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Miruna PopaDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Marielouise KornmayerDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Elena RoussevaDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Stephanie BrooksDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Amir BrkicDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Christian GrebmerDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Christoph KolbDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Isabel DeisenhoferDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Gabriele HesslingDepartment of Electrophysiology, German Heart Center Munich, Technische Universitaet Munich, Lazarettstr. 36, 80636, Munich, Germany.
Deutsches Herzzentrum München · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe prevalence of atrial fibrillation (AF) is significantly higher in adults with congenital heart disease (ACHD) compared to patients without congenital heart disease (CHD). As AF in ACHD patients might have significant hemodynamic consequences, rhythm control is particularly desirable but rarely achieved by antiarrhythmic drugs. The aim of this study was to investigate safety and long-term outcome of AF ablation in ACHD patients.

methodsAll ACHD patients (n = 46) that underwent AF ablation at our centre from 2013 to 2017 were included in the study. CHD was classified as simple (46%), moderate (41%) or complex (13%). The majority of patients (61%) suffered from persistent AF (paroxysmal AF 39%). Persistent AF was present in 57% of patients with simple, in 58% of patients with moderate and 83% of patients with complex CHD. All patients underwent radiofrequency (RF) ablation on uninterrupted oral anticoagulation. Pulmonary vein isolation (PVI) was performed in patients with paroxysmal AF, whereas patients with persistent AF underwent PVI and ablation of complex fractionated atrial electrograms (CFAE).

resultsNo major complications occurred. Single-procedure success after 18 months off antiarrhythmic drugs was 61% for paroxysmal AF and 29% for persistent AF (p = 0.003). Multiple procedures (mean 2.1 ± 1.4) increased long-term success to 82% for paroxysmal AF and 48% for persistent AF (p = 0.05). Long-term ablation success was 64% for simple, 62% for moderate and 50% for complex CHD patients.

conclusionsAF ablation in ACHD patients is feasible and safe regardless of CHD complexity. Success rates in patients with paroxysmal AF are high and comparable to patients without CHD. In ACHD patients with persistent AF, success rates of ablation are markedly reduced which might be due to a different and/or more extensive (bi-)atrial substrate. In the cohort of complex ACHD patients with persistent AF as the dominant AF type, long-term success of AF ablation is limited.

Indexed as

Catheter AblationAdministration, OralAdultAgedAnti-Arrhythmia AgentsAnticoagulantsAtrial FibrillationDrug Administration ScheduleFemaleHeart Defects, CongenitalHumansMaleMiddle AgedRetrospective StudiesTime FactorsTreatment OutcomeAnti-Arrhythmia AgentsAnticoagulantsAdults with congenital heart diseaseAtrial fibrillationAtrial fibrillation ablationOral anticoagulationPulmonary vein isolation

Identifiers

PMID31894385
OpenAlexW2998161627

What OpenQuestion holds

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Registered trials

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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.