Evidence map›Paper›PMID 32063280›Full record

ArticleInternational journal of cardiology2020

The convergent procedure versus catheter ablation alone in longstanding persistent atrial fibrillation: A single centre, propensity-matched cohort study.

E Maclean, J Yap, B Saberwal, S Kolvekar, W Lim, N Wijesuriya, N Papageorgiou, G Dhillon, R J Hunter, M Lowe and 6 more

Abstract read
PubMed Publisher
In one paragraph

Article in International journal of cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
3.4field-weighted citation impact, top 6% 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

17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. 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
    Article
  7. Review
  8. Article
  9. Convergent ablation for persistent atrial fibrillation: outcomes from a single-centre real-world experience.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2022
    Observational
  10. Article
  11. Article
  12. Review
  13. Article
  14. Review
  15. Review
  16. Article
  17. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 3 institutions in 1 country.

E MacleanBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK; William Harvey Research Institute, Charterhouse Square, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK.
J YapBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK.
B SaberwalBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK.
S KolvekarBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK.
W LimBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK.
N WijesuriyaBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK.
N PapageorgiouBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK.
G DhillonBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK.
R J HunterBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK; William Harvey Research Institute, Charterhouse Square, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK.
M LoweBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK.
P LambiaseBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK.
A ChowBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK.
H AbbasBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK.
R SchillingBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK; William Harvey Research Institute, Charterhouse Square, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK.
E RowlandBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK.
S AhsanBarts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK. Electronic address: syedahsan@nhs.net.
St Bartholomew's Hospital · GBQueen Mary University of London · GBWilliam Harvey Research Institute · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMaintenance of sinus rhythm is challenging in patients with longstanding persistent atrial fibrillation (PeAF). Minimally invasive surgical AF ablation may improve outcomes when combined with catheter ablation (the 'convergent' procedure). This study evaluates the safety and efficacy of the convergent procedure versus catheter ablation alone in longstanding PeAF.

methods43 consecutive patients with longstanding PeAF underwent subxiphoid endoscopic ablation of the posterior left atrium followed by catheter ablation from 2013 to 2018. The primary outcome was AF-free survival at 12 months; secondary outcomes included change in EHRA class, echocardiographic data, procedural complications, freedom from anti-arrhythmic drugs (AADs), and long term arrhythmia-free survival. Outcomes were compared with a matched group of 43 patients who underwent catheter ablation alone. Both groups underwent multiple catheter ablations as required. Baseline characteristics were similar between groups.

resultsAfter 12 months, the convergent procedure was associated with increased AF-free survival on AADs (60.5% versus 25.6%, p = .002) and off AADs (37.2% versus 13.9%, p = .025), versus catheter ablation. Allowing for multiple procedures, after 30.5 ± 13.3 months' follow-up the convergent procedure was associated with increased arrhythmia-free survival on AADs (58.1% versus 30.2%, p = .016) and off AADs (32.5% versus 11.6%, p = .036) versus catheter ablation. There were more complications in the convergent procedure group (11.6% versus 2.3%, p = .2). Multivariate analysis identified only the convergent procedure (OR 3.06 (1.23-7.6), p = .017) as predictive of arrhythmia-free survival long term.

conclusionsIn longstanding PeAF, the convergent procedure is associated with improved arrhythmia-free survival versus catheter ablation alone. Complication rates are significant but have been shown to depreciate with experience.

Indexed as

Propensity ScoreAgedAtrial FibrillationCatheter AblationDisease-Free SurvivalEchocardiographyFemaleFollow-Up StudiesHeart AtriaHeart Conduction SystemHumansMaleMinimally Invasive Surgical ProceduresRecurrenceRetrospective StudiesTreatment OutcomeCatheter ablationConvergent procedureHybrid surgical ablationPersistent atrial fibrillation

Identifiers

PMID32063280
OpenAlexW3006603654

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.