Evidence map›Paper›PMID 33864874›Full record

SynthesisProgress in cardiovascular diseases

Right ventricular lead location and outcomes among patients with cardiac resynchronization therapy: A meta-analysis.

Fatima Ali-Ahmed, Frederik Dalgaard, Nancy M Allen Lapointe, Andrzej S Kosinski, Vanessa Blumer, Daniel P Morin, Gillian D Sanders, Sana M Al-Khatib

Open access · greenAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Progress in cardiovascular diseases. 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
0.3field-weighted citation impact, top 41% 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, 4 citations in OpenAlex.

  1. Article
  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

8 authors at 6 institutions in 2 countries.

Fatima Ali-AhmedDepartment of Cardiology, Mayo Clinic, Rochester, MN 55902, United States of America. Electronic address: Ali-Ahmed.Fatima@mayo.edu.
Frederik DalgaardDepartment of Cardiology, Herlev and Gentofte Hospital, Hellerup, Denmark.
Nancy M Allen LapointeDepartment of Medicine, Duke University School of Medicine, Durham, NC 27710, United States of America; Duke-Margolis Center for Health Policy, Durham, NC 27710, United States of America; Duke University, Durham, NC 27710, United States of America.
Andrzej S KosinskiDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC 27710, United States of America.
Vanessa BlumerDivision of Cardiology, Duke University Medical Center, Durham, NC 27710, United States of America; Duke Clinical Research Institute, Durham, NC 27710, United States of America.
Daniel P MorinDepartment of Cardiology, Ochsner Medical Center, New Orleans, LA 70121, United States of America.
Gillian D SandersDuke-Margolis Center for Health Policy, Durham, NC 27710, United States of America; Duke Clinical Research Institute, Durham, NC 27710, United States of America; Department of Population Health Sciences, Durham, NC 27710, United States of America.
Sana M Al-KhatibDivision of Cardiology, Duke University Medical Center, Durham, NC 27710, United States of America; Duke Clinical Research Institute, Durham, NC 27710, United States of America.
Clinical Research Institute · USDuke University · USDuke University Hospital · USGentofte Hospital · DKMayo Clinic in Florida · USOchsner Medical Center · US

Funding

Power of Bayesian Methods, RCTs, and Decision Models to Inform CRT UncertaintiesR01HL131754 · NHLBI · DUKE UNIVERSITY · PI SCHMIDLER, GILLIAN SANDERS · 2017 to 2020
$2.7M
NHLBI NIH HHS R01 HL131754
6 · The paper itself

Abstract

backgroundCardiac resynchronization therapy (CRT) has been demonstrated to improve heart failure (HF) symptoms, reverse LV remodeling, and reduce mortality and HF hospitalization (HFH) in patients with a reduced left ventricular (LV) ejection fraction (LVEF). Prior studies examining outcomes based on right ventricular (RV) lead position among CRT patients have provided mixed results. We performed a systematic review and meta-analysis of randomized controlled trials and prospective observational studies comparing RV apical (RVA) and non-apical (RVNA) lead position in CRT.

methodsOur meta-analysis was constructed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews and meta-analyses. We searched EMBASE and MEDLINE. Eligible studies reported on at least one of the following outcomes of interest: all-cause mortality, the composite endpoint of death and first HFH hospitalization, change in LVEF, New York Heart Association (NYHA) class improvement, and change in LV end systolic volume (LVESV). We performed meta-analysis summaries using a DerSimonian-Laird random-effects model and conservatively used the Knapp-Hartung approach to adjust the standard errors of the estimated model coefficients.

resultsWe included nine studies representing a total of 1832 patients. Of those, 1318 (72%) patients had RVA lead placement and 514 (28%) had RVNA lead placement. The mean age of patients was 65.5 ± 4.4 years, and they were predominantly men (69%-97%). There was no statistically significant difference in all-cause mortality by RVA vs. RVNA (OR = 0.77, 95% CI 0.32-1.89; I

conclusionThis meta-analysis shows that in CRT pacing, RV lead position does not appear to be associated with clinical outcomes or LV reverse remodeling. Further studies should focus on the relationship of RV lead vis-à-vis LV lead location, and its clinical importance.

Indexed as

Cardiac Resynchronization TherapyCardiac Resynchronization Therapy DevicesVentricular Function, RightAgedEquipment DesignFemaleHeart FailureHumansMaleMiddle AgedRecovery of FunctionStroke VolumeTreatment OutcomeVentricular Function, LeftVentricular RemodelingCardiac resynchronization therapyRight lead location

Identifiers

PMID33864874
PMCPMC8667053
OpenAlexW3153128576

What OpenQuestion holds

Textmetadata
LicenceTDM
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.