Evidence map›Paper›PMID 33998277›Full record

Observational studyJournal of the American Heart Association2021

Natural History of Arrhythmia After Successful Isolation of Pulmonary Veins, Left Atrial Posterior Wall, and Superior Vena Cava in Patients With Paroxysmal Atrial Fibrillation: A Multi-Center Experience.

Sanghamitra Mohanty, Chintan Trivedi, Pamela Horton, Domenico G Della Rocca, Carola Gianni, Bryan MacDonald, Angel Mayedo, Javier Sanchez, G Joseph Gallinghouse, Amin Al-Ahmad and 9 more

Registry-linked trialAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of the American Heart Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05296824 (Cryoballoon Isolation of Combined Posterior Wall and Pulmonary Veins Versus Pulmonary Veins Alone for the Treatment of Paroxysmal Atrial Fibrillation), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT05296824 completednot on this map

Cryoballoon Isolation of Combined Posterior Wall and Pulmonary Veins Versus Pulmonary Veins Alone for the Treatment of Paroxysmal Atrial Fibrillation (IMPPROVE-PAF)

TypeobservationalSponsorSacramento EP ResearchRan2014 to 2021Enrolled320ConditionsParoxysmal Atrial FibrillationArmsCryoballoon ablation for the treatment of atrial fibrillation
3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Repeat in situ ablation vs. extensive ablation for recurrent persistent 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 · 2025
    Trial
  3. Efficacy and safety of a novel pulsed field ablation system in paroxysmal atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Article
  4. Empiric superior vena cava isolation during first-time catheter ablation for paroxysmal atrial fibrillation: a systematic review and meta-analysis of randomized trials.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Review
  5. Review
  6. Article
  7. Article
  8. Article
  9. 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
  10. Outcomes of pulmonary vein isolation with radiofrequency balloon vs. cryoballoon ablation: a multi-centric study.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 · 2023
    Article
  11. Article
  12. Observational
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.

Sanghamitra MohantyDepartment of Electrophysiology Texas Cardiac Arrhythmia InstituteSt. David's Medical Center Austin TX.
Chintan TrivediDepartment of Electrophysiology Texas Cardiac Arrhythmia InstituteSt. David's Medical Center Austin TX.
Pamela HortonDepartment of Electrophysiology St. Edward's University Austin TX.
Domenico G Della RoccaDepartment of Electrophysiology Texas Cardiac Arrhythmia InstituteSt. David's Medical Center Austin TX.
Carola GianniDepartment of Electrophysiology Texas Cardiac Arrhythmia InstituteSt. David's Medical Center Austin TX.
Bryan MacDonaldDepartment of Electrophysiology Texas Cardiac Arrhythmia InstituteSt. David's Medical Center Austin TX.
Angel MayedoDepartment of Electrophysiology Texas Cardiac Arrhythmia InstituteSt. David's Medical Center Austin TX.
Javier SanchezDepartment of Electrophysiology Texas Cardiac Arrhythmia InstituteSt. David's Medical Center Austin TX.
G Joseph GallinghouseDepartment of Electrophysiology Texas Cardiac Arrhythmia InstituteSt. David's Medical Center Austin TX.
Amin Al-AhmadDepartment of Electrophysiology Texas Cardiac Arrhythmia InstituteSt. David's Medical Center Austin TX.
Rodney P HortonDepartment of Electrophysiology Texas Cardiac Arrhythmia InstituteSt. David's Medical Center Austin TX.
J David BurkhardtDepartment of Electrophysiology Texas Cardiac Arrhythmia InstituteSt. David's Medical Center Austin TX.
Antonio Dello RussoClinica di Cardiologia ed Aritmologia Ospedali Reuniti Ancona Italy.
Michela CasellaDepartment of Electrophysiology RCCS Monzino Hospital Milan Italy.
Claudio TondoDepartment of Electrophysiology RCCS Monzino Hospital Milan Italy.
Sakis ThemistoclakisDepartment of Electrophysiology Ospedale dell'Angelo Mestre, Venice Italy.
Giovanni ForleoDepartment of Cardiology Luigi Sacco Hospital Milan Italy.
Luigi Di BiaseDepartment of Electrophysiology Texas Cardiac Arrhythmia InstituteSt. David's Medical Center Austin TX.
Andrea NataleDepartment of Electrophysiology Texas Cardiac Arrhythmia InstituteSt. David's Medical Center Austin TX.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background We evaluated long-term outcome of isolation of pulmonary veins, left atrial posterior wall, and superior vena cava, including time to recurrence and prevalent triggering foci at repeat ablation in patients with paroxysmal atrial fibrillation with or without cardiovascular comorbidities. Methods and Results A total of 1633 consecutive patients with paroxysmal atrial fibrillation that were arrhythmia-free for 2 years following the index ablation were classified into: group 1 (without comorbidities); n=692 and group 2 (with comorbidities); n=941. We excluded patients with documented ablation of areas other than pulmonary veins, the left atrial posterior wall, and the superior vena cava at the index procedure. At 10 years after an average of 1.2 procedures, 215 (31%) and 480 (51%) patients had recurrence with median time to recurrence being 7.4 (interquartile interval [IQI] 4.3-8.5) and 5.6 (IQI 3.8-8.3) years in group 1 and 2, respectively. A total of 201 (93.5%) and 456 (95%) patients from group 1 and 2 underwent redo ablation; 147/201 and 414/456 received left atrial appendage and coronary sinus isolation and 54/201 and 42/456 had left atrial lines and flutter ablation. At 2 years after the redo, 134 (91.1%) and 391 (94.4%) patients from group 1 and 2 receiving left atrial appendage/coronary sinus isolation remained arrhythmia-free whereas sinus rhythm was maintained in 4 (7.4%) and 3 (7.1%) patients in respective groups undergoing empirical lines and flutter ablation (

Indexed as

Atrial FibrillationCardiac Surgical ProceduresCatheter AblationFemaleFollow-Up StudiesHeart AtriaHeart Conduction SystemHeart RateHumansIncidenceMaleMiddle AgedPostoperative ComplicationsProspective StudiesPulmonary VeinsRecurrencecatheter ablationlate recurrenceleft atrial appendageparoxysmal atrial fibrillationpulmonary vein isolation

Identifiers

PMID33998277
PMCPMC8483530

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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.