Evidence map›Paper›PMID 34950322›Full record

ArticleJournal of atrial fibrillation2020

Incidence of Early Atrial Fibrillation After Transcatheter versus Surgical Aortic Valve Replacement: A Meta-Analysis of Randomized Controlled Trials.

Haider Altaii, Ramez Morcos, Fady Riad, Halah Abdulameer, Houman Khalili, Brijeshwar Maini, Eric Lieberman, Yoel Vivas, Phi Wiegn, Jose A Joglar and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of atrial fibrillation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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.

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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. 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

13 authors.

Haider AltaiiDivision of Cardiology, Florida Atlantic University, Boca Raton, FL.
Ramez MorcosDivision of Cardiology, Florida Atlantic University, Boca Raton, FL.
Fady RiadHarrington Heart and Vascular Institute, University Hospitals and Case Western Reserve University, Cleveland, OH.
Halah AbdulameerDepartment of Surgery, Florida Atlantic University, Boca Raton, FL.
Houman KhaliliDivision of Cardiology, Florida Atlantic University, Boca Raton, FL.
Brijeshwar MainiDivision of Cardiology, Florida Atlantic University, Boca Raton, FL.
Eric LiebermanDivision of Cardiology, Florida Atlantic University, Boca Raton, FL.
Yoel VivasDivision of Cardiology, Florida Atlantic University, Boca Raton, FL.
Phi WiegnClinical Cardiac Electrophysiology, University of Texas Southwestern Medical Center, Dallas, TX.
Jose A JoglarClinical Cardiac Electrophysiology, University of Texas Southwestern Medical Center, Dallas, TX.
Judith MackallHarrington Heart and Vascular Institute, University Hospitals and Case Western Reserve University, Cleveland, OH.
Sadeer G Al-KindiHarrington Heart and Vascular Institute, University Hospitals and Case Western Reserve University, Cleveland, OH.
Sergio ThalHarrington Heart and Vascular Institute, University Hospitals and Case Western Reserve University, Cleveland, OH.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPost-operative atrial fibrillation (POAF) is common after aortic valve replacement (AVR) and is associated with worse outcomes. We performed a meta-analysis of randomized controlled trials comparing Surgical Aortic Valve Replacement (SAVR) and Transcatheter Aortic Valve Replacement (TAVR) for incidence of POAF at 30 days.

methodsWe searched databases from 1/1/1990 to 1/1/2020 for randomized studies comparing TAVR and SAVR. POAF was defined as either worsening or new-onset atrial fibrillation. Random effects model was used to estimate the risk of POAF with TAVR vs SAVR in all trials, and in subgroups (low, intermediate, high risk, and in self-expandable vs balloon expandable valves). Sensitivity analysis was performed including only studies reporting new-onset atrial fibrillation.

resultsSeven RCTs were identified that enrolled 7,934 patients (3,999 to TAVR and 3,935 to SAVR). The overall incidence of POAF was 9.7% after TAVR and 33.3% after SAVR. TAVR was associated with a lower risk of POAF compared with SAVR (OR 0.21 [0.18-0.24]; P < 0.0001). Compared with SAVR, TAVR was associated with a significantly lower risk of POAF in the high-risk cohort (OR 0.37 [0.27-0.49]; P < 0.0001), in the intermediate-risk cohort (OR 0.23 [0.19-0.28]; P < 0.0001), low-risk cohort (OR 0.13 [0.10-0.16]; P < 0.0001). Sensitivity analysis of 4 trials including only new-onset POAF showed similar summary estimates (OR 0.21, 95% CI [0.18-0.25]; P< 0.0001).

conclusionsTAVR is associated with a significantly lower risk of post-operative atrial fibrillation compared with SAVR in all strata. Further studies are needed to identify the contribution of post-operative atrial fibrillation to the differences in clinical outcomes after TAVR and SAVR.

Indexed as

Atrial fibrillationMeta-analysisSAVRTAVR

Identifiers

PMID34950322
PMCPMC8691290

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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.