Evidence map›Paper›PMID 35419670›Full record

SynthesisJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2023

Pulmonary vein isolation with adjunctive left atrial ganglionic plexus ablation for treatment of atrial fibrillation: a meta-analysis of randomized controlled trials.

Justin Rackley, Matthew Nudy, Mario D Gonzalez, Gerald Naccarelli, Ankit Maheshwari

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the 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
3.0field-weighted citation impact, top 8% 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

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Autonomic dysregulation and atrial arrhythmias.American journal of physiology. Cell physiology · 2025
    Review
  4. Short-term deceleration capacity: a novel non-invasive indicator of parasympathetic activity in patients undergoing pulmonary vein isolation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025
    Article
  5. A comparative meta-analysis of addition of ganglionic plexus ablation versus no ganglionic plexus ablation to pulmonary vein isolation for atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025
    Article
  6. Review
  7. Review
  8. Review
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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

5 authors at 1 institution in 1 country.

Justin RackleyHeart and Vascular Institute, Division of Cardiology, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA.
Matthew NudyHeart and Vascular Institute, Division of Cardiology, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA.
Mario D GonzalezHeart and Vascular Institute, Division of Cardiology, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA.
Gerald NaccarelliHeart and Vascular Institute, Division of Cardiology, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA.
Ankit MaheshwariHeart and Vascular Institute, Division of Cardiology, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA. amaheshwari@pennstatehealth.psu.edu.ORCID http://orcid.org/0000-0002-3096-3372
Penn State Milton S. Hershey Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdjunctive ganglionic plexus (GP) ablation may increase the efficacy of pulmonary vein isolation (PVI) for treatment of atrial fibrillation (AF). Prior meta-analyses examining PVI with adjunctive GP ablation have included non-randomized trials and have included trials evaluating thorascopic epicardial ablation. The objective of this study is to perform a meta-analysis of randomized controlled trials (RCTs) comparing endocardial catheter-based PVI to PVI with adjunctive GP ablation.

methodsSummary odds ratio (OR) and 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed with I

resultsFive RCTs were identified including 814 patients: 406 PVI + GP ablation and 408 PVI alone. The mean age of participants was 56.5 years and 74.7% were male. Four of these trials evaluated catheter-based endocardial ablation for a total of 574 patients: 289 PVI + GP ablation and 285 PVI alone. The odds of arrhythmia recurrence in patients undergoing adjunctive GP ablation with PVI compared with PVI alone were a reduced: odds ratio (OR) 0.58, 95% confidence interval (CI) 0.41-0.82, I

conclusionsThe addition of GP ablation to PVI was associated with reduced arrhythmia recurrence. Adjunctive GP ablation was more effective in paroxysmal AF and in patients with smaller atria. Larger RCTs are needed to confirm the efficacy of GP + PVI ablation.

Indexed as

Atrial FibrillationCatheter AblationPulmonary VeinsFemaleHeart AtriaHumansMaleMiddle AgedRandomized Controlled Trials as TopicRecurrenceTreatment OutcomeAtrial fibrillationGanglion plexus ablationMeta-analysisMeta-regressionPulmonary vein isolation

Identifiers

PMID35419670
OpenAlexW4223891771

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.