Evidence map›Paper›PMID 36327059›Full record

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

Posterior wall isolation in persistent atrial fibrillation. Long-term outcomes of a repeat procedure strategy.

René Worck, Samuel K Sørensen, Arne Johannessen, Martin H Ruwald, Morten Lock Hansen, Martin Haugdal, Jim Hansen

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article 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. It is linked to trial NCT05045131 (PeAF-Box. A Study to Investigate the Feasibility, Safety and Efficacy of Isolating the Left Atrial Posterior Wall Adjunctive to Pulmonary Vein Isolation as First-line Therapeutical Strategy in Treatment of Persistent Atrial Fibrillation), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.3field-weighted citation impact, top 18% 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.

NCT05045131 nacompletednot on this map

PeAF-Box. A Study to Investigate the Feasibility, Safety and Efficacy of Isolating the Left Atrial Posterior Wall Adjunctive to Pulmonary Vein Isolation as First-line Therapeutical Strategy in Treatment of Persistent Atrial Fibrillation

TypeinterventionalSponsorRené Husted WorckRan2016 to 2020Enrolled24ConditionsAtrial FibrillationArmsLeft atrial combined pulmonary vein isolation and posterior wall isolation
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Focal pulsed field ablation and ultrahigh-density mapping - versatile tools for all atrial arrhythmias? Initial procedural experiences.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024
    Article
  3. Emerging Tools and Techniques for Catheter Ablation of Cardiac Arrhythmias: A 2024 Update.The Journal of innovations in cardiac rhythm management · 2024
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

René WorckDepartment of Cardiology, Copenhagen University Hospital Gentofte, Gentofte Hospitalsvej 1, DK-2900, Hellerup, Denmark. rwor0003@regionh.dk.ORCID http://orcid.org/0000-0001-9501-6168
Samuel K SørensenDepartment of Cardiology, Copenhagen University Hospital Gentofte, Gentofte Hospitalsvej 1, DK-2900, Hellerup, Denmark.ORCID http://orcid.org/0000-0001-8134-2245
Arne JohannessenDepartment of Cardiology, Copenhagen University Hospital Gentofte, Gentofte Hospitalsvej 1, DK-2900, Hellerup, Denmark.ORCID http://orcid.org/0000-0003-0294-3750
Martin H RuwaldDepartment of Cardiology, Copenhagen University Hospital Gentofte, Gentofte Hospitalsvej 1, DK-2900, Hellerup, Denmark.ORCID http://orcid.org/0000-0002-1541-309X
Morten Lock HansenDepartment of Cardiology, Copenhagen University Hospital Gentofte, Gentofte Hospitalsvej 1, DK-2900, Hellerup, Denmark.
Martin HaugdalDepartment of Cardiology, Copenhagen University Hospital Gentofte, Gentofte Hospitalsvej 1, DK-2900, Hellerup, Denmark.
Jim HansenDepartment of Cardiology, Copenhagen University Hospital Gentofte, Gentofte Hospitalsvej 1, DK-2900, Hellerup, Denmark.ORCID http://orcid.org/0000-0001-6600-9006
Gentofte Hospital · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPosterior wall isolation (PWI) added to pulmonary vein isolation (PVI) is increasingly used in ablation for persistent atrial fibrillation (PeAF) despite limited evidence of clinical benefit. We investigated the 5-year outcomes of a PVI + PWI ablation strategy with mandatory repeat procedures in PeAF.

methodsTwenty-four patients with PeAF participated in this single-arm prospective study and underwent radiofrequency ablation (RFA) with wide area circumferential ablation (WACA), roof, and inferior lines for PVI + PWI which was reinforced if required during mandated repeat procedures after 6 months. Then, patients were followed for 60 months using continuous heart rhythm monitoring by implanted cardiac monitors (ICM) and atrial fibrillation effect on quality-of-life scoring (AFEQT; range: 20-100 points) for the initial 30 months.

resultsICM-verified cumulated AF recurrence was 54% after 30 months but the ensuing AF burden was only median 0‰ [0 to 4.8‰] overall and 1‰ [0 to 8 ‰] among patients with any recurrence. AFEQT scores increased from baseline 60 points [48 to 72] to 93 points [84 to 96] at repeat procedures P < 0.0001 and further to 96 points [93 to 99] P = 0.03 after 30 months. After 60 months, at least one episode of AF had been documented in 63% and two patients (8%) were in permanent AF.

conclusionReinforced PVI + PWI was associated with low long-term AF burden and corresponding improvements in quality-of-life. Reinforced (or durable) PVI + PWI appears to be a promising strategy to treat PeAF.

trial registrationClinicalTrials.gov. Identifier: NCT05045131.

Indexed as

Atrial FibrillationCatheter AblationPulmonary VeinsHumansProspective StudiesRecurrenceTreatment OutcomeContinuous rhythm monitoringLong-term outcomesMandated repeat ablationPersistent atrial fibrillationPosterior wall

Identifiers

PMID36327059
OpenAlexW4307994290

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.