Evidence map›Paper›PMID 38937763›Full record

ArticleJournal of cardiothoracic surgery2024

Lesion durability found during mandated percutaneous catheter ablation after surgical cryo-ablation for treatment of non-paroxysmal atrial fibrillation.

Alan Bulava, Aleš Mokráček, Petr Němec, Dan Wichterle, Pavel Osmančík, Petr Budera, Petr Kačer, Linda Vetešková, Tomáš Skála, Petr Šantavý and 7 more

Abstract read
In one paragraph

Article in Journal of cardiothoracic surgery, 2024. 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
–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

2 citing papers in PubMed.

  1. Article
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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

17 authors.

Alan BulavaFaculty of Health and Social Sciences, University of South Bohemia in České Budějovice and Cardiac Centre, České Budějovice Hospital, České Budějovice, Czechia. alanbulava@seznam.cz.
Aleš MokráčekFaculty of Health and Social Sciences, University of South Bohemia in České Budějovice and Cardiac Centre, České Budějovice Hospital, České Budějovice, Czechia.
Petr NěmecCentre of Cardiovascular Surgery and Transplantation and Faculty of Medicine, Masaryk University, Brno, Czechia.
Dan WichterleInstitute for Clinical and Experimental Medicine, Prague, Czechia.
Pavel Osmančík3rd Faculty of Medicine, Charles University and University Hospital Královské Vinohrady, Prague, Czechia.
Petr BuderaInstitute for Clinical and Experimental Medicine, Prague, Czechia.
Petr Kačer3rd Faculty of Medicine, Charles University and University Hospital Královské Vinohrady, Prague, Czechia.
Linda VeteškováCentre of Cardiovascular Surgery and Transplantation and Faculty of Medicine, Masaryk University, Brno, Czechia.
Tomáš SkálaFaculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Olomouc, Czechia.
Petr ŠantavýFaculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Olomouc, Czechia.
Jan ChovančíkHospital Agel Třinec - Podlesí, Třinec, Czechia.
Piotr BrannyHospital Agel Třinec - Podlesí, Třinec, Czechia.
Vitalii RizovMasaryk Hospital, Ústí Nad Labem, Czechia.
Miroslav KolesárMasaryk Hospital, Ústí Nad Labem, Czechia.
Iva ŠafaříkováFaculty of Health and Social Sciences, University of South Bohemia in České Budějovice and Cardiac Centre, České Budějovice Hospital, České Budějovice, Czechia.
Marian RybářFaculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czechia.
SURHYB Trial Investigators

Funding

Ministry of Health of the Czech Republic NV19-02-00046
6 · The paper itself

Abstract

objectivesCurrent recommendations support surgical treatment of atrial fibrillation (AF) in patients indicated for cardiac surgery. These procedures are referred to as concomitant and may be carried out using radiofrequency energy or cryo-ablation. This study aimed to assess the electrophysiological findings in patients undergoing concomitant cryo-ablation.

methodsPatients with non-paroxysmal AF undergoing coronary artery bypass grafting and/or valve repair/replacement were included in the trial if concomitant cryo-ablation was part of the treatment plan according to current guidelines. The patients reported in this study were assigned to undergo staged percutaneous radiofrequency catheter ablation (PRFCA), i.e., hybrid treatment, as a part of the SURHYB trial protocol.

resultsWe analyzed 103 patients who underwent PRFCA 105 ± 35 days after surgery. Left and right pulmonary veins (PVs) were found isolated in 65 (63.1%) and 63 (61.2%) patients, respectively. The LA posterior wall isolation and mitral isthmus conduction block were found in 38 (36.9%) and 18 (20.0%) patients, respectively. Electrical reconnections (gaps) in the left PVs were more often localized superiorly than inferiorly (57.9% vs. 26.3%, P = 0.005) and anteriorly than posteriorly (65.8% vs. 31.6%, P = 0.003). Gaps in the right PVs were more equally distributed anteroposteriorly but dominated in superior segments (72.5% vs. 40.0%, P = 0.003). There was a higher number of gaps on the roof line compared to the inferior line (131 (67.2%) vs. 67 (42.2%), P < 0.001). Compared to epicardial cryo-ablation, endocardial was more effective in creating PVs and LA posterior wall isolation (P < 0.05). Cryo-ablation using nitrous oxide (N

conclusionsThe effectiveness of surgical cryo-ablation in achieving transmural and durable lesions in the left atrium is surprisingly low. Gaps are located predominantly in the superior and anterior portions of the PVs and on the roof line. Endocardial cryo-ablation is more effective than epicardial ablation, irrespective of the cooling agent used.

Indexed as

Atrial FibrillationCatheter AblationCryosurgeryPulmonary VeinsAgedCoronary Artery BypassFemaleHumansMaleMiddle AgedTreatment OutcomeConcomitant atrial fibrillation ablationCryoMaze procedureElectrical conductionElectrophysiological studyGaps localizationStaged hybrid ablation

Identifiers

PMID38937763
PMCPMC11210112

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Registered trials

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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.