Evidence map›Paper›PMID 39077091›Full record

ReviewReviews in cardiovascular medicine2023

Catheter Ablation of Persistent AF-Where are We Now?

Louisa O'Neill, Benjamin De Becker, Maarten A J De Smet, Clara Francois, Jean-Benoit Le Polain De Waroux, Rene Tavernier, Mattias Duytschaever, Sebastien Knecht

Abstract readReview
In one paragraph

Review in Reviews in cardiovascular medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing 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.

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 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

8 authors.

Louisa O'NeillDepartment of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium.
Benjamin De BeckerDepartment of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium.
Maarten A J De SmetDepartment of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium.
Clara FrancoisDepartment of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium.
Jean-Benoit Le Polain De WarouxDepartment of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium.
Rene TavernierDepartment of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium.
Mattias DuytschaeverDepartment of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium.
Sebastien KnechtDepartment of Cardiology, AZ Sint-Jan Hospital, 8000 Bruges, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Persistent atrial fibrillation (AF) is a diverse condition that includes various subtypes and underlying causes of arrhythmia. Progress made in catheter ablation technology in recent years has significantly enhanced the durability of ablation. Despite these advances however, the effectiveness of ablation in treating persistent AF is still relatively modest. Studies exploring the mechanisms behind persistent AF have identified substrate-driven focal and re-entrant sources within the atrial body as crucial in sustaining AF among individuals with persistent AF. Furthermore, the widespread adoption of atrial late gadolinium enhancement cardiac magnetic resonance (CMR) imaging and the ongoing refinement of invasive voltage mapping techniques have allowed for detailed assessment of fibrotic remodelling prior to or at the time of procedure. Translation into clinical practice, however, has yielded overall disappointing results. The clinical application of AF mapping in ablation procedures has not shown any substantial advantages beyond the use of pulmonary vein isolation (PVI) alone and adjunct ablation of fibrotic areas has yielded conflicting results in recent randomized trials. The emergence of pulsed field ablation represents a welcome development in the field and several studies have demonstrated an enhanced safety profile and increased procedural efficiency with this non-thermal energy modality. Pulsed field ablation also holds promise for safe and efficient substrate ablation beyond the pulmonary veins, but further trials are needed to assess its impact on longer term success rates. Continued advancements in our comprehension of AF mechanisms, alongside ongoing developments in catheter technology aimed at safe formation of transmural lesions, are essential for achieving better clinical outcomes for patients with persistent AF.

Indexed as

catheter ablationclinical outcomesnovel technologypersistent atrial fibrillation

Identifiers

PMID39077091
PMCPMC11262453

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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.