Evidence map›Paper›PMID 41798597›Full record

ArticleEuropean heart journal open2026

Win ratio analysis of low-voltage area ablation in persistent atrial fibrillation: sub-analysis of SUPPRESS-AF.

Akihiro Sunaga, Yuki Matsuoka, Daisaku Nakatani, Katsuki Okada, Daisuke Sakamoto, Hideaki Hasegawa, Tetsuhisa Kitamura, Masaharu Masuda, Nobuaki Tanaka, Tetsuya Watanabe and 17 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European heart journal open, 2026. 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
  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

27 authors.

Akihiro SunagaDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan.ORCID https://orcid.org/0000-0003-2590-6696
Yuki MatsuokaDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan.
Daisaku NakataniDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan.ORCID https://orcid.org/0000-0002-1534-2033
Katsuki OkadaDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan.ORCID https://orcid.org/0000-0002-1725-781X
Daisuke SakamotoDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan.ORCID https://orcid.org/0009-0009-7272-5266
Hideaki HasegawaDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan.
Tetsuhisa KitamuraDepartment of Social and Environmental Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871  Japan.ORCID https://orcid.org/0000-0003-0107-0580
Masaharu MasudaCardiovascular Center, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki 660-0064, Japan.ORCID https://orcid.org/0000-0002-5566-466X
Nobuaki TanakaCardiovascular Center, Sakurabashi Watanabe Advanced Healthcare Hospital, 4-3-51 Nakanoshima, Kita-ku, Osaka 530-0005, Japan.ORCID https://orcid.org/0000-0002-8324-1728
Tetsuya WatanabeDivision of Cardiology, Osaka General Medical Center, 3-1-56 Mandaihigashi, Sumiyoshi-ku, Osaka 558-8558, Japan.
Hitoshi MinamiguchiCardiovascular Division, Osaka Keisatsu Hospital, 2-6-40 Karasugatsuji, Tennoji-ku, Osaka 543-0042, Japan.ORCID https://orcid.org/0000-0002-3319-6316
Yasuyuki EgamiDivision of Cardiology, Osaka Rosai Hospital, 1179-3 Nagasonetyo, Kita-ku, Sakai 591-8025, Japan.ORCID https://orcid.org/0000-0001-9728-6524
Takafumi OkaDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan.
Tomoko MinamisakaDepartment of Cardiovascular Medicine, Yao Municipal Hospital, 1-3-1 Ryugetyo, Yao 581-0069, Japan.
Takashi KandaCardiovascular Center, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki 660-0064, Japan.ORCID https://orcid.org/0000-0003-1049-4924
Masato OkadaCardiovascular Center, Sakurabashi Watanabe Advanced Healthcare Hospital, 4-3-51 Nakanoshima, Kita-ku, Osaka 530-0005, Japan.ORCID https://orcid.org/0000-0002-3190-7313
Masato KawasakiDivision of Cardiology, Osaka General Medical Center, 3-1-56 Mandaihigashi, Sumiyoshi-ku, Osaka 558-8558, Japan.ORCID https://orcid.org/0000-0003-0200-7196
Yasuhiro MatsudaCardiovascular Center, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki 660-0064, Japan.ORCID https://orcid.org/0009-0000-7671-2205
Koji TanakaCardiovascular Center, Sakurabashi Watanabe Advanced Healthcare Hospital, 4-3-51 Nakanoshima, Kita-ku, Osaka 530-0005, Japan.ORCID https://orcid.org/0000-0002-2441-6364
Nobuhiko MakinoCardiovascular Division, Osaka Keisatsu Hospital, 2-6-40 Karasugatsuji, Tennoji-ku, Osaka 543-0042, Japan.ORCID https://orcid.org/0009-0005-3737-8618
Hirota KidaDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan.
Shungo HikosoCardiovascular Medicine, Nara Medical University, 840 Shijyotyo, Kashihara 634-8522, Japan.ORCID https://orcid.org/0000-0003-2284-1970
Tomoharu DohiDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan.ORCID https://orcid.org/0000-0003-1652-6421
Koichi InoueCardiovascular Division, National Hospital Organization Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka 540-0006, Japan.
Yohei SotomiDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan.ORCID https://orcid.org/0000-0002-7564-2978
Yasushi SakataDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan.ORCID https://orcid.org/0000-0002-5618-4721
OCVC-SUPPRESS-AF investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aims: In persistent atrial fibrillation (AF), low-voltage areas (LVAs) in the left atrium are considered arrhythmogenic. Although substrate ablation targeting LVAs may reduce AF recurrence, its effect on broader clinical outcomes remains unclear, and procedural risks must be considered. This study aims to compare hierarchical clinical outcomes between pulmonary vein isolation (PVI) alone and PVI plus LVA ablation in patients with persistent AF and LVAs using a win ratio analysis. Methods and results: This was a Conclusion: In patients with persistent AF and LVAs, LVA ablation added to PVI did not improve hierarchical clinical outcomes and prolonged procedures. Routine use of current LVA ablation strategies is not supported, though targeted substrate modification may warrant further research. Registration: UMIN-CTR, https://www.umin.ac.jp/ctry. UMIN000035940.

Indexed as

Atrial fibrillationHierarchical clinical outcomesHomogenizationLow-voltage areaSubstrate ablationWin ratio

Identifiers

PMID41798597
PMCPMC12961379

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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.