Evidence map›Paper›PMID 37540340›Full record

SynthesisJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2024

Pulmonary vein isolation plus adjunctive therapy for the treatment of atrial fibrillation: a systematic review and meta-analysis.

Rahul Bussa, Matthew Nudy, Mohammad Ahmed, Jatin Bussa, Sterling Wheaten, Eric Zimmerman, Mario D Gonzalez, Gerald V Naccarelli, Ankit Maheshwari

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the 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 17% 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

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
  3. 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

9 authors at 2 institutions in 1 country.

Rahul BussaDepartment of Internal Medicine, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA. rbussa@pennstatehealth.psu.edu.ORCID http://orcid.org/0000-0001-7917-8749
Matthew NudyDivision of Cardiology, Penn State Hershey Medical Center, Heart and Vascular Institute, Hershey, PA, USA.
Mohammad AhmedDepartment of Internal Medicine, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA.
Jatin BussaDepartment of Biochemistry and Molecular Biology, University of Massachusetts Amherst, Amherst, MA, USA.
Sterling WheatenDepartment of Internal Medicine, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA.
Eric ZimmermanDepartment of Internal Medicine, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA.
Mario D GonzalezDivision of Cardiology, Penn State Hershey Medical Center, Heart and Vascular Institute, Hershey, PA, USA.
Gerald V NaccarelliDivision of Cardiology, Penn State Hershey Medical Center, Heart and Vascular Institute, Hershey, PA, USA.
Ankit MaheshwariDivision of Cardiology, Penn State Hershey Medical Center, Heart and Vascular Institute, Hershey, PA, USA.
Penn State Milton S. Hershey Medical Center · USUniversity of Massachusetts Amherst · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPulmonary vein isolation (PVI) is the primary technique for ablation of atrial fibrillation (AF). It is unclear whether adjunctive therapies in addition to PVI can reduce atrial arrhythmia recurrence (AAR) compared to PVI alone in patients with AF.

methodsA meta-analysis of randomized controlled trials comparing PVI plus an adjunctive therapy (autonomic modulation, linear ablation, non-pulmonary vein trigger ablation, epicardial PVI [hybrid ablation], or left atrial substrate modification) to PVI alone was conducted. The primary outcome was AAR. Cumulative odd's ratios (OR) and 95% confidence intervals (CI) were calculated for each treatment type.

resultsForty-six trials were identified that included 8,500 participants. The mean age (± standard deviation) was 60.2 (±4.1) years, and 27.2% of all patients were female. The mean follow-up time was 14.6 months. PVI plus autonomic modulation and PVI plus hybrid ablation were associated with a relative 53.1% (OR 0.47; 95% CI 0.32 to 0.69; p < 0.001) and 59.1% (OR 0.41; 95% CI 0.23 to 0.75; p = 0.003) reduction in AAR, respectively, compared to PVI alone. All categories had at least moderate interstudy heterogeneity except for hybrid ablation.

conclusionAdjunctive autonomic modulation and epicardial PVI may improve the effectiveness of PVI. Larger, multi-center randomized controlled trials are needed to evaluate the efficacy of these therapies.

Indexed as

Atrial FibrillationCatheter AblationPulmonary VeinsCombined Modality TherapyFemaleHumansMaleMiddle AgedPrevalenceRandomized Controlled Trials as TopicRisk FactorsTreatment OutcomeAblationAdjunctive therapyAtrial fibrillationAutonomic modulationHybrid ablationPulmonary vein isolation

Identifiers

PMID37540340
OpenAlexW4385563473

What Socratic 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 Socratic graph.