Outcomes of paroxysmal AF ablation studies are affected more by study design and patient mix than ablation technique
| Autor: | Ferreira-Martins, J, Howard, J, Al-Khayatt, BM, Shalhoub, J, Sohaib, A, Shun-Shin, M, Novak, P, Leather, R, Sterns, L, Lane, C, Lim, P, Kanagaratnam, P, Peters, N, Francis, D, Sikkel, M |
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| Přispěvatelé: | Wellcome Trust |
| Rok vydání: | 2018 |
| Předmět: |
CATHETER ABLATION
Science & Technology Cardiac & Cardiovascular Systems ELECTROGRAM ABLATION COLLABORATION ablation GANGLIONATED PLEXI ABLATION Cardiovascular System & Hematology CRYOBALLOON Cardiovascular System & Cardiology MANAGEMENT SINGLE PROCEDURE RADIOFREQUENCY ABLATION PULMONARY VEIN ISOLATION PREDICTORS Life Sciences & Biomedicine paroxysmal atrial fibrillation 1102 Cardiorespiratory Medicine and Haematology |
| Popis: | Objective: We tested whether ablation methodology and study design can explain the varying outcomes in terms of AF-free survival at 1 year. Background: There have been numerous paroxysmal AF ablation trials, which are heterogeneous in their use of different ablation techniques and study design. A useful approach to understanding how these factors influence outcome is to dismantle the trials into individual arms and reconstitute them as a large meta-regression. Methods: Data was collected from 66 studies (6941 patients). With freedom from AF as the dependent variable, we performed meta-regression using the individual study arm as the unit. Results: Success rates did not change regardless of the technique used to produce pulmonary vein isolation. Neither were adjunctive lesion sets associated with any improvement in outcome. Studies that included more males and fewer hypertensive patients were found more likely to report better outcomes. ECG method selected to assess outcome also plays an important role. Outcomes were worse in studies that used regular telemonitoring (by 23%, p |
| Databáze: | OpenAIRE |
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