Catheter Ablation of Atrial Fibrillation in Patients With Heart Failure
Authors: William F. McIntyre, Richard P. Whitlock, Emilie P. Belley-Côté
Journal: Annals of Internal Medicine (2019)

Letters2 July 2019Catheter Ablation of Atrial Fibrillation in Patients With Heart FailureWilliam F. McIntyre, MD, Richard P. Whitlock, MD, PhD, and Emilie P. Belley-Côté, MD, MScWilliam F. McIntyre, MDMcMaster University, Hamilton, Ontario, Canada (W.F.M., E.P.B.)Search for more papers by this author, Richard P. Whitlock, MD, PhDPopulation Health Research Institute, McMaster University, Hamilton, Ontario, Canada (R.P.W.)Search for more papers by this author, and Emilie P. Belley-Côté, MD, MScMcMaster University, Hamilton, Ontario, Canada (W.F.M., E.P.B.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0281 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Turagam and colleagues' systematic review and meta-analysis (1) compared catheter ablation with drug therapy in patients with atrial fibrillation and heart failure (HF). After pooling data from 6 studies, the authors concluded that catheter ablation was superior to drug therapy in reducing mortality (risk ratio, 0.52 [95% CI, 0.33 to 0.81]; I2 = 0%) and HF hospitalizations (risk ratio, 0.60 [CI, 0.39 to 0.93]; I2 = 0%).In their assessment of the quality of the evidence, the authors evaluated specific domains in individual studies using the Cochrane risk-of-bias framework and classified these elements as having high, moderate, or low ...References1. Turagam MK, Garg J, Whang W, et al. Catheter ablation of atrial fibrillation in patients with heart failure. A meta-analysis of randomized controlled trials. Ann Intern Med. 2018. [PMID: 30583296]. doi:10.7326/M18-0992 LinkGoogle Scholar2. Guyatt GH, Oxman AD, Vist G, et al. GRADE guidelines: 4. Rating the quality of evidence—study limitations (risk of bias). J Clin Epidemiol. 2011;64:407-15. [PMID: 21247734] doi:10.1016/j.jclinepi.2010.07.017 CrossrefMedlineGoogle Scholar3. Moher D, Liberati A, Tetzlaff J, et al; PRISMA Group.. Preferred Reporting Items for Systematic reviews and Meta-Analyses: the PRISMA statement. Ann Intern Med. 2009;151:264-9. [PMID: 19622511] LinkGoogle Scholar4. Marrouche NF, Brachmann J, Andresen D, et al; CASTLE-AF Investigators.. Catheter ablation for atrial fibrillation with heart failure. N Engl J Med. 2018;378:417-27. [PMID: 29385358] doi:10.1056/NEJMoa1707855 CrossrefMedlineGoogle Scholar5. Walsh M, Srinathan SK, McAuley DF, et al. The statistical significance of randomized controlled trial results is frequently fragile: a case for a Fragility Index. J Clin Epidemiol. 2014;67:622-8. [PMID: 24508144] doi:10.1016/j.jclinepi.2013.10.019 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: McMaster University, Hamilton, Ontario, Canada (W.F.M., E.P.B.)Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (R.P.W.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0281. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCatheter Ablation of Atrial Fibrillation in Patients With Heart Failure Mohit K. Turagam , Jalaj Garg , William Whang , Samantha Sartori , Jacob S. Koruth , Marc A. Miller , Noelle Langan , Aamir Sofi , Anthony Gomes , Subbarao Choudry , Srinivas R. Dukkipati , and Vivek Y. Reddy Catheter Ablation of Atrial Fibrillation in Patients With Heart Failure Mohit K. Turagam , Jalaj Garg , Samantha Sartori , Srinivas R. Dukkipati , and Vivek Y. Reddy Metrics 2 July 2019Volume 171, Issue 1Page: 76KeywordsAtrial fibrillationCardiac ablationCathetersDrug therapyGrading of Recommendations Assessment Development and EvaluationHeart failureHospitalizationsMortalityRisk ratioSystematic reviews ePublished: 2 July 2019 Issue Published: 2 July 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...