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Cochrane Database of Systematic Reviews

Efficacy and safety of ablation for people with non‐paroxysmal atrial fibrillation

Overview of attention for article published in Cochrane database of systematic reviews, November 2016
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (93rd percentile)
  • Good Attention Score compared to outputs of the same age and source (76th percentile)

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1 blog
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1 policy source
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1 Facebook page
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1 Wikipedia page

Citations

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Readers on

mendeley
295 Mendeley
Title
Efficacy and safety of ablation for people with non‐paroxysmal atrial fibrillation
Published in
Cochrane database of systematic reviews, November 2016
DOI 10.1002/14651858.cd012088.pub2
Pubmed ID
Authors

Jonathan Nyong, Guy Amit, Alma J Adler, Onikepe O Owolabi, Pablo Perel, David Prieto‐Merino, Pier Lambiase, Juan Pablo Casas, Carlos A Morillo

Abstract

The optimal rhythm management strategy for people with non-paroxysmal (persistent or long-standing persistent) atrial fibrilation is currently not well defined. Antiarrhythmic drugs have been the mainstay of therapy. But recently, in people who have not responded to antiarrhythmic drugs, the use of ablation (catheter and surgical) has emerged as an alternative to maintain sinus rhythm to avoid long-term atrial fibrillation complications. However, evidence from randomised trials about the efficacy and safety of ablation in non-paroxysmal atrial fibrillation is limited. To determine the efficacy and safety of ablation (catheter and surgical) in people with non-paroxysmal (persistent or long-standing persistent) atrial fibrillation compared to antiarrhythmic drugs. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, conference abstracts, clinical trial registries, and Health Technology Assessment Database. We searched these databases from their inception to 1 April 2016. We used no language restrictions. We included randomised trials evaluating the effect of radiofrequency catheter ablation (RFCA) or surgical ablation compared with antiarrhythmic drugs in adults with non-paroxysmal atrial fibrillation, regardless of any concomitant underlying heart disease, with at least 12 months of follow-up. Two review authors independently selected studies and extracted data. We evaluated risk of bias using the Cochrane 'Risk of bias' tool. We calculated risk ratios (RRs) for dichotomous data with 95% confidence intervals (CIs) a using fixed-effect model when heterogeneity was low (I² <= 40%) and a random-effects model when heterogeneity was moderate or substantial (I² > 40%). Using the GRADE approach, we evaluated the quality of the evidence and used the GRADE profiler (GRADEpro) to import data from Review Manager 5 to create 'Summary of findings' tables. We included three randomised trials with 261 participants (mean age: 60 years) comparing RFCA (159 participants) to antiarrhythmic drugs (102) for non-paroxysmal atrial fibrillation. We generally assessed the included studies as having low or unclear risk of bias across multiple domains, with reported outcomes generally lacking precision due to low event rates. Evidence showed that RFCA was superior to antiarrhythmic drugs in achieving freedom from atrial arrhythmias (RR 1.84, 95% CI 1.17 to 2.88; 3 studies, 261 participants; low-quality evidence), reducing the need for cardioversion (RR 0.62, 95% CI 0.47 to 0.82; 3 studies, 261 participants; moderate-quality evidence), and reducing cardiac-related hospitalisation (RR 0.27, 95% CI 0.10 to 0.72; 2 studies, 216 participants; low-quality evidence) at 12 months follow-up. There was substantial uncertainty surrounding the effect of RFCA regarding significant bradycardia (or need for a pacemaker) (RR 0.20, 95% CI 0.02 to 1.63; 3 studies, 261 participants; low-quality evidence), periprocedural complications, and other safety outcomes (RR 0.94, 95% CI 0.16 to 5.68; 3 studies, 261 participants; very low-quality evidence). In people with non-paroxysmal atrial fibrillation, evidence suggests a superiority of RFCA to antiarrhythmic drugs in achieving freedom from atrial arrhythmias, reducing the need for cardioversion, and reducing cardiac-related hospitalisations. There was uncertainty surrounding the effect of RFCA with significant bradycardia (or need for a pacemaker), periprocedural complications, and other safety outcomes. Evidence should be interpreted with caution, as event rates were low and quality of evidence ranged from moderate to very low.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 295 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
United States 1 <1%
Canada 1 <1%
Unknown 292 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 38 13%
Student > Bachelor 34 12%
Student > Ph. D. Student 27 9%
Researcher 24 8%
Other 20 7%
Other 47 16%
Unknown 105 36%
Readers by discipline Count As %
Medicine and Dentistry 106 36%
Nursing and Health Professions 28 9%
Psychology 7 2%
Pharmacology, Toxicology and Pharmaceutical Science 6 2%
Computer Science 5 2%
Other 30 10%
Unknown 113 38%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 31. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 August 2022.
All research outputs
#1,320,769
of 25,887,951 outputs
Outputs from Cochrane database of systematic reviews
#2,676
of 13,154 outputs
Outputs of similar age
#25,685
of 418,128 outputs
Outputs of similar age from Cochrane database of systematic reviews
#61
of 256 outputs
Altmetric has tracked 25,887,951 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 13,154 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 34.5. This one has done well, scoring higher than 79% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 418,128 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 93% of its contemporaries.
We're also able to compare this research output to 256 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 76% of its contemporaries.