Catheter Ablation of Atrial Fibrillation in Patients With Heart Failure

Letters2 July 2019Catheter Ablation of Atrial Fibrillation in Patients With Heart FailureMohit K. Turagam, MD, Jalaj Garg, MD, Samantha Sartori, PhD, Srinivas R. Dukkipati, MD, and Vivek Y. Reddy, MDMohit K. Turagam, MDMount Sinai Hospital, New York, New York (M.K.T., J.G., S.S., S.R.D., V.Y.R.), Jalaj Garg, MDMount Sinai Hospital, New York, New York (M.K.T., J.G., S.S., S.R.D., V.Y.R.), Samantha Sartori, PhDMount Sinai Hospital, New York, New York (M.K.T., J.G., S.S., S.R.D., V.Y.R.), Srinivas R. Dukkipati, MDMount Sinai Hospital, New York, New York (M.K.T., J.G., S.S., S.R.D., V.Y.R.), and Vivek Y. Reddy, MDMount Sinai Hospital, New York, New York (M.K.T., J.G., S.S., S.R.D., V.Y.R.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0282 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. McIntyre and colleagues raise several important points.First, we agree that, according to the Cochrane risk-of-bias framework, studies are classified as having high, low, or unclear risk. Studies are categorized as having unclear risk if they lack information to classify them as either low or high risk. In our review, the moderate-risk category reflects studies with "unclear risk." We believe that the lack of patient blinding in the included studies was unlikely to have influenced the major end points evaluated (such as mortality and left ventricular ejection fraction). Furthermore, blinded operators analyzed the images in 5 of ...References1. 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 Scholar2. Walter SD. Statistical significance and fragility criteria for assessing a difference of two proportions. J Clin Epidemiol. 1991;44:1373-8. [PMID: 1753268] CrossrefMedlineGoogle Scholar3. 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: Mount Sinai Hospital, New York, New York (M.K.T., J.G., S.S., S.R.D., V.Y.R.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0992. 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 William F. McIntyre , Richard P. Whitlock , and Emilie P. Belley-Côté Metrics Cited byCatheter ablation vs. drug therapy in the treatment of atrial fibrillation patients with heart failure: An update meta-analysis for randomized controlled trialsIncreasing time between first diagnosis of atrial fibrillation and catheter ablation adversely affects long‐term outcomes in patients with and without structural heart diseaseMulti-national survey on the methods, efficacy, and safety on the post-approval clinical use of pulsed field ablation (MANIFEST-PF)Ablation Versus Drug Therapy for Atrial Fibrillation in Racial and Ethnic MinoritiesAblation Versus Drug Therapy for Atrial Fibrillation in Heart Failure 2 July 2019Volume 171, Issue 1Page: 76-77KeywordsAtrial fibrillationCardiac ablationCathetersClinical trial reportingDisclosureGrading of Recommendations Assessment Development and EvaluationHeart failureLeft ventricular ejection fractionMortalityRandomized trials ePublished: 2 July 2019 Issue Published: 2 July 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...