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Record W4211229035 · doi:10.1016/j.cjco.2022.02.001

Rhythm-Monitoring Strategy and Arrhythmia Recurrence in Atrial Fibrillation Ablation Trials: A Systematic Review

2022· review· en· W4211229035 on OpenAlexaff
Rudy R Unni, Ross T. Prager, Roupen Odabashian, Jimmy J. Zhang, Nicholas Ng Fat Hing, Pablo B. Nery, Lebei Pi, Wafa Aldawood, Mouhannad M. Sadek, Calum J. Redpath, David H. Birnie, Wael Alqarawi, Amin Zagzoog, Mehrdad Golian, Andrés Klein, F. Daniel Ramirez, Martin S. Green, Li Chen, Sarah Visintini, George A. Wells, Girish M. Nair

Bibliographic record

VenueCJC Open · 2022
Typereview
Languageen
FieldMedicine
TopicAtrial Fibrillation Management and Outcomes
Canadian institutionsWestern UniversityUniversity of Ottawa
FundersPfizerBristol-Myers Squibb
KeywordsAtrial fibrillationMedicineCardiologyInternal medicineCatheter ablationRhythmRandomized controlled trialCardiac arrhythmiaAnesthesia

Abstract

fetched live from OpenAlex

Background : The rhythm-monitoring strategy after catheter ablation (CA) for atrial fibrillation (AF) impacts the detection of atrial arrhythmia recurrence and is not well characterized. We performed a systematic review and meta-regression analysis to determine whether the duration and mode of rhythm monitoring after CA affects detection of atrial arrhythmia recurrence. Methods Databases were systematically searched for randomized controlled trials of adult patients undergoing first CA for AF from 2007 to 2021. Duration and strategy of rhythm monitoring were extracted. Meta-regression was used to identify any association between duration of monitoring and detection of atrial arrhythmia recurrence. The primary measure of outcome was single-procedure recurrence of atrial arrhythmia. Results The search strategy yielded 57 trial arms from 56 randomized controlled trials comprising 5322 patients: 36 arms of patients with paroxysmal AF (PAF), and 21 arms of patients with persistent AF (PeAF) or both PAF/PeAF. Intermittent monitoring was associated with detection of significantly less atrial arrhythmia recurrence than continuous monitoring in PAF arms (31.2% vs 46.9%, P = 0.001), but not in PeAF/PAF-PeAF combined arms (43.3% vs 63.6%, P = 0.12). No significant relationship was seen between the duration of intermittent rhythm monitoring and atrial arrhythmia recurrence detection in either the PAF ( P = 0.93) or PeAF/PAF-PeAF combined arms ( P = 0.20). Conclusions Continuous rhythm monitoring detected higher atrial arrhythmia recurrence rates, compared to intermittent rhythm monitoring, in patients with PAF. The duration of intermittent monitoring did not show a statistically significant relationship to the yield of arrhythmia detection, in near identical cohorts of trial subjects undergoing similar interventions, with clinical and research implications.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.015
metaresearch head score (Gemma)0.051
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch, Meta-epidemiology (narrow), Meta-epidemiology (broad)
Consensus categoriesnone
DomainCandidate signal: Methods · Consensus signal: none
Study designCandidate signal: Systematic review · Consensus signal: Systematic review
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.998
Threshold uncertainty score0.080

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0150.051
Meta-epidemiology (narrow)0.0020.001
Meta-epidemiology (broad)0.0120.015
Bibliometrics0.0040.006
Science and technology studies0.0000.001
Scholarly communication0.0030.002
Open science0.0020.001
Research integrity0.0020.001
Insufficient payload (model declined to judge)0.0030.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.302
GPT teacher head0.473
Teacher spread0.172 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

Study designSystematic review
DomainMethods
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations19
Published2022
Admission routes1
Has abstractyes

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