“The World Is Not Black and White. More Like Black and Gray”*

Q: What is the clinical evidence from this study?

Study design: Editorial. Population: Atrial fibrillation (n=748). Intervention: AVJ ablation and permanent RVA pacing. Primary outcome: Change in ejection fraction (EF).

Michael O. Sweeney

doi:10.1111/j.1540-8167.2007.01004.x

October 25, 2007Journal of Cardiovascular ElectrophysiologyOpen Access

“The World Is Not Black and White. More Like Black and Gray”*

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Why the study?

Does AVJ ablation and permanent RVA pacing affect ejection fraction in patients with atrial fibrillation?

Structured PICO

Does AVJ ablation and permanent RVA pacing affect ejection fraction in patients with atrial fibrillation?

P

Population

748 patients with atrial fibrillation who underwent AVJ ablation and permanent RVA pacing for rate control over a 12-year span at a single center, with 286 having follow-up echocardiograms.

E

Exposure

Atrioventricular junction (AVJ) ablation and permanent right ventricular apical (RVA) pacing

O

Outcome

Change in ejection fraction (EF) on follow-up echocardiogramsurrogate

Limitations

Only 38.2% of patients had follow-up echocardiograms, introducing significant enrollment bias.
Patients with follow-up echocardiograms were sicker (more hypertension, myocardial infarction, mitral regurgitation, and heart failure) than those without.
Single-center observational experience
Enrollment bias
Missing data (only 38.2% of patients had follow-up echocardiograms)
Selection bias for follow-up testing (patients with echocardiograms were sicker)

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Implication

This editorial highlights that while AVJ ablation and RVA pacing for atrial fibrillation may not reduce ejection fraction on a population scale, it can cause significant EF decline and functional mitral regurgitation in a subset of patients, particularly those with normal baseline EF.

Abstract

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Cite This Study

Michael O. Sweeney (2007) conducted an editorial in Atrial fibrillation (n=748). AVJ ablation and permanent RVA pacing was evaluated on Change in ejection fraction (EF).

synapsesocial.com/papers/6a5d045d289a75eadbc257f8 https://doi.org/10.1111/j.1540-8167.2007.01004.x

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“The World Is Not Black and White. More Like Black and Gray”*

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

“The World Is Not Black and White. More Like Black and Gray”*

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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