Assessment of Redundant Meta-Analyses on Catheter Ablation of Atrial Fibrillation in Patients with Heart Failure

Abstract

Background: The utilization of catheter ablation among patients with atrial fibrillation (AF) and heart failure (HF) has garnered significant attention. There has been a rapid proliferation of diverse articles addressing this topic. This study evaluated the potential redundancy in meta-analyses about this subject. Methods: We searched PubMed, Embase, and the Web of Science for meta-analyses comparing catheter ablation with other therapies among patients with AF and HF from the inception date to December 25, 2023. The extracted data encompassed details about the author, country, publication time, journal, pre-registration status, number and type of included studies, primary endpoints, and results. Additionally, we scrutinized whether these meta-analyses referenced, described, or discussed prior relevant meta-analyses, or were cited within prominent international guidelines. Results: A total of 34 meta-analyses were included. Authors predominantly originated from the United States and China. The majority of articles were published in cardiovascular journals without pre-registration. There were two publication peaks, notably in 2018–2019 and 2023. Primary endpoints predominantly focused on all-cause mortality and alterations in left ventricular ejection fraction (LVEF). A consistent trend emerged across most articles, indicating a 40–50% reduction in mortality and a 5–9% elevation in LVEF associated with catheter ablation. Approximately 79.4%, 64.7%, and 50% of the articles respectively cited, described, and discussed previous meta-analyses on the same subject. Only 9 meta-analyses were referenced in impact international guidelines. Conclusions: Our study demonstrates a notable prevalence of redundant meta-analyses within the domain of catheter ablation among patients with AF and HF.