Interventional procedure overview of pulsed field ablation for atrial fibrillation
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Appendix A: Methods and literature search strategy
Methods and literature search strategy
NICE has identified studies and reviews relevant to PFA for AF from the medical literature.
Search strategy design and peer review
This search report is informed by the Preferred Reporting Items for Systematic reviews and Meta-Analyses literature search extension (PRISMA-S).
A NICE information specialist ran the literature searches on 26/07/2024. See the search strategy history for the full search strategy for each database. Relevant published studies identified during consultation or resolution that are published after this date may also be considered for inclusion.
The principal search strategy was developed in MEDLINE ALL (Ovid interface). It was adapted for use in each of the databases listed in table 4a, taking into account the database's size, search functionality and subject coverage. The MEDLINE ALL strategy was quality assured by a NICE senior information specialist. All translated search strategies were peer reviewed to ensure their accuracy. The quality assurance and peer review procedures were adapted from the Peer Review of Electronic Search Strategies (PRESS) 2015 evidence-based checklist.
Review management
The search results were managed in EPPI‑Reviewer version 5 (EPPI‑R5). Duplicates were removed in EPPI‑R5 using a 2‑step process. First, automated deduplication was done using a high-value algorithm. Second, manual deduplication was used to assess low-probability matches. All decisions about inclusion, exclusion and deduplication were recorded and stored.
Limits and restrictions
The search was not limited by date or language.
The CENTRAL database search removed trial registry records and conference material. The Embase search excluded conference material.
The limit to remove animal studies in the searches is standard NICE practice, which has been adapted from Dickersin K, Scherer R, Lefebvre C (1994) Systematic Reviews: Identifying relevant studies for systematic reviews. BMJ 309(6964): 1286.
Main search
Database | Date searched | Database platform | Database segment or version | Number of results downloaded |
Cochrane Central Register of Controlled Trials (CENTRAL) | 26/07/24
| Wiley | Issue 7 of 12, May 2024 | 43 |
Cochrane Database of Systematic Reviews (CDSR) | 26/07/24 | Wiley | Issue 7 of 12, June 2024 | 7 |
Embase | 26/07/24 | Ovid | 1974 to 2024 July 25 | 577 |
INAHTA International HTA Database | 26/07/24 | https://database.inahta.org/ | n/a | 0 |
MEDLINE ALL | 26/07/24 | Ovid | 1946 to 2024 July 25 | 537 |
Search strategy history
MEDLINE ALL search strategy
1. atrial fibrillation/ 75313
2.((atrial or atria or atrium or auricular or persistent or paroxsymal) adj4 fibrillat*).tw. 98009
3. AF.tw. 56955
4. *Arrhythmias, Cardiac/ 42698
5. (Cardiac adj4 (arrhythmia* or dyrrhymthia*)).tw. 25220
6. *Pulmonary Veins/ 12985
7. ((pulmonary vein* adj4 isolat*) or PVI or PVAI).tw. 7565
8. or/1-7 192830
9. (Puls* adj4 field adj4 ablat*).tw. 509
10. PFA.tw. 3534
11. Farapulse.tw. 25
12. PulseSelect.tw. 2
13. (Sphere-9 or Sphere9).tw. 7
14. Varipulse.tw. 3
15. (("Kardium Globe" or "Acutus" or "Biosense Webster") and ablat*).tw. 288
16. or/9-15 4079
17. 8 and 16 553
18. animals/ not humans/ 5207441
19. 17 not 18 522
Embase search strategy
1. atrial fibrillation/ 127378
2. ((atrial or atria or atrium or auricular or persistent or paroxsymal) adj4 fibrillat*).tw. 176472
3. AF.tw. 108893
4. *heart arrhythmia/ 46145
5. (Cardiac adj4 (arrhythmia* or dyrrhymthia*)).tw. 37059
6. *Pulmonary Vein/ 5067
7. ((pulmonary vein* adj4 isolat*) or PVI or PVAI).tw. 16300
8. or/1-7 315889
9. (Puls* adj4 field adj4 ablat*).tw. 1006
10. PFA.tw. 6118
11. Farapulse.tw. 99
12. PulseSelect.tw. 4
13. (Sphere-9 or Sphere9).tw. 41
14. Varipulse.tw. 8
15. (("Kardium Globe" or "Acutus" or "Biosense Webster") and ablat*).tw. 1104
16. or/9-15 7551
17. 8 and 16 1457
18. nonhuman/ not human/ 5499852
19. 17 not 18 1375
20. (conference abstract* or conference review or conference paper or conference proceeding).db,pt,su. 5991436
21. 19 not 20 537
Cochrane Library (CDSR and CENTRAL) search strategy
#1. MeSH descriptor: [Atrial Fibrillation] explode all trees 7292
#2. ((atrial or atria or atrium or auricular or persistent or paroxsymal) near/4 fibrillat*) 17311
#3. AF 18625
#4. MeSH descriptor: [Arrhythmias, Cardiac] explode all trees 13729
#5. (Cardiac near/4 (arrhythmia* or dyrrhymthia*)) 5090
#6. MeSH descriptor: [Pulmonary Veins] explode all trees 694
#7. ((pulmonary vein* near/4 isolat*) or PVI or PVAI) 2205
#8. {or #1-#7} 36342
#9. (Puls* near/4 field near/4 ablat*) 54
#10. PFA 414
#11. Farapulse 12
#12. PulseSelect 1
#13. (Sphere 9 or Sphere9) 308
#14. Varipulse 2
#15. ((Kardium Globe or Acutus or Biosense Webster) and ablat*) 91
#16. {or #9-#15} 824
#17. #8 and #16 147
#18. "conference":pt or (clinicaltrials or trialsearch):so 765632
#19. #17 not #18 51
INAHTA HTA Database search strategy
1. "Atrial Fibrillation"[mh] 159
2. ((atrial or atria or atrium or auricular or persistent or paroxsymal) and fibrillat*) 192
3. "Arrhythmias, Cardiac"[mh] 55
4. (Cardiac and (arrhythmia* or dyrrhymthia*)) 87
5. "Pulmonary Veins"[mh] 10
6. ((pulmonary vein* and isolat*) or PVI or PVAI) 12
7. #1 OR #2 OR #3 OR #4 OR #5 OR #6 295
8. PFA 0
9. Farapulse 0
10. PulseSelect 0
11. (Sphere 9 or Sphere9) 6
12. Varipulse 0
13. ((Kardium Globe or Acutus or Biosense Webster) and ablat*) 0
14. (Puls* and field*) 12
15. #9 or #10 or #11 or #12 or #13 or #14 18
16. #7 and #15 0
Inclusion criteria
The following inclusion criteria were applied to the abstracts identified by the literature search.
Publication type: clinical studies were included with emphasis on identifying good quality studies. Abstracts were excluded if they did not report clinical outcomes. Reviews, editorials, letters and laboratory or animal studies, were also excluded and so were conference abstracts, because of the difficulty of appraising study methodology.
Study design: Case reports were excluded. For the Farawave technology, studies less than 30 people were excluded.
People with atrial fibrillation.
Intervention or test: pulsed field ablation.
Outcome: articles were retrieved if the abstract contained information relevant to the safety, efficacy, or both.
If selection criteria could not be determined from the abstracts the full paper was retrieved.
Potentially relevant studies not included in the main evidence summary are listed in Appendix B: Other relevant studies.
Find out more about how NICE selects the evidence for the committee.
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