Surrogate Analysis Of Immediate Versus Long-term Success Rates In Cardiac Radiofrequency Ablation

In clinical studies,surrogate endpoint measures are one of the three major elements of study design.Long term follow-up studies are often necessary to obtain endpoint measures for clinical studies.For the development of pilot studies of cardiac radiofrequency ablation for the treatment of AF,long-term success rates were chosen as the primary study endpoint,often with large samples,long follow-up periods,thus increasing the cost of clinical trials and potentially delaying the application of truly effective treatments in the clinic.Comparing the long-term success rate,the immediate success rate was chosen as a surrogate endpoint,which can be easily achieved and requires only a small sample size and a short follow-up time.However,for the surrogate analysis of the experimental effects of the cardiac radiofrequency ablation technique,there is no clear evidence that there is a certain correlation between recent and longterm replacement.Therefore,for an alternative effectiveness research in this field,the analysis of the efficacy of exploring cardiac radiofrequency ablation in the clinic can provide some theoretical basis,thus its real value.In addition,from the literature published at home and abroad,there have been some comparative analyses of ablation methods for AF,but few comparative analyses exist for some of the latest cryoablation methods,nor have they been analyzed by network meta-analysis.Based on the above,the paper conducted the corresponding analysis and research.Research methods: Using a method of extraction analysis based on literature,select literature based on inclusion and exclusion criteria,and then evaluate the quality of literature using Review Manager 5.4 software to obtain corresponding effective data.In addition,the initial sample size of the experiment is used as the weight,and the determination coefficient R-square is used to evaluate the degree of correlation.The data is then subjected to weighted linear regression analysis and mesh meta-analysis.Study conclusions: 1)By meta-analysis,the current comparison of the effects of first generation cryoablation(CB1)and radiofrequency ablation(RFA)in China does not show more obvious bias.Through network meta-analysis,the efficacy of catheter ablation modalities for the treatment of AF was compared as follows: fourth generation cryoablation(CB4)> third generation cryoablation(CB3)> second generation cryoablation(CB2)> first generation cryoablation(CB1)> radiofrequency ablation(RFA).2)Through the analysis of the substitution effect of immediate success rate on long-term success rate,(1)in the case of a three month blank period,the correlation between the success rates of six months and one year is average and does not meet the requirement of strong substitution correlation.(2)In the absence of a three-month blank period,the correlation coefficients between the success rates of six months,twenty-four months,and thirty-six months were all greater than 0.8,indicating a strong correlation,indicating that long-term treatment effects can be expected through immediate success rates.