Electrophysiology’s Identity Crisis: What our Clinical Trials Do and Do Not Say About Us

Although it has not always been this way, the impact of large, randomised clinical trials in electrophysiology is limited, at least compared with other disciplines in cardiology. This has been particularly true regarding procedural aspects of our field: successful randomised trials are rare and obse...

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Bibliographic Details
Published in:Arrhythmia & electrophysiology review 2020-06, Vol.9 (1), p.15-19
Main Authors: Callans, David J, Reynolds, Matthew, Zimetbaum, Peter J
Format: Article
Language:English
Subjects:
Ablation
Cardiac arrhythmia
Cardiology
Cardiovascular disease
Catheters
Clinical trials
Drug therapy
Electrophysiology and Ablation
Heart
Intervention
Mortality
Patients
Statistical analysis
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Summary:Although it has not always been this way, the impact of large, randomised clinical trials in electrophysiology is limited, at least compared with other disciplines in cardiology. This has been particularly true regarding procedural aspects of our field: successful randomised trials are rare and observational trials are small and typically without a proper active control group. In this article, the authors examine the reasons behind this circumstance, which include underinvestment from funding sources; lack of consensus on procedural endpoints; lack of consensus on techniques; and a therapeutic bias in favour of procedural intervention that stands in the way of investigator equipoise. Together, these factors have created a scientific culture dominated by small-scale, siloed, observational research and unwillingness to collaboratively advance the field with consensus and prospective trials. The authors feel that it is increasingly urgent to improve the scientific basis for clinical practice and explore strategies to accomplish this goal.
ISSN:2050-3369
2050-3377
DOI:10.15420/aer.2019.21