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Renal denervation for atrial fibrillation: a comprehensive updated systematic review and meta-analysis

Journal of Human Hypertension volume 37, pages 89–90 (2023)Cite this article

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We would like to thank Dr Cheema, and Dr Shahid, for their insightful comments on our meta-analysis published in The Journal of Human Hypertension and for their shared goal of improving the quality of evidence. Several interesting points are proffered in respect to bias and nonblinding that warrant attention in current and future analyses.

Firstly, considering the issue of combining randomized and non-randomized trials, we believe that this issue is inherent within our analysis and has specified this concern in our limitations section. However, it is important to note that renal denervation is a novel intervention, and the scarcity of literature limits our ability to exclude such trials. In these cases, the Cochrane handbook advises, in section 24.6.2.1, that authors should use their judgment and are allowed to combine non-randomized and randomized trials in a meta-analysis if certain conditions are met, such as low to moderate overall risk of bias (RoB) and if the trials are methodologically homogenous to other included trials [1]. Our MINORS RoB assessment of the non-randomized study by Kiuchi et al. yielded a low overall risk and the methodology and research question addressed by the study are similar to the other randomized studies included within our meta-analysis. Moreover, it is worth noting that the same non-randomized study was included in previous meta-analyses addressing the same topic [2,3,4,5].

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Author notes

  1. These authors contributed equally: Khaled Nawar, Ahmed Mohammad.

Authors and Affiliations

  1. School of Medicine, University College Cork, Cork, Ireland

    Khaled Nawar & Ahmed Mohammad

  2. Department of Physiology, University College Cork, Cork, Ireland

    Edward J. Johns & Mohammed H. Abdulla

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  1. Khaled Nawar
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  2. Ahmed Mohammad
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  3. Edward J. Johns
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  4. Mohammed H. Abdulla
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Correspondence to Mohammed H. Abdulla.

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Nawar, K., Mohammad, A., Johns, E.J. et al. Renal denervation for atrial fibrillation: a comprehensive updated systematic review and meta-analysis. J Hum Hypertens 37, 89–90 (2023). https://doi.org/10.1038/s41371-022-00700-1

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