RESUMO
The aim of this meta-analysis is to compare the safety and efficacy of catheter ablation versus antiarrhythmic drugs (AADs) in the management of ventricular tachycardia (VT) in patients with structural heart diseases. Two independent investigators searched electronic databases including PubMed, Cochrane, and Excerpta Medica database (EMBASE) using keyword combinations (Medical Subject Headings (MeSH) terms and free terms) such as "catheter ablation," "ventricular tachycardia," "escalation," and "antiarrhythmic drugs" from inception to November 30, 2022. The primary efficacy outcomes included recurrence of VT at follow-up, all-cause mortality, and cardiovascular mortality. The secondary efficacy outcomes assessed in the current meta-analysis included implantable cardioverter-defibrillator (ICD) shock and hospitalization due to cardiac reasons. Safety outcomes included treatment-related adverse events and serious adverse events. A total of three studies were included in this meta-analysis. There was no significant difference in the risk of recurrence of VT (RR: 0.94, 95% CI: 0.72-1.24, p-value: 0.67), all-cause mortality (RR: 0.99, 95% CI: 0.67, 1.46, p-value: 0.98), cardiovascular mortality (risk ratio (RR): 0.90, 95% confidence interval (CI): 0.56-1.45, p-value: 0.67), incidence of ICD shocks (RR: 0.99, 95% CI: 0.76-1.29, p-value: 0.93, I-square: 0%), and hospitalization due to cardiac reasons in follow-up (RR: 0.77, 95% CI: 0.55-1.07, p-value: 0.12) between the catheter ablation group and the antiarrhythmic drug group. However, the risk of treatment-related adverse events was lower in the ablation group compared to the antiarrhythmic medicine (AAM) group (RR: 0.44, 95% CI: 0.29-0.67, p-value: 0.0001). In this meta-analysis of three randomized controlled trials (RCTs) among patients with structural heart disease who had ventricular tachycardia, the incidence of the recurrence of VT, all-cause mortality, cardiovascular mortality, and ICD shock was not significantly different between patients who received catheter ablation and antiarrhythmic drugs. However, regarding safety, catheter ablation is a safe procedure with a low risk of treatment-related events compared to antiarrhythmic drugs.
RESUMO
This article was migrated. The article was marked as recommended. BACKGROUND: Two types of assessments used in the medical education are summative and formative assessments. Summative assessments evaluate a student's learning progress and typically provide concrete grades or pass/fail decisions. The main purpose of the formative assessments is to provide the feedback and improve the learning behavior of the students. However, it is less known about the impact of the formative assessments on overall student's performance in summative assessments. This study is intended to study the effects after the implementation of formal formative assessments on students overall performance in summative assessments or any changes in the total grade point average in a Caribbean Medical School which is a low resource context. MATERIALS AND METHODS: A longitudinal cohort study was conducted among the basic sciences students at AUSOM in May 2017. The study was supported by quantitative data, quantitative and qualitative questionnaires to address the objectives of the study. Data collected and analyzed with Stata (Stata 15). RESULTS: 58, among 67 total students took part in the study. The mean grade point average (GPA) with and without formative assessment was 2.83 (SD±.624745) and 2.29 (SD±.76575) respectively. There was a significant improvement in the overall GPA after the introduction of the formative assessments t (58) = 0.000567, p < .001. CONCLUSION: There was a significant improvement in the student's academic performance after the implementation of formative assessments. Formative assessments consolidate the learning and reinforce the learning behavior. It is necessary that formative assessments should be incorporated into the regular assessment system for the optimal educational output.