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Caro et al criticize our management of the heterogeneity between studies in our systematic review of antiarrhythmic agents for maintaining sinus rhythm after AF.¹

We pooled together studies including different types and duration of AF in part because the majority of primary studies did the same, but mainly because our target population was the general population of patients with AF. We consider this ability of a meta-analysis to evaluate a whole population that includes different subgroups as a strength, with the limitation that results are not necessarily applicable to every specific subpopulation, as we explained. Of our planned subgroup analysis, only persistent AF could be analyzed separately, and no difference with the overall results was found.

For all outcomes, raw data were extracted from each included trial in an intention-to-treat basis. Therefore, dissimilarities in outcomes definition and assessment were reduced. Concerning AF recurrence, we used a strict definition: . . . [Full Text of this Article]

AUTHOR INFORMATION
Carmelo Lafuente-Lafuente, MD; Stephane Mouly, MD, PhD; Isabelle Mahe, MD, PhD; Jean-François Bergmann, MD

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RELATED LETTER

Ignoring Study Design Heterogeneity in Meta-analyses
J. Jaime Caro, James G. Xenakis, and Krista F. Huybrechts
Arch Intern Med. 2006;166(18):2046.
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