Rigor Reviewed

Rigor-Reviewed Manuscript

Dual-energy lattice-tip ablation system for persistent atrial fibrillation: a randomized trial.

Name: Αlpha¹ Rigor Record — Dual-energy lattice-tip ablation system for persistent atrial fibrillation: a randomized trial.
Item: Dual-energy lattice-tip ablation system for persistent atrial fibrillation: a randomized trial.
Rating: 39
Author: Αlpha¹

Anter E, Mansour M, Nair DG, Sharma D, Taigen TL, Neuzil P, Kiehl EL, Kautzner J, Osorio J, Mountantonakis S, Natale A, Hummel JD, Amin AK, Siddiqui UR, Harlev D, Hultz P, Liu S, Onal B, Tarakji KG, Reddy VY, SPHERE PER-AF Investigators

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Αlpha¹ Rigor Review — 1★ (Critical), 1 critical, 4 high issues for “Dual-energy lattice-tip ablation system for persistent atrial fibrillation: a randomized trial.”

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Αlpha¹ Editorial

This rigor review was examined and confirmed by Αlpha¹ Editorial · August 16, 2026

Αlpha¹ Rigor Review

Rigor Reviewed

1 / 5

Critical — a demonstrable failure

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

StatisticsImpossible or misreported statistic ×2−2★
IntegrityIntegrity concern ×2−1★
ClaimsUnsupported claim (uncorroborated)−0.5★
ReportingData & code availability partially met−0.25★

A demonstrable critical failure caps the rating at the minimum, regardless of the deductions above.

Model-reported confidence: highReviewer agreement: highEngine: 7.39.0Source: full text

Not verified in this report

The numeric-impossibility checks (GRIM/GRIMMER/DEBIT/SPRITE) did not run: 32 reported means were read, and their group size is not stated where the values are printed (this source has no machine-readable table structure). These checks need the count the mean was averaged over, so none was performed.

Problems surfaced5 types

Numerical inconsistencies1

Values that contradict each other or are impossible for the stated sample: recomputed p-values and test statistics, GRIM/GRIMMER checks on summary numbers, percentages against their own counts, totals against their parts, and estimates against their own confidence intervals.

Internal contradictions in the reported numbersAssessed

Overstated conclusions2

Conclusions that reach past what the paper's own results support — including a significance claim that no longer holds when the statistic is recomputed, and efficacy resting on an unvalidated surrogate endpoint.

Significance claim flips when recomputedRecomputed
Conclusions not supported by the paper’s own evidenceAssessed

Data authenticity concerns1

An adversarial read for patterns associated with data that may not be genuine: results that look too clean, implausibly large effects, duplicated data or images, and methods that do not match the results reported.

Other integrity concernAssessed

Reporting gaps1

Required detail the manuscript never states — study design, biological variables, ethics approval and consent, key resources, statistical reporting, data and code availability, and overall transparency.

Data/code availability incompleteAssessed

This Αlpha¹ Rigor Review uses AI Rigor Reviewers trained on a curated corpus of high-fidelity and retracted papers, with expert supervision and curation. It can still make mistakes; verify each finding against the source before relying on it.

Critical findings

• Recomputed 2 tests: 0 consistent, 2 inconsistent (2 change significance at p<.05); 2 via agent-written checks.

This is a well-designed and well-reported randomized non-inferiority trial with strong methodological reporting across most dimensions. The primary concern is the statistical verification finding that two reported non-inferiority p-values are inconsistent with recomputation, which is a demonstrable error that warrants correction or clarification. Data availability is vague and the reporting guideline is not explicitly stated.

Both reviewers agreed on study type (interventional) and on all dimensions except minor checklist-level divergences (controls, reporting guideline) that do not affect statuses. The statistics verification recomputed only two primary non-inferiority p-values; all other reported statistics (secondary endpoints, CIs) were not machine-verified and should be treated as unverified. The integrity check flagged a low-severity internal contradiction regarding the abstract's description of enrollment vs. randomization, which is explained by the flow diagram.

6 major claims checked against the paper's own evidence: 1 not fully backed by the presented evidence (unsupported or overstated).

Efficacy claim is anchored to an adequate endpoint and a meaningful effect.

Recomputed 2 tests: 0 consistent, 2 inconsistent (2 change significance at p<.05); 2 via agent-written checks.

2 integrity concerns flagged (0 high).

Reporting

Eight Dimensions7 pass · 1 warn

The introduction cites multiple prior studies on AF ablation limitations and the development of the lattice-tip catheter, acknowledging both strengths and weaknesses of existing technologies. The rationale for the trial is clearly linked to the need for more durable lesions and improved procedural efficiency. Limitations of prior research are addressed through the trial design and discussion.

Sub-criteria

prior work citedADEQUATE

premise rationaleADEQUATE

limitations addressedADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

The paper establishes a clear scientific premise with extensive prior work and a logical rationale for the study.

Evidence

paraphrase[Introduction, paragraphs 1-3]

“Conventional catheter ablation technologies are optimized for treating paroxysmal AF but have major shortcomings in treating persistent AF.”

direct quote[Introduction, last paragraph]

“Accordingly, SPHERE Per-AF was a randomized, single-blind, non-inferiority clinical trial that compared the lattice-tip dual-energy ablation platform with a conventional radiofrequency ablation platform in the treatment of drug-refractory persistent AF.”