{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T22:35:36Z","timestamp":1721946936487},"reference-count":9,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,5,13]],"date-time":"2013-05-13T00:00:00Z","timestamp":1368403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ablation procedures in patients with paroxysmal atrial fibrillation (<jats:styled-content style=\"fixed-case\">PAF<\/jats:styled-content>) includes isolation of all pulmonary veins (<jats:styled-content style=\"fixed-case\">PVs<\/jats:styled-content>). We hypothesized that an approach using an algorithm to detect arrhythmogenic <jats:styled-content style=\"fixed-case\">PVs<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">aPVs<\/jats:styled-content>) might lead to shorter procedure duration (<jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>) and fewer proarrhythmic effects (<jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Isolation of the <jats:styled-content style=\"fixed-case\">aPVs<\/jats:styled-content> only leads to a reduced <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>, reduced <jats:styled-content style=\"fixed-case\">PEs<\/jats:styled-content>, and fewer adverse events, with a success rate comparable to the standard all\u2010<jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective trial, 207 patients with <jats:styled-content style=\"fixed-case\">PAF<\/jats:styled-content> were randomized to undergo isolation of the <jats:styled-content style=\"fixed-case\">aPV<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">AG<\/jats:styled-content> group, n\u2009=\u2009105) or isolation of all <jats:styled-content style=\"fixed-case\">PVs<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">VG<\/jats:styled-content> group, n\u2009=\u2009102). The <jats:styled-content style=\"fixed-case\">aPV<\/jats:styled-content> was identified by atrial fibrillation (AF) induction, focal discharge, or short local <jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> decremental conduction during <jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> pacing. Patients were followed with repetitive 7\u2010day Holter electrocardiograms (<jats:styled-content style=\"fixed-case\">ECGs<\/jats:styled-content>) after 3, 6, and 12\u2009months in our arrhythmia clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 97% of patients, at least 1 <jats:styled-content style=\"fixed-case\">aPV<\/jats:styled-content> was identified (mean, 2.1). <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> did not differ significantly (152.3\u2009\u00b1\u200957.1\u2009minutes vs 162\u2009\u00b1\u200968\u2009minutes, <jats:italic>P<\/jats:italic> = 0.27) between the groups, but the number of radiofrequency (<jats:styled-content style=\"fixed-case\">RF<\/jats:styled-content>) applications and fluoroscopy time (<jats:styled-content style=\"fixed-case\">FT<\/jats:styled-content>) and dose were significantly lower in the <jats:styled-content style=\"fixed-case\">AG<\/jats:styled-content> group than in the <jats:styled-content style=\"fixed-case\">VG<\/jats:styled-content> group. The occurrence of <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> (new\u2010onset atrial tachycardia) and adverse events (<jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>) did not differ between the 2 groups (<jats:italic>P<\/jats:italic> = 0.1). Sinus rhythm off antiarrhythmic medication (documented on 7\u2010day Holter <jats:styled-content style=\"fixed-case\">ECGs<\/jats:styled-content>) 12\u2009months after a single procedure was achieved in 53% in the <jats:styled-content style=\"fixed-case\">AG<\/jats:styled-content> group and 59% in the <jats:styled-content style=\"fixed-case\">VG<\/jats:styled-content> group (<jats:italic>P<\/jats:italic> = 0.51).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Isolation of the <jats:styled-content style=\"fixed-case\">aPVs<\/jats:styled-content> detected by a straightforward algorithm leads to similar success rates compared to a standard all\u2010<jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> approach with regard to <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>, <jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>, or <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> and is associated with less <jats:styled-content style=\"fixed-case\">RF<\/jats:styled-content> and a shorter <jats:styled-content style=\"fixed-case\">FT<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22132","type":"journal-article","created":{"date-parts":[[2013,5,13]],"date-time":"2013-05-13T14:12:40Z","timestamp":1368454360000},"page":"422-426","source":"Crossref","is-referenced-by-count":6,"title":["A Prospective Randomized Study Comparing Isolation of the Arrhythmogenic Vein Versus All Veins in Paroxysmal Atrial Fibrillation"],"prefix":"10.1002","volume":"36","author":[{"given":"Stephanie","family":"Fichtner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele","family":"Hessling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Ammar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tilko","family":"Reents","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi L.","family":"Estner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clemens","family":"Jilek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Kathan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"B\u00fcchner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Dillier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Deisenhofer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,5,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199809033391003"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000036744.39782.9F"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2008.01379.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2008.01299.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2005.10.016"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2007.09.024"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2007.01074.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2011.02166.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.101.12.1409"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.22132","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.22132","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T16:11:13Z","timestamp":1696349473000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.22132"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5,13]]},"references-count":9,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2013,7]]}},"alternative-id":["10.1002\/clc.22132"],"URL":"https:\/\/doi.org\/10.1002\/clc.22132","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,5,13]]}}}