{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T21:01:48Z","timestamp":1788037308387,"version":"build-2784847793"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,7,6]],"date-time":"2018-07-06T00:00:00Z","timestamp":1530835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2018,8]]},"abstract":"Abstract<\/jats:title>Background and purpose<\/jats:title>In expectation of better outcome of catheter ablation of atrial fibrillation (AF<\/jats:styled-content>), several strategies of extra\u2010PV<\/jats:styled-content> (pulmonary vein) substrate modification have been utilized. We assessed whether substrate modification or ablation of extra\u2010PV<\/jats:styled-content> source is a predictor of complications.<\/jats:p><\/jats:sec>Methods<\/jats:title>Japanese Heart Rhythm Society requested electrophysiology centers to register the data of patients who underwent AF<\/jats:styled-content> ablation.<\/jats:p><\/jats:sec>Results<\/jats:title>The data of 10\u00a0795 AF<\/jats:styled-content> ablation cases (age; 63.8\u00a0\u00b1\u00a010.6\u00a0years) treated during 2011\u20102016 were registered. Pericardial effusion (n\u00a0=\u00a0105), massive bleeding (n\u00a0=\u00a0108), stroke (n\u00a0=\u00a06), atrial\u2010esophageal fistula (n\u00a0=\u00a02), and other 114 complications occurred in 323 patients (3.0%). Univariate analysis revealed that age\u00a0\u2267\u00a065\u00a0years, female gender, heart failure, CHA<\/jats:styled-content>2DS<\/jats:styled-content>2\u2010VAS<\/jats:styled-content>c\u22673, hemodialysis, deep sedation, and complex fractionated atrial electrogram (CFAE<\/jats:styled-content>)\u2010guided ablation ([+] vs [\u2212]\u00a0=\u00a04.3% vs 2.8%, P<\/jats:italic>\u00a0=\u00a0.005) were related with the higher incidence of complications. Redo session, 3\u2010D imaging system ([+] vs [\u2212]: 4.4% vs 2.9%, P<\/jats:italic>\u00a0=\u00a0.017), and periprocedural dabigatran were related with the lower incidence of complications. None of the linear ablation of the left atrium, ganglionated plexi ablation, and superior vena cava ablation affected the incidence of complications. Multiple logistic regression analysis showed that in addition to 3\u2010D imaging system, age\u00a0\u2267\u00a065\u00a0years, redo session, and deep sedation, CFAE<\/jats:styled-content> ablation was an independent predictor of the risk of complications (OR<\/jats:styled-content> 1.78, P<\/jats:italic>\u00a0=\u00a0.001). Specifically, implantation of a permanent pacemaker due to emerging sinus node dysfunction was frequent after CFAE<\/jats:styled-content> ablation (CFAE<\/jats:styled-content> [+] vs [\u2212]\u00a0=\u00a04\/1047 vs 2\/9748, P<\/jats:italic>\u00a0<\u00a0.001).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Among extra\u2010PV<\/jats:styled-content> ablation strategies, CFAE<\/jats:styled-content>\u2010guided ablation is a predictor of ablation\u2010related complications.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.12081","type":"journal-article","created":{"date-parts":[[2018,7,6]],"date-time":"2018-07-06T09:08:24Z","timestamp":1530868104000},"page":"435-440","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Influence of substrate modification in catheter ablation of atrial fibrillation on the incidence of acute complications: Analysis of 10\u00a0795 procedures in J\u2010CARAF<\/scp> Study 2011\u20102016"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9147-6113","authenticated-orcid":false,"given":"Yuji","family":"Murakawa","sequence":"first","affiliation":[{"name":"Fourth Department of Internal Medicine Teikyo University School of Medicine Kawasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teiichi","family":"Yamane","sequence":"additional","affiliation":[{"name":"The Department of Cardiology The Jikei University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Goya","sequence":"additional","affiliation":[{"name":"Heart Rhythm Center Tokyo Medical and Dental University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Sakurabashi Watanabe Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeto","family":"Naito","sequence":"additional","affiliation":[{"name":"Division of Cardiology Gunma Prefectural Cardiovascular Center Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Kumagai","sequence":"additional","affiliation":[{"name":"Heart Rhythm Center Fukuoka Sanno Hospital Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Miyauchi","sequence":"additional","affiliation":[{"name":"Division of Cardiology Nippon Medical School Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norishige","family":"Morita","sequence":"additional","affiliation":[{"name":"Division of Cardiology Tokai University Hachioji Hospital Hachioji Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiko","family":"Nogami","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Faculty of Medicine University of Tsukuba Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morio","family":"Shoda","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Women's Medical University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Okumura","sequence":"additional","affiliation":[{"name":"Division of Cardiology Saiseikai Kumamoto Hospital Kumamoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenzo","family":"Hirao","sequence":"additional","affiliation":[{"name":"Heart Rhythm Center Tokyo Medical and Dental University Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Japanese Heart Rhythm Society 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