{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T15:59:31Z","timestamp":1740153571921,"version":"3.37.3"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,9,10]],"date-time":"2018-09-10T00:00:00Z","timestamp":1536537600000},"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":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Two methods for testing inducibility of atrial fibrillation (<jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>)\u2014atrial pacing and isoproterenol infusion\u2014have been proposed to determine the endpoint of catheter ablation. However, the utility of the combination for testing electrophysiological inducibility (<jats:styled-content style=\"fixed-case\">EPI<\/jats:styled-content>) and pharmacological inducibility (<jats:styled-content style=\"fixed-case\">PHI<\/jats:styled-content>) is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>After pulmonary vein isolation (<jats:styled-content style=\"fixed-case\">PVI<\/jats:styled-content>), inducibility of atrial tachyarrhythmia was assessed with the dual methods in 291 consecutive patients with <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> (65% paroxysmal) undergoing initial catheter ablation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of <jats:styled-content style=\"fixed-case\">EPI<\/jats:styled-content> was significantly higher in patients with persistent <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> than paroxysmal <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> (32.0% vs 11.7%, respectively, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). The incidence of <jats:styled-content style=\"fixed-case\">PHI<\/jats:styled-content> was not significantly different between the two groups (25.2% vs 26.1%, respectively, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.87). There was no significant difference in <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> recurrence according to inducibility in paroxysmal <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>. In persistent <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>, however, patients achieving neither <jats:styled-content style=\"fixed-case\">EPI<\/jats:styled-content> nor <jats:styled-content style=\"fixed-case\">PHI<\/jats:styled-content> under <jats:styled-content style=\"fixed-case\">PVI<\/jats:styled-content>\u2010only strategy had significantly lower rates of <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> recurrence than those achieving either <jats:styled-content style=\"fixed-case\">EPI<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">PHI<\/jats:styled-content> and consequently requiring additional ablation for inducible atrial tachyarrhythmia (68.5% vs 49.0%, respectively; log\u2010rank test, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.022). In persistent <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>, multivariate Cox regression analysis showed that achieving neither <jats:styled-content style=\"fixed-case\">EPI<\/jats:styled-content> nor <jats:styled-content style=\"fixed-case\">PHI<\/jats:styled-content> was a negative independent predictor of <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> recurrence (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 0.492, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.254\u20100.916, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.026).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Achieving neither <jats:styled-content style=\"fixed-case\">EPI<\/jats:styled-content> nor <jats:styled-content style=\"fixed-case\">PHI<\/jats:styled-content> following <jats:styled-content style=\"fixed-case\">PVI<\/jats:styled-content> was associated with favorable outcome in patients with persistent <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>. The combination of tests may discriminate patients responsive to the <jats:styled-content style=\"fixed-case\">PVI<\/jats:styled-content>\u2010only strategy. Further selective approaches are necessary to improve outcome for inducible atrial tachyarrhythmia in patients with persistent <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.12085","type":"journal-article","created":{"date-parts":[[2018,9,10]],"date-time":"2018-09-10T14:35:04Z","timestamp":1536590104000},"page":"501-510","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of electrophysiological and pharmacological noninducibility following pulmonary vein isolation in patients with paroxysmal and persistent atrial fibrillation"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8337-8572","authenticated-orcid":false,"given":"Takayuki","family":"Otsuka","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine The Cardiovascular Institute Tokyo Japan"},{"name":"Department of Cardiovascular 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