{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T01:42:10Z","timestamp":1789350130057,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,2,18]],"date-time":"2019-02-18T00:00:00Z","timestamp":1550448000000},"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":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Little evidence exists regarding the endpoint and optimum approach to catheter ablation for long\u2010standing persistent atrial fibrillation (<jats:styled-content style=\"fixed-case\">LSPAF<\/jats:styled-content>). We examined the efficacy of pulmonary vein isolation (<jats:styled-content style=\"fixed-case\">PVI<\/jats:styled-content>) plus left atrium posterior wall isolation (<jats:styled-content style=\"fixed-case\">PWI<\/jats:styled-content>) and additional non\u2010<jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> trigger ablation using high\u2010dose isoproterenol for <jats:styled-content style=\"fixed-case\">LSPAF<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One\u2010hundred and fifty\u2010five patients (median <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> duration, 36\u00a0months) underwent catheter ablation for <jats:styled-content style=\"fixed-case\">LSPAF<\/jats:styled-content>; After <jats:styled-content style=\"fixed-case\">PVI<\/jats:styled-content> plus <jats:styled-content style=\"fixed-case\">PWI<\/jats:styled-content>, they underwent provocation of non\u2010<jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> triggers by high\u2010dose isoproterenol and were divided into 3 groups based on the results: group A, <jats:styled-content style=\"fixed-case\">PVI<\/jats:styled-content> plus <jats:styled-content style=\"fixed-case\">PWI<\/jats:styled-content> alone, without induced non\u2010<jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> triggers (single procedure: 105 patients, multiple procedures: 90 patients); group B, mappable non\u2010<jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> triggers demonstrated and ablated (single procedure: 41 patients, multiple procedures: 45 patients); group C, if non\u2010<jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> triggers were unmappable or could not be induced in repeated procedures, adjunctive complex fractionated atrial electrogram ablation was performed (single procedure: 9 patients, multiple procedures: 20 patients).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The Kaplan\u2010Meier estimate of the 1\u2010year freedom from atrial tachyarrhythmias without antiarrhythmic drugs was 65% in all patients, (73%, 56%, and 11% in groups A, B, and C, respectively) after a single procedure, which improved to 86% in all patients (93%, 86%, and 53% in groups A, B, and C, respectively) after multiple procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Even for <jats:styled-content style=\"fixed-case\">LSPAF<\/jats:styled-content>, in approximately 60% of patients, non\u2010<jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> triggers were not elicited, and <jats:styled-content style=\"fixed-case\">PVI<\/jats:styled-content> plus <jats:styled-content style=\"fixed-case\">PWI<\/jats:styled-content> alone achieved good outcomes. Although the inducibility of non\u2010<jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> triggers was associated with recurrence of atrial tachyarrhythmias, additional non\u2010<jats:styled-content style=\"fixed-case\">PV<\/jats:styled-content> trigger ablation may improve the outcome after multiple procedures.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.12168","type":"journal-article","created":{"date-parts":[[2019,2,18]],"date-time":"2019-02-18T08:55:41Z","timestamp":1550480141000},"page":"215-222","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Pulmonary vein isolation plus left atrial posterior wall isolation and additional nonpulmonary vein trigger ablation using high\u2010dose isoproterenol for long\u2010standing persistent atrial 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