{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T20:28:48Z","timestamp":1772828928879,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T00:00:00Z","timestamp":1719878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100019266","name":"Korea Medical Device Development Fund","doi-asserted-by":"publisher","award":["Project number 1711174471; RS\u20102022\u201000141473"],"award-info":[{"award-number":["Project number 1711174471; RS\u20102022\u201000141473"]}],"id":[{"id":"10.13039\/100019266","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The impact of delaying atrial fibrillation catheter ablation (AFCA) for antiarrhythmic drug (AAD) management on the disease course remains unclear. This study investigated AFCA rhythm outcomes based on the diagnosis\u2010to\u2010ablation time (DAT) and AAD responsiveness in participants with persistent AF (PeAF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included data from 1038 AAD\u2010resistant PeAF participants, all of whom had a clear time point for AF diagnosis, especially PeAF at diagnosis time, and had undergone an AFCA for the first time. Participants who experienced recurrences of paroxysmal type on AAD therapy were analyzed as a cohort of AAD\u2010partial responders; those maintaining PeAF on AAD were AAD\u2010non\u2010responders. We determined the DAT cutoff for best discriminating long\u2010term rhythm outcomes using a maximum log\u2010likelihood estimation method based on the Cox proportional hazard regression model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the participants (79.8% male; median age 61), 806 (77.6%) were AAD\u2010non\u2010responders. AAD\u2010non\u2010responders had a higher body mass index and a larger left atrial diameter than AAD\u2010partial\u2010responders. They also had a higher incidence of AF recurrence after AFCA (adjusted hazard ratio 1.75, 95% confidence interval 1.33\u20132.30; log\u2010rank <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) compared to AAD\u2010partial\u2010responders. The maximum log\u2010likelihood estimation showed bimodal cutoffs at 22 and 40\u2009months. The optimal DAT cutoff rhythm outcome was 22\u2009months, which discriminated better in the AAD\u2010partial\u2010responders than in the AAD\u2010non\u2010responders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both DAT and AAD responsiveness influenced AFCA rhythm outcomes. Delaying AFCA to a DAT of longer than 22\u2009months was inadvisable, particularly in the participants in whom PeAF was changed to paroxysmal AF during AAD therapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.13104","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T10:38:35Z","timestamp":1719916715000},"page":"867-878","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effects of antiarrhythmic drug responsiveness and diagnosis\u2010to\u2010ablation time on outcomes after catheter ablation for persistent atrial fibrillation"],"prefix":"10.1002","volume":"40","author":[{"given":"Hong\u2010Ju","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Division of Cardiology, Department of Internal Medicine Yeungnam University College of Medicine  Daegu Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9736-450X","authenticated-orcid":false,"given":"Daehoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kipoong","family":"Kim","sequence":"additional","affiliation":[{"name":"Yonsei University Health System  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung Hwa","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Cardiology Division Gachon University Gil Medical Center  Incheon Republic 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Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4200-3456","authenticated-orcid":false,"given":"Tae\u2010Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1611-8172","authenticated-orcid":false,"given":"Jae\u2010Sun","family":"Uhm","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9036-7225","authenticated-orcid":false,"given":"Boyoung","family":"Joung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, 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