{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T06:48:13Z","timestamp":1782715693945,"version":"3.54.5"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008977","name":"Abbott Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008977","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":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Catheter ablation outcomes remain suboptimal in patients with persistent atrial fibrillation (AF), and the optimal strategy beyond pulmonary vein isolation (PVI) has not been established. We evaluated whether a personalized strategy combining high\u2010density voltage\u2010guided segmental PVI and fractionation mapping\u2010guided substrate modification improves clinical outcomes compared to anatomy\u2010based circumferential PVI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study prospectively enrolled 57 consecutive patients with persistent or long\u2010standing persistent AF who underwent segmental PVI combined with fractionation mapping\u2010guided ablation using the EnSite system (2019\u20132021). Clinical outcomes were compared with a retrospectively identified cohort of 57 patients who underwent anatomy\u2010based circumferential PVI alone (2017\u20132021), matched for baseline characteristics. The primary endpoints were 1\u2010year freedom from AF and AF\/atrial tachycardia (AT) recurrence using Kaplan\u2013Meier analysis and log\u2010rank test. Multivariable Cox proportional hazard regression was performed to adjust for age and left atrial volume.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Kaplan\u2013Meier analysis revealed that the intervention group had a significantly higher 1\u2010year freedom from AF recurrence compared to the PVI only group (78.9% vs. 59.6%, log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039). However, 1\u2010year freedom from any AF\/AT recurrence did not reach statistical significance between the two groups (71.9% vs. 56.1%, log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.137). After adjustment for age and left atrial volume, the intervention group showed a trend toward improved AF\u2010free survival (adjusted hazard ratio [HR] 0.491, 95% CI 0.237\u20131.016,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.055).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with persistent AF, high\u2010density fractionation mapping\u2013guided ablation in addition to segmental PVI was associated with improved 1\u2010year freedom from AF. This tailored substrate modification strategy may enhance rhythm control in this challenging population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.70398","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T06:01:07Z","timestamp":1781762467000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Outcomes of High Density Voltage and Fractionation Mapping\u2010Guided Ablation in Patients With Persistent Atrial Fibrillation"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5699-250X","authenticated-orcid":false,"given":"Min\u2010Su","family":"Jung","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Keimyung University School of Medicine Keimyung University Dongsan Hospital  Daegu Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8042-1029","authenticated-orcid":false,"given":"Hyoung\u2010Seob","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Keimyung University School of Medicine Keimyung University Dongsan Hospital  Daegu Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9710-0945","authenticated-orcid":false,"given":"Jongmin","family":"Hwang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Keimyung University School of Medicine Keimyung University Dongsan Hospital  Daegu Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9887-6398","authenticated-orcid":false,"given":"Tae\u2010Wan","family":"Chung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Keimyung University School of Medicine Keimyung University Dongsan Hospital  Daegu Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euae043"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2010.01.017"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2005.00308.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12870"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.12.054"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1408288"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-019-00693-x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-020-00834-7"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.04.060"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001193"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.8831"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.12.028"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.07.770"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.23722"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.16195"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.123.011861"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13763"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-019-00537-8"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2009.11.002"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.10.065"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2011.02178.x"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000027821.55835.00"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.111.963256"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-020-00795-x"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.114.001672"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp063"}],"container-title":["Journal of Arrhythmia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/joa3.70398","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/joa3.70398","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/joa3.70398","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T06:34:23Z","timestamp":1782714863000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/joa3.70398"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/joa3.70398"],"URL":"https:\/\/doi.org\/10.1002\/joa3.70398","archive":["Portico"],"relation":{},"ISSN":["1880-4276","1883-2148"],"issn-type":[{"value":"1880-4276","type":"print"},{"value":"1883-2148","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2026-02-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70398"}}