{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:51:04Z","timestamp":1792133464677,"version":"4.4.0"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Outcome data for the Gemini S bipolar radiofrequency clamp are almost absent; the only indexed report being a three\u2010patient case series. We describe 1\u2010year outcomes in a consecutive cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed all consecutive patients treated with the Gemini S clamp between January 2021 and August 2024. Epicardial box isolation was combined with left atrial appendage (LAA) exclusion; completeness was confirmed by entry and exit block on epicardial three\u2010dimensional mapping. The primary outcome was freedom from AF recurrence at 12\u2009months, on and off antiarrhythmic drugs (AADs) after a 90\u2010day blanking period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010three patients were included (mean age 64.4\u2009\u00b1\u20098.0\u2009years; 82.6% male). AF was paroxysmal in 34.8%, persistent in 26.1%, and long\u2010standing persistent in 39.1%; 60.9% had prior catheter ablation and 69.6% had failed or were intolerant to a Class I or III agent. A complete block\u2010verified box lesion was achieved in 95.7% and LAA exclusion in 91.3%. Three patients (13.0%) required conversion to sternotomy for bleeding, exceeding larger series. There was no death, stroke, phrenic nerve palsy, or pacemaker implantation. At 1\u2009year, 87.0% (95% CI 67.9\u201395.5) were in sinus rhythm, all off Class I\/III AADs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sinus rhythm was achieved in 87.0% of patients at 1 year. As the largest reported experience with this device, the series provides device\u2010level evidence where little existed, but it is descriptive, not powered for comparison, and the conversion rate needs confirmation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.70498","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:37:09Z","timestamp":1792132629000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Totally Thoracoscopic Atrial Fibrillation Ablation With the Gemini S Bipolar Clamp: A Single\u2010Center Descriptive Cohort Study of 1\u2010Year Rhythm, Safety, and Quality\u2010of\u2010Life Outcomes"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9250-5775","authenticated-orcid":false,"given":"Michal","family":"Gruszczynski","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery City Hospital of Zurich\u2010Triemli  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5855-8993","authenticated-orcid":false,"given":"Hector","family":"Rodriguez Cetina Biefer","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery City Hospital of Zurich\u2010Triemli  Zurich Switzerland"},{"name":"Department of Cardiac Surgery University Hospital Zurich  Zurich Switzerland"},{"name":"Center for Experimental and Translational Cardiology (CTEC) University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6891-3975","authenticated-orcid":false,"given":"Laura","family":"Rings","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery City Hospital of Zurich\u2010Triemli  Zurich Switzerland"},{"name":"Department of Cardiac Surgery University Hospital Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sacha P.","family":"Salzberg","sequence":"additional","affiliation":[{"name":"Herzklinik Swiss Ablation  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8573-1018","authenticated-orcid":false,"given":"Vasileios","family":"Ntinopoulos","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery City Hospital of Zurich\u2010Triemli  Zurich Switzerland"},{"name":"Department of Cardiac Surgery University Hospital Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7910-5152","authenticated-orcid":false,"given":"Omer","family":"Dzemali","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery City Hospital of Zurich\u2010Triemli  Zurich Switzerland"},{"name":"Department of Cardiac Surgery University Hospital Zurich  Zurich Switzerland"},{"name":"Center for Experimental and Translational Cardiology (CTEC) University of Zurich  Zurich Switzerland"},{"name":"Faculty of Medical Sciences State University of Tetova  Tetova Republic of North Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"issue":"5","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the Diagnosis and Management of Atrial Fibrillation Developed in Collaboration With the European Association for Cardio\u2010Thoracic Surgery (EACTS)","volume":"42","author":"Hindricks G.","year":"2021","journal-title":"European Heart Journal"},{"issue":"1","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.jacc.2011.12.055","article-title":"Hybrid Thoracoscopic Surgical and Transvenous Catheter Ablation of Atrial Fibrillation","volume":"60","author":"Pison L.","year":"2012","journal-title":"Journal of the American College of Cardiology"},{"issue":"3","key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1093\/ejcts\/ezy475","article-title":"Hybrid Versus Catheter Ablation in Patients With Persistent and Longstanding Persistent Atrial Fibrillation: A Systematic Review and Meta\u2010Analysis","volume":"56","author":"Heijden C. A. J.","year":"2019","journal-title":"European Journal of Cardio\u2010Thoracic Surgery"},{"issue":"1","key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"i26","DOI":"10.1093\/ejcts\/ezy117","article-title":"Three\u2010Year Follow\u2010Up of Hybrid Ablation for Atrial Fibrillation","volume":"53","author":"Maesen B.","year":"2018","journal-title":"European Journal of Cardio\u2010Thoracic Surgery"},{"issue":"1","key":"e_1_2_13_6_1","doi-asserted-by":"crossref","DOI":"10.1093\/ehjcr\/ytab530","article-title":"Epicardial Box Lesion Using Bipolar Biparietal Radiofrequency and Multimodality Scar Evaluation\u2014A Case Series","volume":"6","author":"Bijvoet G. P.","year":"2021","journal-title":"European Heart Journal \u2010 Case Reports"},{"issue":"5","key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.joa.2017.08.001","article-title":"2017 HRS\/EHRA\/ECAS\/APHRS\/SOLAECE Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Executive Summary","volume":"33","author":"Calkins H.","year":"2017","journal-title":"Journal of Arrhythmia"},{"issue":"1","key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1161\/CIRCEP.110.958033","article-title":"Development and Validation of the Atrial Fibrillation Effect on QualiTy\u2010Of\u2010Life (AFEQT) Questionnaire in Patients With Atrial Fibrillation","volume":"4","author":"Spertus J.","year":"2011","journal-title":"Circulation. Arrhythmia and Electrophysiology"},{"issue":"5","key":"e_1_2_13_9_1","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCOUTCOMES.118.005358","article-title":"Defining Clinically Important Difference in the Atrial Fibrillation Effect on Quality\u2010Of\u2010Life Score","volume":"12","author":"Holmes D. N.","year":"2019","journal-title":"Circulation. Cardiovascular Quality and Outcomes"},{"issue":"6","key":"e_1_2_13_10_1","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1093\/icvts\/ivab355","article-title":"Long\u2010Term Follow\u2010Up of Thoracoscopic Ablation in Long\u2010Standing Persistent Atrial Fibrillation","volume":"34","author":"Harlaar N.","year":"2022","journal-title":"Interactive Cardiovascular and Thoracic Surgery"},{"issue":"6","key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1177\/1556984520956314","article-title":"Epicardial and Endocardial Validation of Conduction Block After Thoracoscopic Epicardial Ablation of Atrial Fibrillation","volume":"15","author":"Vroomen M.","year":"2020","journal-title":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery"},{"issue":"12","key":"e_1_2_13_12_1","article-title":"Hybrid Convergent Procedure for the Treatment of Persistent and Long\u2010Standing Persistent Atrial Fibrillation: Results of CONVERGE Clinical Trial","volume":"13","author":"DeLurgio D. B.","year":"2020","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"issue":"6","key":"e_1_2_13_13_1","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1093\/europace\/euy323","article-title":"Thoracoscopic Ablation for the Treatment of Atrial Fibrillation: A Systematic Outcome Analysis of a Multicentre Cohort","volume":"21","author":"Laar C.","year":"2019","journal-title":"Europace"},{"issue":"11","key":"e_1_2_13_14_1","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1093\/europace\/eux385","article-title":"Totally Thoracoscopic Ablation for Atrial Fibrillation: A Systematic Safety Analysis","volume":"20","author":"Vos L. 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Arrhythmia and Electrophysiology"},{"key":"e_1_2_13_20_1","doi-asserted-by":"crossref","first-page":"1921","DOI":"10.1016\/j.jacc.2012.04.060","article-title":"Catheter Ablation of Long\u2010Standing Persistent Atrial Fibrillation: 5\u2010Year Outcomes of the Hamburg Sequential Ablation Strategy","volume":"60","author":"Tilz R. R.","year":"2012","journal-title":"Journal of the American College of Cardiology"},{"issue":"1","key":"e_1_2_13_21_1","doi-asserted-by":"crossref","DOI":"10.1093\/icvts\/ivae132","article-title":"Quality of Life Improvement From Thoracoscopic Atrial Fibrillation Ablation in Women Versus Men: A Prospective Cohort Study","volume":"39","author":"Vos L. M.","year":"2024","journal-title":"Interdisciplinary Cardiovascular and Thoracic Surgery"},{"issue":"3","key":"e_1_2_13_22_1","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s10840-019-00546-7","article-title":"Improvement in the Quality of Life of Patients With Persistent or Long\u2010Standing Persistent Atrial Fibrillation After Hybrid Ablation","volume":"57","author":"Osmancik P.","year":"2019","journal-title":"Journal of Interventional Cardiac Electrophysiology"}],"container-title":["Journal of Arrhythmia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/joa3.70498","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/joa3.70498","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/joa3.70498","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:37:12Z","timestamp":1792132632000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/joa3.70498"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/joa3.70498"],"URL":"https:\/\/doi.org\/10.1002\/joa3.70498","archive":["Portico"],"relation":{},"ISSN":["1880-4276","1883-2148"],"issn-type":[{"value":"1880-4276","type":"print"},{"value":"1883-2148","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-08-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70498"}}