{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T02:46:52Z","timestamp":1768272412854,"version":"3.49.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:00:00Z","timestamp":1726099200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:00:00Z","timestamp":1726099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Interv Card Electrophysiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Catheter ablation has obtained class 1 indication in ablation of young, healthy patients with symptomatic paroxysmal atrial fibrillation (AF). Anti-arrhythmic drugs (AADs) remain first-line therapy before ablating persistent AF (PersAF). We sought to evaluate the efficacy of a direct-to-catheter ablation approach against catheter ablation post AADs in PersAF.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>In this DECAAF II subanalysis, patients were stratified into two subgroups: \u2018Direct-to-catheter\u2019 group comprising patients who had not received AADs prior to ablation, and\u2019second-line ablation\u2019 group, comprising patients who had been on any AAD therapy at any time before ablation. Patients were followed over 18\u00a0months. The primary outcome was AF recurrence. Secondary outcomes included AF burden, quality of life (QoL) that assessed by the AFSS and SF-36 scores, and changes in the left atrial volume index (LAVI) assessed by LGE-MRI scans.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The analysis included 815 patients, with 279 classified as\u2019direct-to-catheter\u2019 group and 536 classified as\u2019Second-line ablation\u2019 group. The primary outcome was similar between both groups (44.8% vs 44.4%, p\u2009&gt;\u20090.05), as was AF burden (20% vs 16%, p\u2009&gt;\u20090.05). Early remodeling, reflected by LAVI reduction, was similar between the groups (9.1 [1.6\u201418.0] in the second-line ablation group and 9.5 [2.5\u201419.7] in the direct-to-catheter group, p\u2009&gt;\u20090.05). QoL pre\/post ablation was also similar (p\u2009&gt;\u20090.05). On multivariate analysis, history of AAD was not predictive of AF recurrence(p\u2009&gt;\u20090.05).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Prior AAD therapy demonstrated minimal impact on atrial remodeling and QoL improvement, in addition to limited benefit on AF recurrence and burden post-ablation in patients with PersAF. Additional studies are warranted to explore the efficacy of catheter ablation as a first-line therapy in PersAF.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s10840-024-01916-6","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T14:06:41Z","timestamp":1726495601000},"page":"787-793","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Direct-to-catheter ablation versus second line catheter ablation for persistent atrial fibrillation: Effect on arrhythmia recurrence, AF burden, early left atrium remodeling and quality of life"],"prefix":"10.1007","volume":"68","author":[{"given":"Hadi","family":"Younes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Besim","family":"Ademi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eli","family":"Tsakiris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amitabh C.","family":"Pandey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Mekhael","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charbel","family":"Noujaim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chanho","family":"Lim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lilas","family":"Dagher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdel Hadi El","family":"Hajjar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghassan","family":"Bidaoui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayana","family":"Bsoul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ala","family":"Assaf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swati","family":"Rao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Mahnkopf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghaith","family":"Shamaileh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Kreidieh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abboud","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinshuo","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yishi","family":"Jia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco T.","family":"Polo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nassir F.","family":"Marrouche","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eoin","family":"Donnellan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,9,12]]},"reference":[{"issue":"2","key":"1916_CR1","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1177\/1747493019897870","volume":"16","author":"G Lippi","year":"2020","unstructured":"Lippi G, Sanchis-Gomar F, Cervellin G. Global epidemiology of atrial fibrillation: An increasing epidemic and public health challenge. Int J Stroke. 2020;16(2):217\u201321.","journal-title":"Int J Stroke"},{"key":"1916_CR2","doi-asserted-by":"crossref","unstructured":"Andrade, J.G., Ablation as First-line Therapy for Atrial Fibrillation. Eur Cardiol Rev. 2023;18.","DOI":"10.15420\/ecr.2023.04"},{"key":"1916_CR3","unstructured":"King GS, G.A., Grigorova Y, et al., Antiarrhythmic Medications. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-."},{"key":"1916_CR4","unstructured":"Joglar JA et al. 2023 ACC\/AHA\/ACCP\/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines. 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Europace. 2012;14(5):646\u201352.","journal-title":"Europace"}],"container-title":["Journal of Interventional Cardiac Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10840-024-01916-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10840-024-01916-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10840-024-01916-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T22:31:13Z","timestamp":1757111473000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10840-024-01916-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,12]]},"references-count":11,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["1916"],"URL":"https:\/\/doi.org\/10.1007\/s10840-024-01916-6","relation":{},"ISSN":["1572-8595"],"issn-type":[{"value":"1572-8595","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,12]]},"assertion":[{"value":"2 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 September 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted following approval from the Institutional Review Board (IRB) of Tulane University. All procedures performed in studies involving human participants adhered to the ethical standards of the institutional and\/or national research committee and complied with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Dr. Nassir Marrouche reports receiving consulting fees from Biosense Webster, Boston Scientific, and AtriCure. He also reports being a speaker for Abbott, Biosense Webster, AtriCure, and Sanofi, and receiving research support from Abbott, Medtronic, Biosense Webster, Siemens, GE, Boston Scientific, Sanofi, and Samsung. Additionally, Dr. Marrouche has a family member who is the CEO of Cardiac Designs, is the founder of Marrek, is named in a patent for MRI fibrosis imaging, and was a previous shareholder of Cardiac Designs. All other co-authors have no relevant conflicts of interest to disclose.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}