{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:06:42Z","timestamp":1790251602250,"version":"4.1.0"},"reference-count":26,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","heartrhythmjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Heart Rhythm"],"published-print":{"date-parts":[[2026,8]]},"DOI":"10.1016\/j.hrthm.2026.08.045","type":"journal-article","created":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T15:25:38Z","timestamp":1788017138000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Very late recurrence after atrial fibrillation ablation: Clinical characteristics and pulmonary vein reconnection patterns"],"prefix":"10.1016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3416-4102","authenticated-orcid":false,"given":"Jeff R.","family":"Ma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno Scardamaglia","family":"Kistler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"Crowley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Segan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Chieng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hariharan","family":"Sugumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Prabhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang-Han","family":"Ling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"Kistler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6990-302X","authenticated-orcid":false,"given":"Aleksandr","family":"Voskoboinik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.hrthm.2026.08.045_bib1","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","volume":"45","author":"Van Gelder","year":"2024","journal-title":"Eur Heart J"},{"key":"10.1016\/j.hrthm.2026.08.045_bib2","doi-asserted-by":"crossref","first-page":"3105","DOI":"10.1016\/j.jacc.2020.04.065","article-title":"Recurrence of atrial fibrillation after catheter ablation or antiarrhythmic drug therapy in the CABANA trial","volume":"75","author":"Poole","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.hrthm.2026.08.045_bib3","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1056\/NEJM199809033391003","article-title":"Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins","volume":"339","author":"Ha\u00efssaguerre","year":"1998","journal-title":"N Engl J Med"},{"key":"10.1016\/j.hrthm.2026.08.045_bib4","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.112.004549","article-title":"Long-term outcomes of catheter ablation of atrial fibrillation: a systematic review and meta-analysis","volume":"2","author":"Ganesan","year":"2013","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.hrthm.2026.08.045_bib5","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1161\/CIRCEP.111.962100","article-title":"Natural history and long-term outcomes of ablated atrial fibrillation","volume":"4","author":"Hussein","year":"2011","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.045_bib6","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euae043","article-title":"2024 European Heart Rhythm Association\/Heart Rhythm Society\/Asia Pacific Heart Rhythm Society\/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation","volume":"26","author":"Tzeis","year":"2024","journal-title":"Europace"},{"key":"10.1016\/j.hrthm.2026.08.045_bib7","first-page":"474","article-title":"Relationship between pulmonary vein reconnection and atrial fibrillation recurrence: A systematic review and meta-analysis","volume":"2","author":"Nery Pablo","year":"2016","journal-title":"JACC Clin Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.045_bib8","article-title":"Late recurrence of atrial fibrillation 5 years after catheter ablation: predictors and outcome","volume":"25","author":"Choi","year":"2023","journal-title":"Europace"},{"key":"10.1016\/j.hrthm.2026.08.045_bib9","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.120.008646","article-title":"Incidence and predictors of very late recurrence of atrial fibrillation following cryoballoon pulmonary vein isolation","volume":"13","author":"Musat","year":"2020","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.045_bib10","doi-asserted-by":"crossref","first-page":"e1852","DOI":"10.1016\/j.hrthm.2026.02.047","article-title":"Early recurrence of atrial arrhythmias and its impact on late recurrence after pulmonary vein isolation using pulsed field ablation of paroxysmal atrial fibrillation: A long-term follow-up study","volume":"23","author":"Lisica","year":"2026","journal-title":"Heart Rhythm"},{"key":"10.1016\/j.hrthm.2026.08.045_bib11","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euaf007","article-title":"Early versus late atrial fibrillation recurrence after pulsed field ablation: insights from the admIRE trial","volume":"27","author":"Di Biase","year":"2025","journal-title":"Europace"},{"key":"10.1016\/j.hrthm.2026.08.045_bib12","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jacc.2015.04.056","article-title":"Atrial fibrillation activates AMP-dependent protein kinase and its regulation of cellular calcium handling: Potential role in metabolic adaptation and prevention of progression","volume":"66","author":"Harada","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.hrthm.2026.08.045_bib13","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1111\/pace.14656","article-title":"Mechanisms of late arrhythmia recurrence after initially successful pulmonary vein isolation in patients with atrial fibrillation","volume":"46","author":"Erhard","year":"2023","journal-title":"Pacing Clin Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.045_bib14","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1016\/j.jacep.2020.04.035","article-title":"Mechanisms of long-term recurrence 3 years after catheter ablation of atrial fibrillation","volume":"6","author":"Park","year":"2020","journal-title":"JACC Clin Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.045_bib15","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.ijcard.2016.08.222","article-title":"Delayed recurrence of atrial fibrillation 2 years after catheter ablation is associated with metabolic syndrome","volume":"223","author":"Baek","year":"2016","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.hrthm.2026.08.045_bib16","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1111\/jce.14867","article-title":"Repeat catheter ablation for recurrent atrial fibrillation: Electrophysiologic findings and clinical outcomes","volume":"32","author":"Daimee","year":"2021","journal-title":"J Cardiovasc Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.045_bib17","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euae096","article-title":"Repeat catheter ablation after very late recurrence of atrial fibrillation after pulmonary vein isolation","volume":"26","author":"Stauffer","year":"2024","journal-title":"Europace"},{"key":"10.1016\/j.hrthm.2026.08.045_bib18","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.1161\/CIRCULATIONAHA.110.946806","article-title":"Long-term results of catheter ablation in paroxysmal atrial fibrillation: lessons from a 5-year follow-up","volume":"122","author":"Ouyang","year":"2010","journal-title":"Circulation"},{"key":"10.1016\/j.hrthm.2026.08.045_bib19","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1016\/j.jacep.2018.09.020","article-title":"Less pulmonary vein reconnection at redo procedures following radiofrequency point-by-point antral pulmonary vein isolation with the use of contemporary catheter ablation technologies","volume":"4","author":"Sandorfi","year":"2018","journal-title":"JACC Clin Electrophysiol"},{"key":"10.1016\/j.hrthm.2026.08.045_bib20","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1093\/eurheartj\/ehae580","article-title":"Radiofrequency catheter ablation of persistent atrial fibrillation by pulmonary vein isolation with or without left atrial posterior wall isolation: long-term outcomes of the CAPLA trial","volume":"46","author":"William","year":"2025","journal-title":"Eur Heart J"},{"key":"10.1016\/j.hrthm.2026.08.045_bib21","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1056\/NEJMoa1408288","article-title":"Approaches to catheter ablation for persistent atrial fibrillation","volume":"372","author":"Verma","year":"2015","journal-title":"N Engl J Med"},{"key":"10.1016\/j.hrthm.2026.08.045_bib22","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijcha.2025.101662","article-title":"The impact of empirical superior vena cava isolation in addition to pulmonary vein isolation on outcomes in atrial fibrillation \u2013Systematic review, meta-analysis, and meta-regression","volume":"58","author":"Pranata","year":"2025","journal-title":"IJC Heart & Vasculature"},{"key":"10.1016\/j.hrthm.2026.08.045_bib23","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1016\/j.jacc.2015.03.002","article-title":"Long-term effect of goal-directed weight management in an atrial fibrillation cohort: A long-term follow-up study (LEGACY)","volume":"65","author":"Pathak Rajeev","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.hrthm.2026.08.045_bib24","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1093\/europace\/euy117","article-title":"PREVEntion and regReSsive effect of weight-loss and risk factor modification on atrial fibrillation: the REVERSE-AF study","volume":"20","author":"Middeldorp","year":"2018","journal-title":"Europace"},{"key":"10.1016\/j.hrthm.2026.08.045_bib25","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1001\/jamacardio.2025.4007","article-title":"Aggressive risk factor reduction study for atrial fibrillation implications for ablation outcomes: the ARREST-AF randomized clinical trial","volume":"10","author":"Pathak","year":"2025","journal-title":"JAMA Cardiol"},{"key":"10.1016\/j.hrthm.2026.08.045_bib26","first-page":"2227","article-title":"Predictors of late recurrence after second catheter ablation for persistent atrial fibrillation","volume":"22","author":"Ukita","year":"2025","journal-title":"Heart Rhythm"}],"container-title":["Heart Rhythm"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1547527126027487?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1547527126027487?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:26:10Z","timestamp":1790249170000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1547527126027487"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":26,"alternative-id":["S1547527126027487"],"URL":"https:\/\/doi.org\/10.1016\/j.hrthm.2026.08.045","relation":{},"ISSN":["1547-5271"],"issn-type":[{"value":"1547-5271","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Very late recurrence after atrial fibrillation ablation: Clinical characteristics and pulmonary vein reconnection patterns","name":"articletitle","label":"Article Title"},{"value":"Heart Rhythm","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.hrthm.2026.08.045","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Heart Rhythm Society. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}