{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:51:21Z","timestamp":1760028681695},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We evaluated the rate of progression of permanent atrial fibrillation (AF) and identified clinical factors that predict this event in 63 consecutive patients who had undergone AV junctional ablation and DDDR pacemaker implantation for drug-refractory paroxysmal atrial fibrillation\/flutter. Immediately after ablation, anti-arrhythmic drugs were discontinued in all cases. Permanent AF was con-sidered to have developed if AF was present on two consecutive 6-monthly examinations with no interim documented sinus rhythm. During a mean follow-up of 23\u00b116 months, 22 (35%) of the 63 patients developed permanent AF. The actuarial estimate of progression of permanent AF was 22%, 40% and 56%, respectively, 1, 2 and 3 years after ablation. Age and underlying heart disease were independent predictors of progression of permanent AF. Only one (6%) of 16 patients with idiopathic AF had permanent AF (low risk group). Among the 47 patients with structural heart disease, permanent AF developed in 18 (62%) of the 29 who were aged &gt;75 years or had &gt;12 arrhythmic episodes per year and a symptom duration &gt;4 years (high risk group), but only in three (17%) of the remaining 18 patients who did not (intermediate risk group). In conclusion, during a 3-year follow-up period, about half of the patients with a history of drug-refractory paroxysmal AF did not develop permanent AF after AV junctional ablation and dual-chamber pacemaker implantation, even in the absence of anti-arrhythmic drug therapy. Moreover, subgroups of patients whose risk of permanent AF progression differed were identified on the basis of simple baseline clinical variables. The results of this study form the necessary background for the correct management of patients after AV junction ablation and for the planning of future trials in this field.<\/jats:p>","DOI":"10.1053\/eupc.1998.0008","type":"journal-article","created":{"date-parts":[[2003,7,23]],"date-time":"2003-07-23T00:16:03Z","timestamp":1058919363000},"page":"35-39","source":"Crossref","is-referenced-by-count":13,"title":["Determinants of development of permanent atrial fibrillation and its treatment"],"prefix":"10.1093","volume":"1","author":[{"given":"L.","family":"Gianfranchi","sequence":"first","affiliation":[{"name":"Arrhythmologic Center, Ospedali Riuniti, Lavagna"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Brignole","sequence":"additional","affiliation":[{"name":"Arrhythmologic Center, Ospedali Riuniti, Lavagna"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Menozzi","sequence":"additional","affiliation":[{"name":"Arrhythmologic Center, Ospedale S Maria Nuova, Reggio Emilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Lolli","sequence":"additional","affiliation":[{"name":"Arrhythmologic Center, Ospedale S Maria Nuova, Reggio Emilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Bottoni","sequence":"additional","affiliation":[{"name":"Arrhythmologic Center, Ospedale S Maria Nuova, Reggio Emilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1999,1,1]]},"reference":[{"key":"2019091808552842800_b1","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1111\/j.1540-8159.1995.tb06982.x","article-title":"Long-term follow-up of patients treated by radiofrequency ablation of the atrioventricular junction","volume":"18","author":"Jensen","year":"1995","journal-title":"PACE"},{"key":"2019091808552842800_b2","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/S0002-8703(96)90528-1","article-title":"Quality of life and outcomes after radiofrequency His-bundle catheter ablation and permanent pacemaker implantation: impact of treatment in paroxysmal and established atrial fibrillation","volume":"131","author":"Fitzpatrick","year":"1996","journal-title":"Am Heart J"},{"key":"2019091808552842800_b3","doi-asserted-by":"crossref","first-page":"2617","DOI":"10.1161\/01.CIR.96.8.2617","article-title":"An assessment of atrioventricular junction ablation and DDDR mode-switching pacemaker versus pharmacological treatment in patients with severely symptomatic paroxysmal atrial fibrillation. 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