{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:03Z","timestamp":1753876203942,"version":"3.41.2"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Pulmonary vein isolation (PVI) has emerged as a safe and effective treatment for patients with paroxysmal and persistent atrial fibrillation. Nevertheless, in some patients, a relapse of atrial fibrillation occurs although pulmonary veins are durably isolated. For those patients, the underlying mechanisms of atrial fibrillation perpetuation are manifold and optimal treatment options are not yet defined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We describe a case of a 55-year-old man with a history of atrial fibrillation and previous PVI presenting with persistent AF and arrhythmia induced cardiomyopathy. During the redo procedure, electro-anatomical mapping revealed durably isolated PV. Bipolar mapping showed large low-voltage areas at the posterior wall and the septum. As the patient was refractory to electrical cardioversion, it was decided to modify the large low-voltage areas as potential arrhythmic substrate. After performing additional ablation with isolation of the posterior wall and two anterior\/septal lines, the patient spontaneously converted to sinus rhythm.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Ablation in patients with persistent AF despite durable PVI remains a challenge for the treating team. Individualized ablation approaches addressing additional arrhythmic substrates or extra-PV triggers can be considered to treat patients with persistent AF and durable PVI.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae358","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T14:57:03Z","timestamp":1721660223000},"source":"Crossref","is-referenced-by-count":0,"title":["Case report of persistent atrial fibrillation with durably isolated pulmonary veins: what\u2019s next?"],"prefix":"10.1093","volume":"8","author":[{"given":"Philipp","family":"Bengel","sequence":"first","affiliation":[{"name":"Department of Internal Medicine I, Cardiology and Angiology, Justus-Liebig-University Giessen , Klinikstr. 33, 35392 Giessen , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Sossalla","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Cardiology and Angiology, Justus-Liebig-University Giessen , Klinikstr. 33, 35392 Giessen , Germany"},{"name":"Department of Cardiology, Kerckhoff Heart Center , Bad Nauheim , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1104-8491","authenticated-orcid":false,"given":"Borislav","family":"Dinov","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Cardiology and Angiology, Justus-Liebig-University Giessen , Klinikstr. 33, 35392 Giessen , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,7,23]]},"reference":[{"key":"2024080510271254500_ytae358-B1","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":"2024080510271254500_ytae358-B2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/europace\/eux274","article-title":"2017 HRS\/EHRA\/ECAS\/APHRS\/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation","volume":"20","author":"Calkins","year":"2018","journal-title":"Europace"},{"key":"2024080510271254500_ytae358-B3","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euae043","article-title":"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":"2024080510271254500_ytae358-B4","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1001\/jama.2022.23722","article-title":"Effect of catheter ablation using pulmonary vein isolation with vs without posterior left atrial wall isolation on atrial arrhythmia recurrence in patients with persistent atrial fibrillation: the CAPLA randomized clinical trial","volume":"329","author":"Kistler","year":"2023","journal-title":"JAMA"},{"key":"2024080510271254500_ytae358-B5","doi-asserted-by":"crossref","first-page":"ii8","DOI":"10.1093\/europace\/euab268","article-title":"What we have learned: is pulmonary vein isolation still the cornerstone of atrial fibrillation ablation?","volume":"24","author":"Metzner","year":"2022","journal-title":"Europace"},{"key":"2024080510271254500_ytae358-B6","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1016\/j.jacep.2019.05.012","article-title":"Meta-analysis of randomized controlled trials of atrial fibrillation ablation with pulmonary vein isolation versus without","volume":"5","author":"Sau","year":"2019","journal-title":"JACC Clin Electrophysiol"},{"key":"2024080510271254500_ytae358-B7","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1111\/jce.12603","article-title":"Electrophysiologic findings and long-term outcomes in patients undergoing third or more catheter ablation procedures for atrial fibrillation","volume":"26","author":"Lin","year":"2015","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2024080510271254500_ytae358-B8","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1093\/ehjqcco\/qcab066","article-title":"Comparative efficacy and safety of different catheter ablation strategies for persistent atrial fibrillation: a network meta-analysis of randomized clinical trials","volume":"8","author":"Saglietto","year":"2022","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"2024080510271254500_ytae358-B9","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1001\/jama.2014.3","article-title":"Association of atrial tissue fibrosis identified by delayed enhancement MRI and atrial fibrillation catheter ablation: the DECAAF study","volume":"311","author":"Marrouche","year":"2014","journal-title":"JAMA"},{"key":"2024080510271254500_ytae358-B10","doi-asserted-by":"crossref","first-page":"12271","DOI":"10.1038\/s41598-019-48669-1","article-title":"Non-pulmonary vein triggers of atrial fibrillation are likely to arise from low-voltage areas in the left atrium","volume":"9","author":"Kawai","year":"2019","journal-title":"Sci Rep"},{"key":"2024080510271254500_ytae358-B11","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1161\/01.CIR.100.1.87","article-title":"Promotion of atrial fibrillation by heart failure in dogs: atrial remodeling of a different sort","volume":"100","author":"Li","year":"1999","journal-title":"Circulation"},{"key":"2024080510271254500_ytae358-B12","doi-asserted-by":"crossref","first-page":"2296","DOI":"10.1001\/jama.2022.8831","article-title":"Effect of MRI-guided fibrosis ablation vs conventional catheter ablation on atrial arrhythmia recurrence in patients with persistent atrial fibrillation: the DECAAF II randomized clinical trial","volume":"327","author":"Marrouche","year":"2022","journal-title":"JAMA"},{"key":"2024080510271254500_ytae358-B13","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":"2024080510271254500_ytae358-B14","doi-asserted-by":"crossref","DOI":"10.1056\/EVIDoa2200141","article-title":"Low-Voltage myocardium-guided ablation trial of persistent atrial fibrillation","volume":"1","author":"Huo","year":"2022","journal-title":"NEJM Evidence"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytae358\/58616966\/ytae358.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/8\/ytae358\/58734149\/ytae358.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/8\/ytae358\/58734149\/ytae358.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T10:27:29Z","timestamp":1722853649000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytae358\/7718438"}},"subtitle":[],"editor":[{"given":"Andreas","family":"Metzner","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Feickert","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Leo","family":"Bergau","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Gal","family":"Tsaban","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,7,23]]},"references-count":14,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytae358","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2024,8]]},"published":{"date-parts":[[2024,7,23]]},"article-number":"ytae358"}}