{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T03:14:38Z","timestamp":1788146078631,"version":"build-2803163510"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":59,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["2019-0097"],"award-info":[{"award-number":["2019-0097"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["2021-00202"],"award-info":[{"award-number":["2021-00202"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swedish Heart Lung foundation","award":["20190301"],"award-info":[{"award-number":["20190301"]}]},{"name":"Swedish Heart Lung foundation","award":["20200537"],"award-info":[{"award-number":["20200537"]}]},{"name":"Swedish Heart Lung foundation","award":["20210302"],"award-info":[{"award-number":["20210302"]}]},{"DOI":"10.13039\/501100018713","name":"Center for Innovative Medicine","doi-asserted-by":"publisher","award":["20190797"],"award-info":[{"award-number":["20190797"]}],"id":[{"id":"10.13039\/501100018713","id-type":"DOI","asserted-by":"publisher"}]},{"name":"ALF Region Stockholm","award":["FoUI-954075"],"award-info":[{"award-number":["FoUI-954075"]}]},{"name":"\u00c5ke Wibergs Stiftelse","award":["M19-0424"],"award-info":[{"award-number":["M19-0424"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Voltage-based ablation is a promising catheter ablation strategy for atrial fibrillation (AF) in which low-voltage zones (LVZs) are targeted as a complement to pulmonary vein isolation (PVI). In a randomized setting, we intend to investigate whether PVI plus ablation of LVZs, compared to PVI-only, decreases the incidence of arrhythmia recurrence and improves health-related quality of life (HRQoL) in patients with persistent AF and LVZs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Individually designed ablation of low-voltage areas in persistent atrial fibrillation trial (IDEAL-AF; NCT04377594) is a multi-centre, randomized, controlled clinical trial. Patients with persistent AF and LVZs \u2265 3.0\u2005cm\u00b2 outside the PVI ablation lines will be randomized in a 1:1 ratio to either PVI or PVI plus LVZ ablation. The primary outcome will be the recurrence of atrial arrhythmias off anti-arrhythmic drugs during 12 months of follow-up after one to two ablation procedures within 6 months. A 3-month blanking period will be applied after the first procedure. Patients will be monitored using a smart phone-based ECG recording device throughout the follow-up period. With an anticipated enrolment of 936 patients, this study has 80% power to detect a 20% absolute risk reduction in the primary endpoint. Additionally, HRQoL improvement will be assessed using three questionnaires.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>IDEAL-AF is a multi-centre, randomized, controlled clinical trial investigating whether ablation of LVZs in addition to PVI reduces the recurrence rate of atrial arrhythmias and improves HRQoL compared to PVI-only in patients with persistent AF and LVZs. This study has the potential to modify recommendations regarding ablation techniques for this specific patient cohort.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeaf037","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T06:28:26Z","timestamp":1745908106000},"source":"Crossref","is-referenced-by-count":3,"title":["Individually designed ablation of low-voltage areas in persistent atrial fibrillation\u2014a randomized controlled trial (IDEAL-AF): study design and rationale"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6431-8358","authenticated-orcid":false,"given":"Astrid","family":"Paul Nordin","sequence":"first","affiliation":[{"name":"Heart and Lung Disease Unit, Department of Medicine, Huddinge, Karolinska Institutet , H\u00e4lsov\u00e4gen 13, S-141 86 Stockholm ,","place":["Sweden"]},{"name":"Department of Cardiology, Karolinska University Hospital , H\u00e4lsov\u00e4gen 13, S-141 86 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H\u00e4lsov\u00e4gen 13, S-141 86 Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Finn","family":"\u00c5kerstr\u00f6m","sequence":"additional","affiliation":[{"name":"Heart and Lung Disease Unit, Department of Medicine, Huddinge, Karolinska Institutet , H\u00e4lsov\u00e4gen 13, S-141 86 Stockholm ,","place":["Sweden"]},{"name":"Department of Cardiology, Karolinska University Hospital , H\u00e4lsov\u00e4gen 13, S-141 86 Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2618-5966","authenticated-orcid":false,"given":"Henrik","family":"Almroth","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Link\u00f6ping University Hospital , S-581 85 Link\u00f6ping ,","place":["Sweden"]},{"name":"Department of Health, Medicine and Caring Sciences, Link\u00f6ping University , S-581 85 Link\u00f6ping 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