{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T12:51:25Z","timestamp":1787748685353,"version":"build-2784847793"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T00:00:00Z","timestamp":1599091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100007497","name":"Biosense Webster, Inc.","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007497","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To evaluate the safety and effectiveness of pulmonary vein isolation in paroxysmal atrial fibrillation (PAF) using a standardized workflow aiming to enclose the veins with contiguous and optimized radiofrequency lesions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>This multicentre, prospective, non-randomized study was conducted at 17 European sites. Pulmonary vein isolation was guided by VISITAG SURPOINT (VS target \u2265550 on the anterior wall; \u2265400 on the posterior wall) and intertag distance (\u22646\u2009mm). Atrial arrhythmia recurrence was stringently monitored with weekly and symptom-driven transtelephonic monitoring on top of standard-of-care monitoring (24-h Holter and 12-lead electrocardiogram at 3, 6, and 12\u2009months follow-up). Three hundred and forty participants with drug refractory PAF were enrolled. Acute effectiveness (first-pass isolation proof to a 30-min wait period and adenosine challenge) was 82.4% [95% confidence interval (CI) 77.4\u201386.7%]. At 12-month follow-up, the rate of freedom from any documented atrial arrhythmia was 78.3% (95% CI 73.8\u201382.8%), while freedom from atrial arrhythmia by standard-of-care monitoring was 89.4% (95% CI 78.8\u201387.0%). Freedom fromrepeat ablations by the Kaplan\u2013Meier analysis was 90.4% during 12\u2009months of follow-up. Of the 34 patients with repeat ablations, 14 (41.2%) demonstrated full isolation of all pulmonary vein circles. Primary adverse event (PAE) rate was 3.6% (95% CI 1.9\u20136.3%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The VISTAX trial demonstrated that a standardized PAF ablation workflow aiming for contiguous lesions leads to low rates of PAEs, high acute first-pass isolation rates, and 12-month freedom from arrhythmias approaching 80%. Further research is needed to improve the reproducibility of the outcomes across a wider range of centres.<\/jats:p>\n                  <jats:p>Clinical trial registration: ClinicalTrials.gov, number NCT03062046, https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03062046.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euaa157","type":"journal-article","created":{"date-parts":[[2020,6,6]],"date-time":"2020-06-06T11:11:31Z","timestamp":1591441891000},"page":"1645-1652","source":"Crossref","is-referenced-by-count":105,"title":["Standardized pulmonary vein isolation workflow to enclose veins with contiguous lesions: the multicentre VISTAX trial"],"prefix":"10.1093","volume":"22","author":[{"given":"Mattias","family":"Duytschaever","sequence":"first","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Hospital, Bruges, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Vijgen","sequence":"additional","affiliation":[{"name":"Division of Electrophysiology, Hasselt Heart Center, Jessa Hospital, Hasselt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"De Potter","sequence":"additional","affiliation":[{"name":"Department of Cardiology, OLV Hospital, Aalst, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Scherr","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Medical University Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Van Herendael","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ziekenhuis Oost \u2013 Limburg, Genk, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastien","family":"Knecht","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AZ Sint-Jan Hospital, Bruges, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Kobza","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center, Luzerner Kantonsspital, Luzern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Berte","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center, Luzerner Kantonsspital, Luzern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"Sandgaard","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Paul","family":"Albenque","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinique Pasteur, Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabor","family":"Szeplaki","sequence":"additional","affiliation":[{"name":"Department of Cardiac Electrophysiology, Mater Private Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yorick Jeroen","family":"Stevenhagen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Thoraxcentrum, Medisch Spectrum Twente, Enschede, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Taghji","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Private Hospital Clairval Marseille, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Thomas' Hospital London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Macours","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Biosense Webster, Inc., Diegem, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhiraj","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,9,3]]},"reference":[{"key":"2020111111425117400_euaa157-B1","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":"2020111111425117400_euaa157-B2","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":"2020111111425117400_euaa157-B3","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.119.007247","article-title":"Repeat ablation for atrial fibrillation recurrence post cryoballoon or radiofrequency ablation in the FIRE AND ICE Trial","volume":"12","author":"Kuck","year":"2019","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2020111111425117400_euaa157-B4","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.jacep.2016.07.014","article-title":"Relationship between catheter stability and 12-month success after pulmonary vein isolation: a subanalysis of the SMART-AF trial","volume":"2","author":"Reddy","year":"2016","journal-title":"JACC Clin Electrophysiol"},{"key":"2020111111425117400_euaa157-B5","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.116.004867","article-title":"Determinants of acute and late pulmonary vein reconnection in contact force-guided pulmonary vein isolation: identifying the weakest link in the ablation chain","volume":"10","author":"El Haddad","year":"2017","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2020111111425117400_euaa157-B6","first-page":"775","article-title":"Ablation index, a novel marker of ablation lesion quality: prediction of pulmonary vein reconnection at repeat electrophysiology study and regional differences in target values","volume":"19","author":"Das","year":"2017","journal-title":"Europace"},{"key":"2020111111425117400_euaa157-B7","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.jacep.2017.06.023","article-title":"Evaluation of a strategy aiming to enclose the pulmonary veins with contiguous and optimized radiofrequency lesions in paroxysmal atrial fibrillation: a pilot study","volume":"4","author":"Taghji","year":"2018","journal-title":"JACC Clin Electrophysiol"},{"key":"2020111111425117400_euaa157-B8","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.hrthm.2019.11.004","article-title":"Long-term impact of catheter ablation on arrhythmia burden in low-risk patients with paroxysmal atrial fibrillation: the CLOSE to CURE study","volume":"17","author":"Duytschaever","year":"2020","journal-title":"Heart Rhythm"},{"key":"2020111111425117400_euaa157-B9","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1016\/j.jacc.2012.11.064","article-title":"Cryoballoon ablation of pulmonary veins for paroxysmal atrial fibrillation: first results of the North American Arctic Front (STOP AF) pivotal trial","volume":"61","author":"Packer","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2020111111425117400_euaa157-B10","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1001\/jama.2009.2029","article-title":"Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial","volume":"303","author":"Wilber","year":"2010","journal-title":"JAMA"},{"key":"2020111111425117400_euaa157-B11","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.jacc.2014.04.072","article-title":"Paroxysmal AF catheter ablation with a contact force sensing catheter: results of the prospective, multicenter SMART-AF trial","volume":"64","author":"Natale","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2020111111425117400_euaa157-B12","first-page":"48","article-title":"Results from a multicentre comparison of cryoballoon vs. radiofrequency ablation for paroxysmal atrial fibrillation: is cryoablation more reproducible?","volume":"19","author":"Providencia","year":"2017","journal-title":"Europace"},{"key":"2020111111425117400_euaa157-B13","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1111\/jce.13227","article-title":"Safety and efficacy of pulmonary vein isolation using a surround flow catheter with contact force measurement capabilities: a multicenter registry","volume":"28","author":"Stabile","year":"2017","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2020111111425117400_euaa157-B14","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/s10840-019-00587-y","article-title":"An ablation index operator-independent approach to improve efficacy in atrial fibrillation ablation at 24-month follow-up: a single center experience","volume":"57","author":"Casella","year":"2020","journal-title":"J Interv Card Electrophysiol"},{"key":"2020111111425117400_euaa157-B15","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":"2020111111425117400_euaa157-B16","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.jacep.2018.11.020","article-title":"Pulmonary vein reconnection no longer occurs in the majority of patients after a single pulmonary vein isolation procedure","volume":"5","author":"De Pooter","year":"2019","journal-title":"JACC Clin Electrophysiol"},{"key":"2020111111425117400_euaa157-B17","doi-asserted-by":"crossref","first-page":"2254","DOI":"10.1016\/j.jacc.2019.08.1036","article-title":"Risk of mortality following catheter ablation of atrial fibrillation","volume":"74","author":"Cheng","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2020111111425117400_euaa157-B18","doi-asserted-by":"crossref","first-page":"f392","DOI":"10.1093\/europace\/eux264","article-title":"Safety and efficiency of porous-tip contact-force catheter for drug-refractory symptomatic paroxysmal atrial fibrillation ablation: results from the SMART SF trial","volume":"20","author":"Chinitz","year":"2018","journal-title":"Europace"},{"key":"2020111111425117400_euaa157-B19","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.ipej.2019.05.001","article-title":"Ablation-index guided versus conventional contact-force guided ablation in pulmonary vein isolation - systematic review and meta-analysis","volume":"19","author":"Pranata","year":"2019","journal-title":"Indian Pacing Electrophysiol J"}],"container-title":["EP Europace"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/europace\/article-pdf\/22\/11\/1645\/34247437\/euaa157.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/europace\/article-pdf\/22\/11\/1645\/34247437\/euaa157.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T16:44:16Z","timestamp":1605113056000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/22\/11\/1645\/5900851"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,3]]},"references-count":19,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,9,3]]},"published-print":{"date-parts":[[2020,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euaa157","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,11]]},"published":{"date-parts":[[2020,9,3]]}}}