{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:25:08Z","timestamp":1791545108708,"version":"4.3.4"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T00:00:00Z","timestamp":1605571200000},"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\/100004374","name":"Medtronic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004374","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004331","name":"Johnson & Johnson","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004331","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000046","name":"Abbott","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000046","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Previous studies could not demonstrate any benefit of more intensive ablation in addition to pulmonary vein isolation (PVI) including complex fractionated atrial electrogram (CFAE) and linear ablation for recurrence in the initial catheter ablation of persistent atrial fibrillation (AF). This study aimed to establish the non-inferiority of PVI alone to PVI plus these additional ablation strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Patients with persistent AF who underwent an initial catheter ablation (n\u2009=\u2009512, long-standing persistent AF; 128 cases) were randomly assigned in a 1:1 ratio to either PVI alone (PVI-alone group) or PVI plus CFAE and\/or linear ablation (PVI-plus group). After excluding 15 cases who did not receive procedures, we analysed 249 and 248 patients, respectively. The primary endpoint was recurrence of AF, atrial flutter, and\/or atrial tachycardia, and the non-inferior margin was set at a hazard ratio of 1.43. In the PVI-plus group, 85.1% of patients had linear ablation and 15.3% CFAE ablation. After 12\u2009months, freedom from the primary endpoint occurred in 71.3% of patients in the PVI-alone group and in 78.3% in the PVI-plus group [hazard ratio = 1.56 (95% confidence interval: 1.10\u20132.24), non-inferior P\u2009=\u20090.3062]. The procedure-related complication rates were 2.0% in the PVI-alone group and 3.6% in the PVI-plus group (P\u2009=\u20090.199).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This randomized trial did not establish the non-inferiority of PVI alone to PVI plus linear ablation or CFAE ablation in patients with persistent AF, but implied that the PVI plus strategy was promising to improve the clinical efficacy (NCT03514693).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euaa293","type":"journal-article","created":{"date-parts":[[2020,9,12]],"date-time":"2020-09-12T07:11:58Z","timestamp":1599894718000},"page":"565-574","source":"Crossref","is-referenced-by-count":87,"title":["Pulmonary vein isolation alone vs. more extensive ablation with defragmentation and linear ablation of persistent atrial fibrillation: the EARNEST-PVI trial"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8389-549X","authenticated-orcid":false,"given":"Koichi","family":"Inoue","sequence":"first","affiliation":[{"name":"Cardiovascular Center, Sakurabashi-Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka 530-0001, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shungo","family":"Hikoso","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Sakurabashi-Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka 530-0001, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaharu","family":"Masuda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshio","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akio","family":"Hirata","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Osaka General Medical Center, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Egami","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Osaka Police Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Minamiguchi","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Sakurabashi-Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka 530-0001, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miwa","family":"Miyoshi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuaki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Sakurabashi-Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka 530-0001, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takafumi","family":"Oka","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Sakurabashi-Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka 530-0001, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Okada","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Sakurabashi-Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka 530-0001, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kanda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Osaka Hospital, Japan Community Healthcare Organization, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuhisa","family":"Kitamura","sequence":"additional","affiliation":[{"name":"Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoharu","family":"Dohi","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Sakurabashi-Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka 530-0001, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Sunaga","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Sakurabashi-Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka 530-0001, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroya","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Sakurabashi-Watanabe Hospital, 2-4-32 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