{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:19:37Z","timestamp":1787008777351,"version":"build-2736575974"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T00:00:00Z","timestamp":1653955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>An epicardial approach is an effective means to detect and eliminate residual potentials in non-transmural lesions created during prior endocardial ablation. We sought to determine the impact of a combined epicardial and endocardial approach compared with a conventional endocardial approach, on recurrence-free survival after redo ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Participants with recurred persistent atrial fibrillation after prior endocardial ablation were randomized (1:1) to undergo treatment with the combined approach (epicardial followed by endocardial ablation) for the treatment group or conventional approach (endocardial ablation only) for the control group. The primary outcome was the time to recurrence of atrial fibrillation or atrial tachycardia following a 90-day blanking period within 12 months after the procedure. The secondary safety outcome was the occurrence of procedure-related complications within 24\u2005h after the procedure. Of 100 randomized participants {median age, 59.0 [(interquartile range (IQR): 53.8\u201364.3] years, including 16% women, with one prior ablation (IQR: 1\u20131)}, 93 (93%) completed the trial. Events relevant to the primary outcome occurred in 16 patients in the treatment group and in 21 patients in the control group {Kaplan\u2013Meier estimator percentages, 32 vs. 42%; hazard ratio, 0.71 [95% confidence interval (CI): 0.37\u20131.37]}. The periprocedural complication rate was lower in the treatment group [2 vs. 16%; odds ratio, 0.11 (95% CI: 0.00\u20130.87)] with similar achievement of the procedural endpoint in the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the redo procedure for persistent atrial fibrillation, the combined approach had no significant difference of recurrence-free survival and a lower procedural complication rate compared with the conventional approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euac058","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T07:11:50Z","timestamp":1649920310000},"page":"1412-1419","source":"Crossref","is-referenced-by-count":3,"title":["Combined epicardial and endocardial approach for redo radiofrequency catheter ablation in patients with persistent atrial fibrillation: a randomized clinical trial"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7430-415X","authenticated-orcid":false,"given":"Kwang No","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Cardiology, Ajou University School of Medicine , World cup-ro 164, Yeongtong-gu, Suwon-si, Gyeonggi-do 16499 , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital , Keunjaebong-gil 7, Hwaseong-si, Gyeonggi-do 18450 , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki Yung","family":"Boo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Jeju National University Hospital , Aran 13-gil 15, Jeju-si, Jeju-do 63241 , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun Gi","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital , Goryeodae-ro 73, Seongbuk-gu, Seoul 02841 , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Young","family":"Roh","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital , Gurodong-ro 148, Guro-gu, Seoul 08308 , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaemin","family":"Shim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital , Goryeodae-ro 73, Seongbuk-gu, Seoul 02841 , Republic of 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