{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T03:38:10Z","timestamp":1788838690085,"version":"build-2803163510"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2019,8,14]],"date-time":"2019-08-14T00:00:00Z","timestamp":1565740800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>There is no valid treatment strategy for addressing paroxysmal atrial fibrillation (AF) in patients with unclosed atrial septal defect (ASD). We aimed to assess the efficacy of catheter ablation (CA) compared with transcatheter ASD closure alone for treating pre-existing paroxysmal AF in patients with ASD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Among 908 patients who underwent transcatheter ASD closure, we evaluated 50 consecutive patients (63\u2009\u00b1\u200912 years) with paroxysmal AF. We compared the AF outcomes of these patients after transcatheter ASD closure between those with and without CA prior to ASD closure. Thirty (60%) patients underwent CA. During the follow-up period after ASD closure (mean: 49\u2009\u00b1\u200923 months), recurrence of AF was observed in 6\/30 (20%) patients with upfront CA and 12\/20 (60%) patients with ASD closure alone. Kaplan\u2013Meier analysis showed that the AF-free survival rate was significantly higher for patients with CA than for those with ASD closure alone (79% vs. 37% at 5 years, P\u2009=\u20090.002). Upfront CA and previous heart failure hospitalization were associated with recurrence of AF after ASD closure [hazard ratio (HR) 0.18, 95% confidence interval (CI) 0.06\u20130.53; P\u2009=\u20090.002 and HR 4.64, 95% CI 1.60\u201313.49; P\u2009=\u20090.005, respectively].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In ASD patient with paroxysmal AF, transcatheter ASD closure alone demonstrated high AF recurrence rate after ASD closure. On the other hand, upfront CA prior to ASD closure substantially suppressed AF recurrence over the long term. A combination of CA and transcatheter ASD closure may be a feasible treatment strategy for paroxysmal AF in patients with ASD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euz207","type":"journal-article","created":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T07:09:55Z","timestamp":1562656195000},"page":"1663-1669","source":"Crossref","is-referenced-by-count":28,"title":["Efficacy of catheter ablation for paroxysmal atrial fibrillation in patients with atrial septal defect: a comparison with transcatheter closure alone"],"prefix":"10.1093","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3591-9415","authenticated-orcid":false,"given":"Koji","family":"Nakagawa","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teiji","family":"Akagi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Nagase","sequence":"additional","affiliation":[{"name":"Department of Cardiac Arrhythmias, National Cerebral and Cardiovascular Center, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoichi","family":"Takaya","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasufumi","family":"Kijima","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Cardiovascular Center, St. Luke\u2019s International Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norihisa","family":"Toh","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuyuki","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Nishii","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazufumi","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kengo","family":"Kusano","sequence":"additional","affiliation":[{"name":"Department of Cardiac Arrhythmias, National Cerebral and Cardiovascular Center, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho Kita-ku, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,13]]},"reference":[{"key":"2019110403561270600_euz207-B1","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1016\/j.jcin.2015.02.002","article-title":"Long-term outcome after transcatheter closure of atrial septal defect in older patients: impact of age at procedure","volume":"8","author":"Takaya","year":"2015","journal-title":"J Am 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