{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T19:02:11Z","timestamp":1769281331247,"version":"3.49.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Region \u00d6rebro L\u00e4n and \u00d6rebro University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Minimally invasive surgical ablation for atrial fibrillation is an alternative to catheter ablation. Achieving a lasting sinus rhythm in long-standing persistent atrial fibrillation is challenging, and long-term data after surgery are limited. In 2016, we published a randomized trial comparing totally endoscopic box lesion ablation of the left atrium (case) to medical therapy (control) during 1 year in patients with long-standing persistent atrial fibrillation. This study presents data from a follow-up of our previous cohort to investigate the rhythm outcome long-term.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an observational follow-up study. Most recent heart rhythm, time from totally endoscopic ablation to first relapse in atrial fibrillation, re-ablation, stroke, medication, left ventricular ejection fraction, and mortality were gathered from medical records and analysed with descriptive statistics and survival analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At the end of the randomized trial, 80% of the cases had sinus rhythm without antiarrhythmic drugs. During a mean follow-up of 9 years, 43% of cases and 74% of controls had undergone additional ablation procedures (P = .009). At the last follow-up, 21% of cases and 5% of controls were in SR. After totally endoscopic ablation, the mean time from surgery to first relapse in atrial fibrillation was 23 months (14-31 [95% CI] P &amp;lt; .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this population of patients with long-standing persistent atrial fibrillation, totally endoscopic box lesion ablation of the left atrium had short-term efficacy in restoring sinus rhythm. Long-term efficacy could not be demonstrated, with a high proportion of relapse in atrial fibrillation beyond 1 year post ablation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/icvts\/ivag004","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T12:37:53Z","timestamp":1767875873000},"source":"Crossref","is-referenced-by-count":0,"title":["A Retrospective Long-Term Follow-Up of the Randomized Study: Total Endoscopic Ablation of Patients With Long-Standing Persistent Atrial Fibrillation"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7447-8996","authenticated-orcid":false,"given":"Anders","family":"Wickbom","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, \u00d6rebro University Hospital , \u00d6rebro, SE-70185,","place":["Sweden"]},{"name":"Department of Medical Sciences, Faculty of Medicine and Health, \u00d6rebro University , \u00d6rebro, SE-70182,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2654-9427","authenticated-orcid":false,"given":"Espen","family":"Fengsrud","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Faculty of Medicine and Health, \u00d6rebro University , \u00d6rebro, SE-70182,","place":["Sweden"]},{"name":"Department of Cardiology, \u00d6rebro University Hospital , \u00d6rebro, SE-70185,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6913-0669","authenticated-orcid":false,"given":"Anders","family":"Ahlsson","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Faculty of Medicine and Health, \u00d6rebro University , \u00d6rebro, 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