{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T14:20:10Z","timestamp":1771510810468,"version":"3.50.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T00:00:00Z","timestamp":1687392000000},"content-version":"vor","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007497","name":"Biosense Webster","doi-asserted-by":"crossref","award":["IIS-490"],"award-info":[{"award-number":["IIS-490"]}],"id":[{"id":"10.13039\/100007497","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Pulmonary vein isolation (PVI) guided by the Ablation Index (AI) has shown high acute and mid-term efficacy in the treatment of paroxysmal atrial fibrillation (AF). Previous data before the AI-era had suggested that wide-area circumferential ablation (WACA) was preferable to ostial ablation. However, with the use of AI, we hypothesize that ostial circumferential ablation is non-inferior to WACA and can improve outcomes in paroxysmal AF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Prospective, multicentre, non-randomized, non-inferiority study of consecutive patients were referred for paroxysmal AF ablation from January 2020 to September 2021. All procedures were performed using the AI software, and patients were separated into two different groups: WACA vs. ostial circumferential ablation. Acute reconnection, procedural data, and 1-year arrhythmia recurrence were assessed. During the enrolment period, 162 patients (64% males, mean age of 60 \u00b1 11 years) fulfilled the study inclusion criteria\u201481 patients [304 pulmonary vein (PV)] in the WACA group and 81 patients (301 PV) in the ostial group. Acute PV reconnection was identified in 7.9% [95% confidence interval (CI), 4.9\u201311.1%] of PVs in the WACA group compared with 3.3% (95% CI, 1.8\u20136.1%) of PVs in the ostial group [P &amp;lt; 0.001 for non-inferiority; adjusted odds ratio 0.51 (95% CI, 0.23\u20130.83), P = 0.05]. Patients in the WACA group had longer ablation (35 vs. 29\u2005min, P = 0.001) and procedure (121 vs. 102\u2005min, P &amp;lt; 0.001) times. No significant difference in arrhythmia recurrence was seen at 1-year of follow-up [11.1% in WACA vs. 9.9% in ostial, hazard ratio 1.13 (95% CI, 0.44\u20131.94), P = 0.80 for superiority].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In paroxysmal AF patients treated with tailored AI-guided PVI, ostial circumferential ablation is not inferior to WACA with regard to acute PV reconnection, while allowing quicker procedures with less ablation time.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euad160","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T21:32:06Z","timestamp":1687642326000},"source":"Crossref","is-referenced-by-count":13,"title":["Ostial vs. wide area circumferential ablation guided by the Ablation Index in paroxysmal atrial fibrillation"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9791-767X","authenticated-orcid":false,"given":"Pedro A","family":"Sousa","sequence":"first","affiliation":[{"name":"Pacing and Electrophysiology Unit, Department of Cardiology, Coimbra\u2019s Hospital and University Center , Morada: Praceta Prof Mota Pinto, Coimbra 3000-075 , Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4064-3767","authenticated-orcid":false,"given":"S\u00e9rgio","family":"Barra","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital da Luz Arr\u00e1bida , V. N. Gaia , Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3716-0257","authenticated-orcid":false,"given":"Carolina","family":"Saleiro","sequence":"additional","affiliation":[{"name":"Pacing and Electrophysiology Unit, Department of Cardiology, Coimbra\u2019s Hospital and University Center , Morada: Praceta Prof Mota Pinto, Coimbra 3000-075 , Portugal"}]},{"given":"Ziad","family":"Khoueiry","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinique Saint Pierre , Perpignan , France"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3852-3314","authenticated-orcid":false,"given":"Lu\u00eds","family":"Ad\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Center of S\u00e3o Jo\u00e3o , Porto , Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9717-6202","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Primo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Vila Nova de Gaia and Espinho Hospital Center , V. N. Gaia , Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2650-0036","authenticated-orcid":false,"given":"Philippe","family":"Lagrange","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinique Saint Pierre , Perpignan , France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7827-4042","authenticated-orcid":false,"given":"Ana","family":"Lebreiro","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Center of S\u00e3o Jo\u00e3o , Porto , Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5790-9483","authenticated-orcid":false,"given":"Paulo","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Vila Nova de Gaia and Espinho Hospital Center , V. N. Gaia , Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9206-8026","authenticated-orcid":false,"given":"Mariana","family":"Pereira","sequence":"additional","affiliation":[{"name":"Biosense Webster , Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6173-3449","authenticated-orcid":false,"given":"Lu\u00eds","family":"Puga","sequence":"additional","affiliation":[{"name":"Pacing and Electrophysiology Unit, Department of Cardiology, Coimbra\u2019s Hospital and University Center , Morada: Praceta Prof Mota Pinto, Coimbra 3000-075 , Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7836-8161","authenticated-orcid":false,"given":"B\u00e1rbara","family":"Oliveiros","sequence":"additional","affiliation":[{"name":"ICBR, Faculty of Medicine, University of Coimbra , Coimbra , Portugal"}]},{"given":"Lu\u00eds","family":"Elvas","sequence":"additional","affiliation":[{"name":"Pacing and Electrophysiology Unit, Department of Cardiology, Coimbra\u2019s Hospital and University Center , Morada: Praceta Prof Mota Pinto, Coimbra 3000-075 , Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9255-3064","authenticated-orcid":false,"given":"Lino","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Pacing and Electrophysiology Unit, Department of Cardiology, Coimbra\u2019s Hospital and University Center , Morada: Praceta Prof Mota Pinto, Coimbra 3000-075 , Portugal"},{"name":"ICBR, Faculty of Medicine, University of Coimbra , Coimbra , Portugal"}]}],"member":"286","published-online":{"date-parts":[[2023,6,22]]},"reference":[{"key":"2023062312025318900_euad160-B1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the task force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) 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