{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:07:42Z","timestamp":1784268462468,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,9,24]],"date-time":"2018-09-24T00:00:00Z","timestamp":1537747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Outcome data after catheter ablation (CA) for longstanding persistent atrial fibrillation (LSPAF) lasting less than 2 years are limited and highly variable with different ablation approaches. We aimed to assess the long\u2010term outcomes in patients with LSPAF lasting less than 2 years undergoing extended pulmonary vein antrum isolation (PVAI) versus those with additional non\u2010pulmonary vein (PV) trigger ablation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>In this prospective analysis, 381 consecutive patients with LSPAF lasting less than 2 years (age: 64\u2009\u00b1\u20099 years, 76% male, atrial fibrillation duration: 19\u2009\u00b1\u20095 months) undergoing their first CA were classified into two groups: Group 1 (<jats:italic>n<\/jats:italic>\u2009=\u2009104) received PVAI extended to PW plus isolation of superior vena cava (SVC) and Group 2 (\n<jats:italic>n<\/jats:italic>\u2009=\u2009277) received PVAI\u2009+\u2009PW\u2009+\u2009SVC\u2009+\u2009non\u2010PV\u2013trigger ablation. All patients were followed\u2010up for at least 2 years. In case of recurrence, repeat procedure was offered and non\u2010PV triggers were targeted for ablation in all.<\/jats:p><jats:p>After a single procedure, 26 (25%) patients in Group 1 and 172 (62.1%) in Group 2 remained arrhythmia\u2010free (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). A second procedure was performed in 58 of 78 (74.4%) patients in Group 1 and 77 of 105 (73.3%) patients in Group 2. Non\u2010PV triggers were identified in 52 (89.6%) and 54 (70.1%) patients in Groups 1 and 2, respectively, and targeted for ablation. Overall, 72 (69.2%) patients in Group 1 and 238 (86%) in Group 2 remained arrhythmia\u2010free (\n<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with LSPAF lasting less than 2 years, extended PVAI plus SVC isolation was less likely to achieve long\u2010term sinus rhythm. In the majority of patients, recurrence was due to non\u2010PV triggers and ablation of those resulted in better outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.13721","type":"journal-article","created":{"date-parts":[[2018,8,31]],"date-time":"2018-08-31T07:36:35Z","timestamp":1535700995000},"page":"1607-1615","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Long\u2010term outcomes of catheter ablation in patients with longstanding persistent atrial fibrillation lasting less than 2 years"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3837-3462","authenticated-orcid":false,"given":"Domenico G.","family":"Della Rocca","sequence":"first","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute, St. David's Medical Center Austin Texas"},{"name":"Department of Cardiovascular Medicine University of Tor Vergata Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanghamitra","family":"Mohanty","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute, St. David's Medical Center Austin Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasant","family":"Mohanty","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute, St. David's Medical Center Austin Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chintan","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute, St. David's Medical Center Austin Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8174-7207","authenticated-orcid":false,"given":"Carola","family":"Gianni","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute, St. David's Medical Center Austin Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amin","family":"Al\u2010Ahmad","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute, St. David's Medical Center Austin Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. David","family":"Burkhardt","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute, St. David's Medical Center Austin Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Joseph","family":"Gallinghouse","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute, St. David's Medical Center Austin Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Hranitzky","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute, St. David's Medical Center Austin Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier E.","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute, St. David's Medical Center Austin Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney P.","family":"Horton","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute, St. David's Medical Center Austin Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6508-4047","authenticated-orcid":false,"given":"Luigi","family":"Di Biase","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute, St. David's Medical Center Austin Texas"},{"name":"Arrhythmia Services, Department of Medicine Montefiore Medical Center, Albert Einstein College of Medicine Bronx New York"},{"name":"Department of Clinical and Experimental Medicine University of Foggia Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5487-0728","authenticated-orcid":false,"given":"Andrea","family":"Natale","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute, St. David's Medical Center Austin Texas"},{"name":"Interventional Electrophysiology, Scripps Clinic La Jolla California"},{"name":"Department of Cardiology MetroHealth Medical Center, Case Western Reserve University School of Medicine Cleveland Ohio"},{"name":"Division of Cardiology, Stanford University Stanford California"},{"name":"Atrial Fibrillation and Arrhythmia Center, 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