{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T12:46:02Z","timestamp":1776689162708,"version":"3.51.2"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,5,16]],"date-time":"2020-05-16T00:00:00Z","timestamp":1589587200000},"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":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Catheter ablation (CA) for long\u2010standing persistent atrial fibrillation (LS\u2010AF) remains challenging. We aimed to explore whether sinus rhythm (SR) restoration and left atrium (LA) function after pretreatment with antiarrhythmic drugs (AAD's) and electrical cardioversion (ECV) predict procedural outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>We included 100 consecutive patients with LS\u2010AF who were treated with AAD\/ECV for at least 3 months before CA. The echocardiographic LA strain during reservoir phase (LASr) was assessed after pretreatment as a marker of LA fibrosis. The recurrence was recorded for \u22651 year after the last procedure. During a 34\u2009\u00b1\u200916\u2010month follow\u2010up period, the single and multiple procedures and pharmaceutically assisted success rates were 40% and 71%, respectively. Patients with preprocedural SR restoration and higher LASr showed a significantly higher recurrence\u2010free probability after the last CA (logrank <jats:italic>P<\/jats:italic>\u2009=\u2009.001\u00a0and\u00a0<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001, respectively). Failure of preprocedural SR restoration and LASr \u22648.6% were independently associated with recurrence after the last CA (hazard ratio [HR]: 3.13, 95% confidence interval [CI]: 1.42\u20106.91, <jats:italic>P<\/jats:italic>\u2009=\u2009.005; HR: 3.89, 95% CI: 1.65\u20109.17, <jats:italic>P<\/jats:italic>\u2009=\u2009.002, respectively). These parameters added incrementally to the predictive value of AF duration and LA dilatation (<jats:italic>P<\/jats:italic>\u2009=\u2009.03\u00a0and\u00a0<jats:italic>P<\/jats:italic>\u2009=\u2009.002, respectively) and improved the recurrence\u2010risk stratification (net reclassification improvement\u2009=\u20090.39; 95% CI\u2009=\u20090.13\u20100.65; <jats:italic>P<\/jats:italic>\u2009=\u2009.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with LS\u2010AF, the inability to restore SR and lower LASr after AAD\/ECV treatment independently and incrementally predicts the recurrence after CA. These findings might be useful for determining LS\u2010AF ablation candidates.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14540","type":"journal-article","created":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T09:59:52Z","timestamp":1589191192000},"page":"1709-1718","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Preprocedural restoration of sinus rhythm and left atrial strain predict outcomes of catheter ablation for long\u2010standing persistent atrial fibrillation"],"prefix":"10.1111","volume":"31","author":[{"given":"Yuichi","family":"Hanaki","sequence":"first","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1901-7112","authenticated-orcid":false,"given":"Tomoko","family":"Machino\u2010Ohtsuka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazutaka","family":"Aonuma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Machino","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiro","family":"Yamasaki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miyako","family":"Igarashi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukio","family":"Sekiguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiko","family":"Nogami","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Ieda","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine University of Tsukuba  Tsukuba 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