{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:54:02Z","timestamp":1788263642499,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T00:00:00Z","timestamp":1608249600000},"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":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The role of nonpulmonary vein (PV) triggers ablation in persistent atrial fibrillation (PEAF) was suggested but it is still under debate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to assess the effectiveness of non\u2010PV trigger\u2010targeted ablation for patients with PEAF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients with PEAF undergoing catheter ablation (CA) between January 2015 and April 2017 were enrolled. Isoproterenol plus adenosine challenge was performed to provoke non\u2010PV triggers. Non\u2010PV triggers were defined as the trigger beats inducing AF (non\u2010PV AF triggers) and\/or frequent premature contractions (non\u2010PV PACs) from other than PVs. Three groups were defined: Group 1 (<jats:italic>n<\/jats:italic>\u2009=\u2009186) without non\u2010PV triggers; Group 2 (<jats:italic>n<\/jats:italic>\u2009=\u200965) with non\u2010PV triggers that could be completely eliminated with CA; Group 3 (<jats:italic>n<\/jats:italic>\u2009=\u200949) with non\u2010PV triggers still inducible after CA. The primary endpoint was freedom from any atrial tachyarrhythmia (ATa) recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 300 patients (230 males, age 64\u2009\u00b1\u200910) were enrolled. The mean follow\u2010up period was 27\u2009\u00b1\u200910 months. Freedom from ATa recurrence at 1\u00a0and 2 years were significantly lower in Group 3 compared to the other two groups (Group 1; 74.7%, 67.2% vs. Group 2; 75.8%, 68.3% vs. Group 3: 52.1%, 38.6%, <jats:italic>p<\/jats:italic>\u2009=\u2009.0005), irrespective of the type of non\u2010PV triggers (non\u2010PV AF triggers vs. non\u2010PV PACs). On multivariate analysis, unsuccessful elimination of non\u2010PV triggers was an independent predictor for ATa recurrence (hazard ratio\u2009=\u20091.80, 95% confidence interval\u2009=\u20091.07\u20132.95, <jats:italic>p<\/jats:italic>\u2009=\u2009.026).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Successful non\u2010PV triggers elimination can improve the ATa recurrence rate in PEAF ablation. ATa recurrence rate is higher, if non\u2010PV AF triggers or even non\u2010PV PACs remain in patients with PEAF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14830","type":"journal-article","created":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T14:56:33Z","timestamp":1607007393000},"page":"224-234","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Clinical impact of eliminating nonpulmonary vein triggers of atrial fibrillation and nonpulmonary vein premature atrial contractions at initial ablation for persistent atrial fibrillation"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0299-362X","authenticated-orcid":false,"given":"Shota","family":"Tohoku","sequence":"first","affiliation":[{"name":"Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan"},{"name":"Abteilung f\u00fcr Kardiologie, Medizinische Klinik III, Agaplesion Markus Krankenhaus Cardioangiologisches Centrum Bethanien, Frankfurt Academy For Arrhythmias Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Fukunaga","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michio","family":"Nagashima","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kengo","family":"Korai","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Hirokami","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kokura Memorial Hospital Kitakyushu 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