{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T12:08:16Z","timestamp":1782907696199,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T00:00:00Z","timestamp":1612915200000},"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":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A computer simulation model has demonstrated that atrial fibrillation (AF) driver can be attached to heterogeneous fibrosis assessed by late gadolinium enhancement magnetic resonance imaging (LGE\u2010MRI). However, it has not been well elucidated in patients with persistent AF. The aim of this study was to investigate whether radiofrequency (RF) applications in the fragmented LGE area (FLA) could terminate AF or convert it to atrial tachycardia (AT) and improve the rhythm outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 31 consecutive persistent AF patients with FLAs were enrolled (FLA ablation group, mean age: 69\u2009\u00b1\u20098\u2009years, mean left atrial diameter: 42\u2009\u00b1\u20096\u2009mm). A favorable response was defined as direct AF termination or AT conversion during RF applications at the FLA. The rhythm outcome was compared between the FLA ablation group and FLA burden\u2010matched pulmonary vein isolation (PVI) group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Favorable responses were found in 15 (48%) of 31 patients in the FLA group (AF termination in seven, AT conversion in eight patients), but not in the PVI group. AF recurrence at 12\u2009months follow\u2010up was significantly less in the FLA ablation group than in the PVI group (4 [13%] vs. 12 [39%] of 31 patients, log\u2010rank <jats:italic>p<\/jats:italic>\u2009=\u2009.023). In patients with a favorable response, AT recurred in 1 (7%) of 15 patients, but AF did not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>FLA ablation could terminate AF or convert it to AT in half of the patients. No AF recurrence was documented in patients with a favorable response.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14925","type":"journal-article","created":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T18:42:19Z","timestamp":1612377739000},"page":"1014-1023","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Feasibility of catheter ablation in patients with persistent atrial fibrillation guided by fragmented late\u2010gadolinium enhancement areas"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9305-4854","authenticated-orcid":false,"given":"Kunihiko","family":"Kiuchi","sequence":"first","affiliation":[{"name":"Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Fukuzawa","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1768-802X","authenticated-orcid":false,"given":"Mitsuru","family":"Takami","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Division of Radiology, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Izawa","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayumi","family":"Shigeru","sequence":"additional","affiliation":[{"name":"Kobe Circulation Clinic Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Oonishi","sequence":"additional","affiliation":[{"name":"Kobe Circulation Clinic Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideya","family":"Suehiro","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomomi","family":"Akita","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Takemoto","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsusuke","family":"Yatomi","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0521-3008","authenticated-orcid":false,"given":"Toshihiro","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Sakai","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazutaka","family":"Nakasone","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Sonoda","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoko","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Takahara","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriyuki","family":"Negi","sequence":"additional","affiliation":[{"name":"Division of Diagnostic Imaging, Department of Diagnostic Radiology Kobe University Hospital Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsusuke","family":"Kyotani","sequence":"additional","affiliation":[{"name":"Division of Diagnostic Imaging, Department of Diagnostic Radiology Kobe University Hospital Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Kono","sequence":"additional","affiliation":[{"name":"Division of Radiology, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken\u2010ichi","family":"Hirata","sequence":"additional","affiliation":[{"name":"Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1408288"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2016.08.041"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14240"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2016.12.033"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2019.12.011"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvw073"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41551-019-0437-9"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14073"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14664"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2017.07.016"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.110.960567"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eux310"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13888"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.12036"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.113.000689"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.113.001251"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euz159"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.113.000890"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.10.065"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.01.014"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2017.07.019"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.12232"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.120.008707"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.115.002897"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvz083"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.14925","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.14925","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.14925","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T17:58:38Z","timestamp":1693331918000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.14925"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,10]]},"references-count":25,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1111\/jce.14925"],"URL":"https:\/\/doi.org\/10.1111\/jce.14925","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,10]]},"assertion":[{"value":"2020-10-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}