{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:22:45Z","timestamp":1791397365897,"version":"4.3.3"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T00:00:00Z","timestamp":1620172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 106\u20102314\u2010B\u2010010\u2010046\u2010MY3"],"award-info":[{"award-number":["MOST 106\u20102314\u2010B\u2010010\u2010046\u2010MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 107\u20102314\u2010B\u2010010\u2010061\u2010MY2"],"award-info":[{"award-number":["MOST 107\u20102314\u2010B\u2010010\u2010061\u2010MY2"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST109\u20102314\u2010B\u2010010\u2010058\u2010MY2"],"award-info":[{"award-number":["MOST109\u20102314\u2010B\u2010010\u2010058\u2010MY2"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"publisher","award":["V109D48\u2010001\u2010MY2\u20102"],"award-info":[{"award-number":["V109D48\u2010001\u2010MY2\u20102"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"publisher","award":["C19\u2010027"],"award-info":[{"award-number":["C19\u2010027"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to assess the comparative efficacy of four ablation strategies on the incidence rates of freedom from atrial fibrillation (AF) or atrial tachycardia (AT) through a 3\u2010year follow\u2010up in patients with persistent AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>The optimal substrate modification strategies using catheter ablation for patients with persistent AF remain unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with persistent AF were enrolled consecutively to undergo each of four ablation strategies: (a) Group 1 (Gp 1, <jats:italic>n<\/jats:italic>\u2009=\u200969), pulmonary vein isolation (PVI) plus rotor ablation assisted by similarity index and phase mapping; (b) Gp 2 (<jats:italic>n<\/jats:italic>\u2009=\u200975), PVI plus linear ablations at the left atrium; (c) Gp 3 (<jats:italic>n<\/jats:italic>\u2009=\u200942), PVI plus the elimination of complex fractionated atrial electrograms; (d) Gp 4 (<jats:italic>n<\/jats:italic>\u2009=\u200967), PVI only. Potential confounders were adjusted via a multivariate survival parametric model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline characteristics were similar across the four groups. At a follow\u2010up period of 34.9\u2009\u00b1\u200938.6 months, patients in Gp 1 showed the highest rate of freedom from AF compared with the other three groups (<jats:italic>p<\/jats:italic>\u2009=\u2009.002), while patients in Gp 3 and 4 showed lower rates of freedom from AT than those of the other two groups (<jats:italic>p<\/jats:italic>\u2009=\u2009.006). Independent predictors of recurrence of AF were the ablation strategy (<jats:italic>p<\/jats:italic>\u2009=\u2009.002) and left atrial diameter (LAD) (<jats:italic>p<\/jats:italic>\u2009=\u2009.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with persistent AF, a substrate modification strategy using rotor ablation assisted by similarity index and phase mapping provided a benefit for maintaining sinus rhythm compared with the other strategies. Both ablation strategy and baseline LAD predicted the 3\u2010year outcomes of freedom from AT\/AF<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15033","type":"journal-article","created":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T05:06:06Z","timestamp":1617771966000},"page":"1561-1571","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Optimal substrate modification strategies using catheter ablation in patients with persistent atrial fibrillation: 3\u2010year follow\u2010up outcomes"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6218-7139","authenticated-orcid":false,"given":"Yu\u2010Cheng","family":"Hsieh","sequence":"first","affiliation":[{"name":"Cardiovascular Center Taichung Veterans General Hospital  Taichung Taiwan"},{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, National Yang\u2010Ming University School of Medicine, Taipei National Yang Ming Chiao Tung University  Hsinchu Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8395-1052","authenticated-orcid":false,"given":"Yenn\u2010Jiang","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, National Yang\u2010Ming University School of Medicine, Taipei National Yang Ming Chiao Tung University  Hsinchu Taiwan"},{"name":"Division of Cardiology, Department of Medicine, Heart Rhythm Center Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Men\u2010Tzung","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Engineering National Central University  Chungli Taiwan"},{"name":"Center for Dynamical Biomarkers and Translational Medicine National Central University  Chungli Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun\u2010Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, National Yang\u2010Ming University School of Medicine, Taipei National Yang Ming Chiao Tung University  Hsinchu Taiwan"},{"name":"Division of Cardiology, Department of Medicine, Heart Rhythm Center Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin\u2010Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, National Yang\u2010Ming University School of Medicine, Taipei National Yang Ming Chiao Tung University  Hsinchu Taiwan"},{"name":"Division of Cardiology, Department of Medicine, Heart Rhythm Center Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Engineering National Central University  Chungli Taiwan"},{"name":"Center for Dynamical Biomarkers and Translational Medicine National Central University  Chungli Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fa\u2010Po","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, National Yang\u2010Ming University School of Medicine, Taipei National Yang Ming Chiao Tung University  Hsinchu Taiwan"},{"name":"Division of Cardiology, Department of Medicine, Heart Rhythm Center Taipei Veterans General Hospital  Taipei 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