{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T01:15:59Z","timestamp":1782782159275,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"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":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Linear ablation in addition to pulmonary vein antrum isolation (PVAI) has failed to improve the success rate for persistent atrial fibrillation (PeAF), due to incomplete block of ablation lines, especially in the mitral isthmus (MI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>The study enrolled 191 patients (66 in group 1 and 125 in group 2). In group 1, ethanol infusion into the vein of Marshall\u00a0was first\u00a0performed, followed by radiofrequency (RF) applications targeting bilateral PVAI and bidirectional block in the roofline, cavotricuspid isthmus, and MI. In group 2, PVAI and the three linear ablations were completed using only RF energy. MI block was achieved in 63 (95.5%) and 101 (80.8%) patients in groups 1 and 2, respectively (<jats:italic>p<\/jats:italic>\u2009=\u2009.006). Patients in group 1 had shorter ablation time for left pulmonary vein antrum (8.15\u00a0vs. 12.59\u2009min, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and MI (7.0\u00a0vs. 11.8\u2009min, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and required less cardioversion (50 [78.5%] vs. 113 [90.4%], <jats:italic>p<\/jats:italic>\u2009=\u2009.007). During the 12\u2010month follow\u2010up, 58 (87.9%) patients were free from atrial fibrillation\/atrial tachycardia in group 1 compared with 81 (64.8%) in group 2 (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). In multivariate cox regression, the \u201cupgraded 2C3L\u201d procedure is associated with a lower recurrence rate (hazard ratio\u2009=\u20090.27, 95% confidence interval\u2009=\u20090.12\u20130.59).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared with the conventional \u201c2C3L\u201d approach, the \u201cupgraded 2C3L\u201d approach has higher effectiveness for ablation of PeAF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15108","type":"journal-article","created":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T10:54:41Z","timestamp":1621853681000},"page":"1849-1856","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Effectiveness of ethanol infusion into the vein of Marshall combined with a fixed anatomical ablation strategy (the \u201cupgraded 2C3L\u201d approach) for catheter ablation of persistent atrial fibrillation"],"prefix":"10.1111","volume":"32","author":[{"given":"Yiwei","family":"Lai","sequence":"first","affiliation":[{"name":"Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxia","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5421-4421","authenticated-orcid":false,"given":"Caihua","family":"Sang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital Capital Medical University  Beijing 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