{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T05:39:14Z","timestamp":1775453954163,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T00:00:00Z","timestamp":1653955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Posterior wall isolation (PWI) added to pulmonary vein isolation (PVI) is increasingly used despite limited evidence of clinical benefit. We investigated the feasibility, durability, and efficacy of index\u2010procedure PVI\u2009+\u2009PWI radio frequency ablation (RFA) in patients with persistent atrial fibrillation (PeAF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Twenty\u2010four patients with PeAF participated in the prospective PeAF\u2010Box study and underwent RFA with wide area circumferential ablation, roof\u2010 and inferior lines to achieve PVI\u2009+\u2009PWI at index procedure. Follow\u2010up included monitoring by an implantable cardiac monitor, esophagoscopy and mandated invasive lesion\u2010reassessment at 6 months. PWI was achieved at minor procedural cost in all patients following PVI. In 33% of patients a median of three ablations in the narrow zone between the center of the posterior wall (PW) and the posterior right carina was pivotal for swift achievement of PWI. At the 6\u2010month reassessment procedure 85% (95% confidence interval [CI]: 77%\u201392%) of pulmonary veins (PVs) and 46% (95% CI: 26%\u201367%) of PWs remained durably isolated. AF recurred in 25% and was associated with PV\u2010reconnection (<jats:italic>p<\/jats:italic>\u2009=\u2009.02) but not PW\u2010reconnection (<jats:italic>p<\/jats:italic>\u2009=\u2009.27). AF\u2010burden was 0% (interquartile range [IQR]: 0%\u20130%) overall and after recurrence 1% (IQR: 0%\u20137%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Index procedure PVI\u2009+\u2009PWI for PeAF was feasible when recognizing that limited ablation in a PW center\u2010to\u2010right\u2010carina zone was required in a subset of patients. Despite limited chronic PWI durability this strategy was followed by low AF\u2010burden. A PVI\u2009+\u2009PWI strategy appears promising in ablation for PeAF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15556","type":"journal-article","created":{"date-parts":[[2022,5,22]],"date-time":"2022-05-22T14:14:40Z","timestamp":1653228880000},"page":"1667-1674","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Posterior wall isolation in persistent atrial fibrillation feasibility, safety, durability, and efficacy"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9501-6168","authenticated-orcid":false,"given":"Ren\u00e9","family":"Worck","sequence":"first","affiliation":[{"name":"Department of Cardiology Copenhagen University Hospital Gentofte  Hellerup Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8134-2245","authenticated-orcid":false,"given":"Samuel K.","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Copenhagen University Hospital Gentofte  Hellerup Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0294-3750","authenticated-orcid":false,"given":"Arne","family":"Johannessen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Copenhagen University Hospital Gentofte  Hellerup Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1541-309X","authenticated-orcid":false,"given":"Martin","family":"Ruwald","sequence":"additional","affiliation":[{"name":"Department of Cardiology Copenhagen University Hospital Gentofte  Hellerup Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Haugdal","sequence":"additional","affiliation":[{"name":"Department of Cardiology Copenhagen University Hospital Gentofte  Hellerup 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