{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:39:18Z","timestamp":1787495958532,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T00:00:00Z","timestamp":1670371200000},"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":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pulmonary vein isolation (PVI) is effective at treating 50% of unselected patients with persistent atrial fibrillation (AF). Alternatively, PVI combined with a new ablation strategy entitled the Marshall\u2010PLAN ensures a 78% 1\u2010year sinus rhythm (SR) maintenance rate in the same population. However, a substantial subset of patients could undergo the Marshall\u2010PLAN unnecessarily. It is therefore essential to identify those patients who can be treated with PVI alone versus those who may truly benefit from the Marshall\u2010PLAN before ablation is performed. In this context, we hypothesized that electrical cardioversion (EC) could help to select the most appropriate strategy for each patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicentre, prospective, randomized study, patients with AF recurrence within 4 weeks after EC will be randomized 1:1 to PVI alone or the Marshall\u2010PLAN. Conversely, patients in whom SR is maintained for \u22654 weeks after EC will be treated with PVI only and included in a prospective registry. The primary endpoint will be the 1\u2010year SR maintenance rate after a single ablation procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and Conclusion<\/jats:title>\n                    <jats:p>The Marshall\u2010PLAN might be necessary in patients with an advanced degree of persistent AF (i.e., where SR is not maintained for \u22654 uninterrupted weeks after EC). Conversely, in patients with mild or moderate persistent AF (i.e., where SR is maintained for \u22654 weeks after EC), PVI alone might be a sufficient ablation strategy. The PACIFIC trial is the first study designed to assess whether rhythm monitoring after EC could help to identify patients who should undergo adjunctive ablation strategies beyond PVI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.15761","type":"journal-article","created":{"date-parts":[[2022,11,26]],"date-time":"2022-11-26T17:00:16Z","timestamp":1669482016000},"page":"270-278","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Pulmonary vein isolation alone or in combination with substrate modulation after electrical cardioversion failure in patients with persistent atrial fibrillation: The PACIFIC trial: Study design"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9568-2806","authenticated-orcid":false,"given":"Agust\u00edn Alfonso","family":"Bortone","sequence":"first","affiliation":[{"name":"Service de Cardiologie H\u00f4pital Priv\u00e9 Les Franciscaines, ELSAN  N\u00eemes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7227-3428","authenticated-orcid":false,"given":"Eloi","family":"Marijon","sequence":"additional","affiliation":[{"name":"Service de Cardiologie H\u00f4pital Europ\u00e9en Georges Pompidou  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1600-3137","authenticated-orcid":false,"given":"Luca Rosario","family":"Limite","sequence":"additional","affiliation":[{"name":"Service de Cardiologie H\u00f4pital Priv\u00e9 Les Franciscaines, ELSAN  N\u00eemes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Lagrange","sequence":"additional","affiliation":[{"name":"Service de Cardiologie Clinique St Pierre, ELSAN  Perpignan 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