{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:48:12Z","timestamp":1790221692404,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82070412"],"award-info":[{"award-number":["82070412"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary vein isolation (PVI) demonstrates less efficacy in persistent atrial fibrillation (PersAF) compared to paroxysmal AF. Although recent multiple\u2010center RCTs have shown that additional ablation, except for the ethanol intervention of the Marshall vein, has not significantly benefited in persistent AF. Therefore, the most important issue is how to identify PVI\u2010responsive PersAF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This exploratory cohort study assessed a novel direct current cardioversion\u2013electrophysiological study (DC\u2010EPS) protocol before ablation, and evaluated whether inducibility can be guided by a PVI procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective cohort study, patients were classified as Protocol\u2010Negative (AF non\u2010inducible post\u2010cardioversion) and Protocol\u2010Positive group (failed cardioversion, spontaneous AF recurrence within 5\u2009min, or induced AF). PVI alone was done in the Protocol\u2010Negative group, while PVI with adjunctive line ablation (Roof\/MI\/CTI lines) was performed in the Protocol\u2010Positive group. The procedure success endpoint is freedom from atrial arrhythmias &gt;\u200930\u2009s without antiarrhythmic drugs within 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over the 12\u2010month follow\u2010up, 41 of 48 patients (85.4%) in the Protocol\u2010Negative group and 37 of 61 patients (60.7%) in the Protocol\u2010Positive group remained free from ATA. Arrhythmia\u2010free survival was significantly higher in the Protocol\u2010Negative group (HR\u2009=\u20090.326; 95% CI, 0.140\u20130.756;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009). After multivariable adjustment, the recurrence risk remained lower in Protocol\u2010Negative patients (adjusted HR 0.328, 95% CI 0.138\u20130.779,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012). Protocol\u2010Negative patients exhibited preserved cardiac architecture (left atrial volume: 134.5 vs. 151.8\u2009mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022) and less fibrosis (low\u2010voltage area: 0 vs. 1.3\u2009cm\u00b2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with DC\u2010EPS\u2013defined Protocol\u2010Negativity have an excellent PVI responder. These findings suggest that PV antrum isolation may be enough in the initial procedure, and require a multi\u2010center RCT for further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70240","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T06:54:47Z","timestamp":1768028087000},"page":"484-492","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Simple Method Is Used to Identify PVI\u2010Responsive Patients With Persistent Atrial Fibrillation: Electrical Cardioversion and Noninduction Before Procedure"],"prefix":"10.1111","volume":"37","author":[{"given":"Hai\u2010yang","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Cardiology, Sun Yat\u2010Sen Memorial Hospital Sun Yat\u2010Sen University Guangzhou China"},{"name":"Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sun Yat\u2010Sen Memorial Hospital Sun Yat\u2010Sen University Guangzhou China"},{"name":"Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sun Yat\u2010Sen Memorial Hospital Sun Yat\u2010Sen University Guangzhou China"},{"name":"Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0968-1972","authenticated-orcid":false,"given":"Jianhua","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sun Yat\u2010Sen Memorial Hospital Sun Yat\u2010Sen University Guangzhou 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