{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:08:16Z","timestamp":1787015296775,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:00:00Z","timestamp":1777766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:00:00Z","timestamp":1777766400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The role of dominant frequency (DF)\u2013guided ablation after pulmonary vein isolation (PVI) in persistent atrial fibrillation (AF) remains uncertain. We evaluated the clinical and mechanistic impact of DF mapping in a multicenter randomized study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>\n                      In this multicenter, prospective study, 103 patients were enrolled. Patients with high\u2010DF sites (\u2265\u20097\u2009Hz) were randomized 1:1 to PVI plus DF ablation (DF group,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932) or PVI alone (PVI group,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932). Patients without high\u2010DF sites (&lt;\u20097\u2009Hz,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200939) underwent PVI only (non\u2010DF group; exploratory cohort). The primary endpoint was freedom from documented AF recurrence without antiarrhythmic drugs (AADs) at 12 months. AF\u2010free survival off AADs was 81.3% in the DF group versus 68.9% in the PVI group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.228) at 12 months. Arrhythmia\u2010free survival with or without AADs was 78.1% versus 65.6% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.263). The non\u2010DF group showed the most favorable outcomes (83.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.065 vs PVI group). No adverse events were associated with DF mapping or ablation. Multivariate analysis identified right atrial (RA) low\u2010voltage area extent (HR 1.031, 95% CI 1.005\u20131.058,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018) and LA diameter (HR 0.899, 95% CI 0.816\u20130.991,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032) as independent predictors of recurrence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this multicenter randomized trial, adjunctive DF\u2010guided ablation following PVI did not result in a statistically significant improvement in arrhythmia\u2010free survival compared with PVI alone. However, the absence of high\u2010DF sites was associated with favorable outcomes, and RA low\u2010voltage burden emerged as an independent predictor of recurrence, supporting the potential mechanistic value of DF mapping and highlighting the prognostic importance of right atrial structural remodeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>UMIN000042543.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70357","type":"journal-article","created":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T21:05:09Z","timestamp":1777842309000},"page":"1410-1420","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prospective Trial of Radiofrequency Catheter Ablation of High Dominant Frequencies After Pulmonary Vein Isolation in Non\u2010Paroxysmal Atrial Fibrillation (PAD\u2010AF Trial): A Multicenter, Randomized Clinical Trial"],"prefix":"10.1111","volume":"37","author":[{"given":"Koji","family":"Kumagai","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Tohoku Medical and Pharmaceutical University  Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoaki","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Mito Saiseikai General Hospital Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Kutsuzawa","sequence":"additional","affiliation":[{"name":"Division of Cardiology Yamagata University Hospital Yamagata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0500-1371","authenticated-orcid":false,"given":"Yuichi","family":"Hanaki","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Tsukuba Hospital Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2345-9557","authenticated-orcid":false,"given":"Masahide","family":"Harada","sequence":"additional","affiliation":[{"name":"Division of Cardiology Fujita Health University  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Hachiya","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Tsuchiura Kyodo General Hospital Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhi","family":"Hasebe","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tohoku Medical and Pharmaceutical University  Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5931-6139","authenticated-orcid":false,"given":"Kazuki","family":"Noda","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Sendai City Medical Center Sendai Open Hospital Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minoru","family":"Yambe","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tohoku Medical and Pharmaceutical University  Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1894-3328","authenticated-orcid":false,"given":"Hirohito","family":"Metoki","sequence":"additional","affiliation":[{"name":"Division of Public Health, Hygiene, and Epidemiology Tohoku Medical and Pharmaceutical University  Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazutaka","family":"Aonuma","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Tsukuba Hospital Ibaraki 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Artificial Intelligence for Individualized Treatment of Persistent Atrial Fibrillation: A Randomized Controlled Trial","volume":"31","author":"Deisenhofer I.","year":"2025","journal-title":"Nature Medicine (New York, NY, United States)"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70357","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.70357","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70357","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:06:43Z","timestamp":1785420403000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.70357"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,3]]},"references-count":25,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/jce.70357"],"URL":"https:\/\/doi.org\/10.1111\/jce.70357","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,3]]},"assertion":[{"value":"2025-10-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}