{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:42:17Z","timestamp":1789486937690,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"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":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Atrial tachyarrhythmias frequently recur after surgical ablation and often require catheter ablation (CA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of patients who underwent CA for symptomatic atrial fibrillation or flutter (AF hereafter) following surgical ablation. Clinical data, including patient and surgical characteristics and results of electrophysiology testing and mapping, were recorded. Recurrence was defined as 30\u2009s of AF, atrial flutter, or atrial tachycardia following a 3\u2010month blanking period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010seven patients were included in the study (mean age 67.0\u2009\u00b1\u20099.8 years, 43% female) who underwent isolated surgical ablation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095), concomitant mitral valve surgery (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921), aortic valve (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095), tricuspid valve surgery (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096), and\/or coronary artery bypass grafting (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096). The mean time from surgical ablation to CA was 5.9\u2009\u00b1\u20095.1 years. Among the 37 patients, 19 (51%) experienced one or more pulmonary vein reconnections (mean 3.0\u2009\u00b1\u20091.3 veins per patient), and 15 (41%) developed mitral annular flutter. Following ablation, 12 (32%) patients developed recurrent arrhythmia by 1\u2010year post\u2010ablation. Age, sex, body mass index, time from surgical ablation to CA left ventricular ejection fraction &lt;\u200950%, prior CA, left atrial diameter, and mitral annular flutter were not associated with recurrence. The number of pulmonary vein reconnections at the time of repeat CA was predictive of arrhythmia recurrence in subsequent follow\u2010up (OR 2.148 [95% CI: 1.059\u22124.357];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pulmonary vein reconnection and mitral annular flutter are common recurrence mechanisms in patients with symptomatic arrhythmia recurrence following surgical ablation. The number of pulmonary vein reconnections predicts recurrent arrhythmia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70477","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T17:54:46Z","timestamp":1787248486000},"page":"2047-2054","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mechanisms of Recurrent Arrhythmia in Patients With Prior Surgical Ablation of Atrial Fibrillation Who Undergo Catheter Ablation"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5641-8543","authenticated-orcid":false,"given":"Mark S.","family":"Brahier","sequence":"first","affiliation":[{"name":"Duke University Hospital Durham North Carolina USA"},{"name":"Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Brahier","sequence":"additional","affiliation":[{"name":"Duke University Hospital Durham North Carolina USA"},{"name":"Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Schwennesen","sequence":"additional","affiliation":[{"name":"Duke University Hospital Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7880-9745","authenticated-orcid":false,"given":"Kelly","family":"Arps","sequence":"additional","affiliation":[{"name":"Division of Electrophysiology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Williams","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany","family":"Zwischenberger","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4613-582X","authenticated-orcid":false,"given":"Zak","family":"Loring","sequence":"additional","affiliation":[{"name":"Electrophysiology Section Duke Heart Center, Duke University Hospital &amp; Duke Clinical Research Institute Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5791-1954","authenticated-orcid":false,"given":"Daniel","family":"Friedman","sequence":"additional","affiliation":[{"name":"Electrophysiology Section Duke Heart Center, Duke University Hospital &amp; Duke Clinical Research Institute Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0772-2404","authenticated-orcid":false,"given":"Jonathan P.","family":"Piccini","sequence":"additional","affiliation":[{"name":"Duke University Hospital Durham North Carolina USA"},{"name":"Electrophysiology Section Duke Heart Center, Duke University Hospital &amp; Duke Clinical Research Institute Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2019422"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joa.2017.08.001"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03510350050036"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1500528"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-305351"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.21037\/acs-2023-afm-16"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.12.001"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.117.005785"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2017.02.018"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12406"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euac102"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2016.02.003"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2023.12.003"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.14656"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2020.04.035"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2005.00323.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.10.040"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.759967"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.01.019"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70477","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.70477","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70477","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:39:11Z","timestamp":1789479551000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.70477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,20]]},"references-count":19,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/jce.70477"],"URL":"https:\/\/doi.org\/10.1111\/jce.70477","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,20]]},"assertion":[{"value":"2026-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}