{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:02:17Z","timestamp":1791295337112,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early recurrences of atrial fibrillation (AF) after ablation are often considered transient. However, they may be caused by a combination of temporary and permanent proarrhythmogenic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We evaluated whether adjunctive GP ablation was associated with the timing and clinical implications of early AF recurrence, and explored the hypothesis that autonomic mechanisms contribute to early recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from the randomized AFACT study, we compared patients with advanced AF who underwent stand\u2010alone thoracoscopic ablation with or without GP ablation. Early recurrence was defined as AF or atrial tachycardia\u00a0recurrence within 90 days postoperative. Cox models were used to assess time\u2010dependent effects and identify clinical predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 235 patients were included in the current analysis. Seventy\u2010one patients had early recurrence: 36 in the GP ablation group and 35 in the non\u2010GP ablation group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.730). Of these, 45 (63%) occurred within the first 30 days. Patients in the GP ablation group had their first recurrence later than those in the non\u2010GP group (24 [14\u201334] vs. 14 [11\u201324] days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.046). In the GP ablation group, markers of arrhythmogenic substrate (i.e., age, left atrial volume index, diabetes, CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      \u2010VASc score, and persistent AF) were associated with early recurrence. Additionally, early recurrence was associated with late recurrence in the GP ablation group, but not in the non\u2010GP ablation group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adjunctive GP ablation was associated with later onset of first early recurrence, while the overall early recurrence rate was not reduced. In the GP ablation group, early recurrence was associated with subsequent late recurrence. These exploratory findings are compatible with a model in which early recurrence reflects both transient autonomic triggers and pre\u2010existing substrate, but this mechanism remains hypothesis\u2010generating.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Clinical Trial Registration:<\/jats:bold>\n                      ClinicalTrials.gov Identifier: NCT01091389.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70517","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:31:01Z","timestamp":1791293461000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Ganglionated Plexus Ablation on Early Recurrence After Thoracoscopic Atrial Fibrillation Ablation: A Post Hoc Analysis of the AFACT Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3811-1801","authenticated-orcid":false,"given":"Zhenyu","family":"Dong","sequence":"first","affiliation":[{"name":"Departments of Clinical and Experimental Cardiology, Heart Center Amsterdam UMC, location University of Amsterdam Amsterdam the Netherlands"},{"name":"Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9800-9550","authenticated-orcid":false,"given":"Marc M.","family":"Terpstra","sequence":"additional","affiliation":[{"name":"Departments of Clinical and Experimental Cardiology, Heart Center Amsterdam UMC, location University of Amsterdam Amsterdam the Netherlands"},{"name":"Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8733-0867","authenticated-orcid":false,"given":"Jolien","family":"Neefs","sequence":"additional","affiliation":[{"name":"Departments of Clinical and Experimental Cardiology, Heart Center Amsterdam UMC, location University of Amsterdam Amsterdam the Netherlands"},{"name":"Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4884-3879","authenticated-orcid":false,"given":"Nicoline W.E.","family":"van den Berg","sequence":"additional","affiliation":[{"name":"Departments of Clinical and Experimental Cardiology, Heart Center Amsterdam UMC, location University of Amsterdam Amsterdam the Netherlands"},{"name":"Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Femke R.","family":"Piersma","sequence":"additional","affiliation":[{"name":"Departments of Clinical and Experimental Cardiology, Heart Center Amsterdam UMC, location University of Amsterdam Amsterdam the Netherlands"},{"name":"Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastien P.J.","family":"Krul","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Center, Isala Zwolle the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter R.","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Cardiology Onze Lieve Vrouwe Gasthuis (OLVG) Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim\u2010Jan P.","family":"van Boven","sequence":"additional","affiliation":[{"name":"Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias Amsterdam the Netherlands"},{"name":"Department of Cardiothoracic Surgery Heart Center, Amsterdam UMC, location University of Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas S.S.G.","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Cardiology Onze Lieve Vrouwe Gasthuis (OLVG) Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9433-6119","authenticated-orcid":false,"given":"Ruben","family":"Coronel","sequence":"additional","affiliation":[{"name":"Departments of Clinical and Experimental Cardiology, Heart Center Amsterdam UMC, location University of Amsterdam Amsterdam the Netherlands"},{"name":"Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8122-7017","authenticated-orcid":false,"given":"Joris R.","family":"de Groot","sequence":"additional","affiliation":[{"name":"Departments of Clinical and Experimental Cardiology, Heart Center Amsterdam UMC, location University of Amsterdam Amsterdam the Netherlands"},{"name":"Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4712-6228","authenticated-orcid":false,"given":"Antoine H.G.","family":"Driessen","sequence":"additional","affiliation":[{"name":"Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias Amsterdam the Netherlands"},{"name":"Department of Cardiothoracic Surgery Heart Center, Amsterdam UMC, location University of Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC Guidelines for the Management of Atrial Fibrillation Developed in Collaboration With the European Association for Cardio\u2010Thoracic Surgery (EACTS)","volume":"45","author":"Van Gelder I. C.","year":"2024","journal-title":"European Heart Journal"},{"key":"e_1_2_13_3_1","first-page":"416","article-title":"The Blinding Period Following Ablation Therapy for Atrial Fibrillation","volume":"7","author":"Gottlieb L. A.","year":"2021","journal-title":"JACC: Clinical Electrophysiology"},{"key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1016\/j.hrthm.2021.06.1172","article-title":"Prevalence and Outcome of Early Recurrence of Atrial Tachyarrhythmias in the Cryoballoon vs Irrigated Radiofrequency Catheter Ablation (CIRCA\u2010DOSE) Study","volume":"18","author":"Steinberg C.","year":"2021","journal-title":"Heart Rhythm"},{"key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.hrthm.2018.09.008","article-title":"Botulinum Toxin Injection in the Autonomic Ganglion Plexi to Prevent Postoperative Atrial Fibrillation: More Than a Cosmetic Treatment","volume":"16","author":"Groot J. 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D.","year":"2024","journal-title":"Journal of the American College of Cardiology"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70517","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.70517","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70517","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:31:11Z","timestamp":1791293471000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.70517"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":19,"alternative-id":["10.1111\/jce.70517"],"URL":"https:\/\/doi.org\/10.1111\/jce.70517","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"assertion":[{"value":"2026-01-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jce.70517"}}