{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:02:22Z","timestamp":1791295342254,"version":"4.1.0"},"reference-count":20,"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:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"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"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82170318"],"award-info":[{"award-number":["82170318"]}],"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>As more adults with atrial septal defect (ASD) survive into older age and undergo atrial fibrillation (AF) ablation, evidence to guide post\u2010ablation risk stratification remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate long\u2010term outcomes after the first AF ablation across ASD management states compared with an intact interatrial septum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This real\u2010world cohort study included 27\u2009675 patients undergoing their first AF ablation, classified by interatrial septal status as intact septum (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200927\u2009134), unrepaired ASD (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009232), percutaneous closure (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009119), or surgical repair (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009190). Three pairwise comparisons with an intact septum were constructed. Propensity score overlap weighting was used to balance baseline characteristics, and Cox proportional hazards models were used to assess outcomes. The primary outcome was atrial arrhythmia recurrence after the 3\u2010month blanking period; the secondary outcome was a composite cardiovascular outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with an intact septum, unrepaired ASD was associated with a higher recurrence risk (hazard ratio [HR], 1.27; 95% CI, 1.07\u20131.51;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), with excess risk mainly observed between 3 months and 1 year after ablation. Surgical repair was also associated with higher recurrence risk (HR, 1.21; 95% CI, 1.01\u20131.46;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038), with differences emerging beyond 1 year. Percutaneous closure was not associated with increased recurrence risk (HR, 1.07; 95% CI, 0.83\u20131.38;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.589). Composite cardiovascular outcomes did not differ significantly across groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ASD management status identified distinct temporal patterns of atrial arrhythmia recurrence after AF ablation, suggesting that ASD should not be treated as a single binary condition in post\u2010ablation risk assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70525","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:38:09Z","timestamp":1791293889000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Atrial Septal Defect Management Status and Long\u2010Term Outcomes After Atrial Fibrillation Ablation: A Real\u2010World Cohort Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6652-8997","authenticated-orcid":false,"given":"Fengyuan","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital Capital Medical University Beijing China"},{"name":"National Clinical Research Center for Cardiovascular Diseases Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6264-0175","authenticated-orcid":false,"given":"Xiaodong","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital Capital Medical University Beijing China"},{"name":"National Clinical Research Center for Cardiovascular Diseases Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1356-9903","authenticated-orcid":false,"given":"Fanchao","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital Capital Medical University Beijing China"},{"name":"National Clinical Research Center for Cardiovascular Diseases Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2077-3593","authenticated-orcid":false,"given":"Shuqi","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital Capital Medical University Beijing China"},{"name":"National Clinical Research Center for Cardiovascular Diseases Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxin","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital Capital Medical University Beijing China"},{"name":"National Clinical Research Center for Cardiovascular Diseases Beijing 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Cardiovascular Diseases Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7212-6203","authenticated-orcid":false,"given":"Ronghui","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital Capital Medical University Beijing China"},{"name":"National Clinical Research Center for Cardiovascular Diseases Beijing China"},{"name":"Department of Cardiology, National Cardiovascular Disease Regional Center for Anhui The First Affiliated Hospital of Anhui Medical University Hefei Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Beijing Anzhen Hospital Capital Medical University Beijing China"},{"name":"National Clinical Research Center for Cardiovascular Diseases Beijing 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