{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T20:25:16Z","timestamp":1789503916405,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,11,2]],"date-time":"2016-11-02T00:00:00Z","timestamp":1478044800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>We aimed to identify the predictors of clinical outcomes after circumferential pulmonary vein isolation (CPVI) without any substrate modification for longstanding persistent atrial fibrillation (LSP\u2010AF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study retrospectively analyzed 70 consecutive LSP\u2010AF patients who underwent an initial CPVI and were followed\u2010up for more than 1 year. The right and left atrial volumes indexed to the body surface areas (right atrial volume index [RAVI] and left atrial volume index [LAVI]) were determined by preacquired contrast\u2010enhanced computed tomography (CT). The %RAVI\/LAVI was obtained as 100 \u00d7 RAVI\/LAVI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During a median follow\u2010up period of 15 months (interquartile range, 13\u201319 months), 21 patients (30%) had arrhythmia recurrences after the CPVI. Antiarrhythmic drugs were continued in 34 patients (48%). In the Cox proportional hazard model, the %RAVI\/LAVI was a significant positive predictor of arrhythmia recurrences (hazard ratio, 1.048; P = 0.039). A receiver\u2010operating characteristic analysis demonstrated that at an optimal cutoff of 100.1 for the %RAVI\/LAVI, the sensitivity and specificity for predicting arrhythmia recurrences were 85.7% and 71.4%, respectively. The Kaplan\u2010Meier analysis showed that arrhythmia recurrences were less frequent in patients with a %RAVI\/LAVI of &lt;100.1 than in those with a %RAVI\/LAVI of \u2265100.1 (P &lt; 0.0001), and the arrhythmia\u2010free survival rate at 12 months was 89.7% and 45.2%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The ratio of the RAVI to LAVI on CT may be a useful predictor of clinical outcomes after CPVI of LSP\u2010AF. LSP\u2010AF patients with a less predominant right atrial enlargement relative to the left atrial enlargement may be good candidates for successful treatment with CPVI alone as the ablation strategy for LSP\u2010AF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.12953","type":"journal-article","created":{"date-parts":[[2016,9,19]],"date-time":"2016-09-19T03:23:06Z","timestamp":1474255386000},"page":"1181-1190","source":"Crossref","is-referenced-by-count":14,"title":["The Right to Left Atrial Volume Ratio Predicts Outcomes after Circumferential Pulmonary Vein Isolation of Longstanding Persistent Atrial Fibrillation"],"prefix":"10.1111","volume":"39","author":[{"given":"TAKEHITO","family":"SASAKI","sequence":"first","affiliation":[{"name":"Division of Cardiology Gunma Prefectural Cardiovascular Center  Maebashi City Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KOHKI","family":"NAKAMURA","sequence":"additional","affiliation":[{"name":"Division of Cardiology 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