{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:44:17Z","timestamp":1792165457002,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,2,5]],"date-time":"2020-02-05T00:00:00Z","timestamp":1580860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>It remains unclear whether the curative result of paroxysmal atrial fibrillation (PAF) is a result of pulmonary vein (PV) isolation, PV antrum modification (PVAM), or both. We hypothesized that sufficient antrum modification (PVAM) is as important as PV isolation (PVI) for atrial fibrillation (AF) control and that PVAM can be evaluated by quantified lesion deployment using a force\u2010sensing catheter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Patients of symptomatic PAF were randomly assigned 2:1 into a PVAM group or a circumferential PV isolation (CPVI) group. In the PVAM group, circumferential quantitative ablation evaluated by automatical VisiTag module was performed. In the CPVI group, conventional circumferential ablation was performed to achieve the end point of all\u2010PV isolation. In total, 180 patients with PAF were enrolled and randomly assigned to either the PVAM group (<jats:italic>n<\/jats:italic>\u00a0=\u00a0120) or the CPVI group (<jats:italic>n<\/jats:italic>\u00a0=\u00a060). A total of 179 patients successfully underwent ablation. In the PVAM group, 68 patients achieved all PVI (PVAM\u2010PVI), while 51 did not (PVAM\u2010non\u2010PVI). At 18 months, there was no significant difference in the maintenance of sinus rhythm between the PVAM and CPVI groups (84.9\u00a0vs 79.7%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.382). The PVAM\u2010PVI subgroup demonstrated a higher arrhythmia\u2010free survival compared with the PVAM\u2010non\u2010PVI subgroup (92.6\u00a0vs 74.5%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.006) and the CPVI group (92.6 vs 79.7%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.036).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The trial shows that sufficient force\u2010sensing guided PVAM can result in satisfying outcomes in PAF patients. Notably, sufficient PVAM with all\u2010PV isolated will further increase the success rate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.13863","type":"journal-article","created":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T09:25:40Z","timestamp":1576661140000},"page":"280-288","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Circumferential pulmonary vein antrum ablation for the treatment of paroxysmal atrial fibrillation: A randomized controlled trial"],"prefix":"10.1111","volume":"43","author":[{"given":"Qiang","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"},{"name":"Department of Cardiology Zhejiang Provincial People's Hospital  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weizhu","family":"Ju","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangyi","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0125-3926","authenticated-orcid":false,"given":"Fengxiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingfang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daowu","family":"Wang","sequence":"additional","affiliation":[{"name":"The Heart and Lung Institute The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9844-486X","authenticated-orcid":false,"given":"Minglong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199809033391003"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.12.016"},{"issue":"6","key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/j.hrthm.2007.04.005","article-title":"HRS\/EHRA\/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for personnel, policy, procedures and follow\u2010up. 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