{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T03:05:08Z","timestamp":1786417508618,"version":"build-2736575974"},"reference-count":16,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T00:00:00Z","timestamp":1726704000000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Clinical Research Special Fund for Central High-level Hospital","award":["2023-GSP-GG-33"],"award-info":[{"award-number":["2023-GSP-GG-33"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2024,9,4]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The value of empirical superior vena cava isolation (SVCI) following pulmonary vein isolation (PVI) to improve the efficacy of radiofrequency catheter ablation (RFCA) for paroxysmal atrial fibrillation (PAF) remains controversial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate the efficacy and safety of quantitative ablation index (AI)-guided empirical SVCI, in addition to PVI, for patients with PAF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with symptomatic PAF who underwent RFCA between October 2021 and May 2023 were retrospectively analysed. Patients were categorised into PVI-only group and PVI+SVCI group based on the intraoperative ablation strategy. RFCA was guided by quantitative AI in both groups. Regular clinical follow-ups were conducted to detect AF recurrence, defined as any episode of atrial fibrillation, atrial flutter or atrial tachycardia lasting &gt;30\u2009s.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 246 patients were enrolled, with 108 patients in the PVI group and 138 patients in the PVI+SVCI group. Compared with the PVI group, patients in the PVI+SVCI group had a higher prevalence of coronary artery disease (p=0.04), stroke (p=0.02) and a smaller left atrial diameter (p&lt;0.01). After a follow-up period of 16\u00b16 months, the ablation success rate was significantly higher in the SVCI+PVI group compared with the PVI group (91.3% vs 81.5%, p=0.02). Multivariable logistic regression analysis indicated that SVCI was an independent predictor of reduced AF recurrence postablation (Relative Risk [RR] 0.4, 95% CI 0.19 to 0.90, p=0.026). No significant difference in complication rates was observed between the groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Quantitative AI-guided empirical SVCI, in addition to PVI, improves the success rate of RFCA for PAF without increasing the risk of complications.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2024-002873","type":"journal-article","created":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T02:00:27Z","timestamp":1726797627000},"page":"e002873","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Empirical superior vena cava electrical isolation guided by quantitative ablation index improves outcomes of radiofrequency catheter ablation for paroxysmal atrial fibrillation"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7019-3042","authenticated-orcid":false,"given":"Wenchi","family":"Guan","sequence":"first","affiliation":[{"name":"Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9353-4604","authenticated-orcid":false,"given":"Jun","family":"Liu","sequence":"additional","affiliation":[{"name":"Fuwai Hospital, Chinese Academy of Medical Sciences; Fuwai Shenzhen Hospital,Chinese Academy of Medical Sciences, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keping","family":"Chen","sequence":"additional","affiliation":[{"name":"Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4003-4323","authenticated-orcid":false,"given":"Yan","family":"Yao","sequence":"additional","affiliation":[{"name":"Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,9,19]]},"reference":[{"key":"2025081710163284000_11.2.e002873.1","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.hrthm.2015.10.023","article-title":"Prevalence and distribution of focal triggers in persistent and long-standing persistent atrial fibrillation","volume":"13","author":"Santangeli","year":"2016","journal-title":"Heart Rhythm"},{"key":"2025081710163284000_11.2.e002873.2","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1111\/jce.12342","article-title":"Role of arrhythmogenic superior vena cava on atrial 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guidance","volume":"34","author":"Liu","year":"2023","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2025081710163284000_11.2.e002873.9","first-page":"1019","article-title":"The influence of metabolic syndrome on atrial fibrillation recurrence: five-year outcomes after a single cryoballoon ablation procedure","volume":"18","author":"Xia","year":"2021","journal-title":"J Geriatr Cardiol"},{"key":"2025081710163284000_11.2.e002873.10","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.1111\/jce.14122","article-title":"Pulmonary vein isolation using a higher power shorter duration CLOSE protocol with a surround flow ablation catheter","volume":"30","author":"Berte","year":"2019","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2025081710163284000_11.2.e002873.11","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-016-0198-2"},{"key":"2025081710163284000_11.2.e002873.12","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1007\/s10840-021-01112-w","article-title":"The target ablation index values for electrical isolation of the superior vena cava","volume":"64","author":"Kawano","year":"2022","journal-title":"J Interv Card Electrophysiol"},{"key":"2025081710163284000_11.2.e002873.13","doi-asserted-by":"crossref","first-page":"e124","DOI":"10.1093\/europace\/eux262","article-title":"Isolation of the superior vena cava from the right atrial posterior wall: a novel ablation approach","volume":"20","author":"Gianni","year":"2018","journal-title":"Europace"},{"key":"2025081710163284000_11.2.e002873.14","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1093\/europace\/euz226","article-title":"Pulmonary vein encirclement using an Ablation Index-guided point-by-point 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