{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:58:07Z","timestamp":1781629087507,"version":"3.54.5"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Although catheter ablation (CA) is a standard treatment for atrial fibrillation (AF), its long-term efficacy remains unclear. This study aimed to elucidate the incidences of AF recurrence and of progression from paroxysmal to persistent AF, after CA, in patients with paroxysmal AF.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We examined the incidence of AF recurrence and AF progression in 1220 consecutive patients (mean age, 61 years), with symptomatic paroxysmal AF, undergoing CA, based on extensive pulmonary vein isolation and focal ablation for nonpulmonary vein foci. AF recurrence\u2013free survival probabilities at 5 years were 59.4% after the initial CA and 81.1% after the final CA (average, 1.3 procedures). During a median follow-up period of 47.9 (range, 5.3\u2013123.3) months after the initial CA, AF progressed from paroxysmal to persistent in 15 (1.2%) patients (0.3%\/y). The duration of AF history (hazard ratio [HR], 1.03;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001), number of ineffective antiarrhythmics (HR, 1.09;\n              <jats:italic>P<\/jats:italic>\n              =0.005), and left atrial diameter indexed by the body surface area (HR, 1.05;\n              <jats:italic>P<\/jats:italic>\n              =0.001) were significant predictors of AF recurrence. Patient age (HR, 1.12;\n              <jats:italic>P<\/jats:italic>\n              =0.0001) and left atrial diameter indexed by the body surface area (HR, 1.26;\n              <jats:italic>P<\/jats:italic>\n              =0.0006) were significantly associated with AF progression. Patients aged \u226465 years and with a left atrial diameter indexed by the body surface area of \u226424.0 mm\/m\n              <jats:sup>2<\/jats:sup>\n              did not develop AF progression for \u226410 years after the initial CA.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Although the long-term follow-up revealed the effect of CA on preventing AF recurrence, repeated CA sessions might be required. The rate of progression from paroxysmal to persistent AF was 0.3%\/y.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.113.000471","type":"journal-article","created":{"date-parts":[[2014,3,8]],"date-time":"2014-03-08T05:18:15Z","timestamp":1394255895000},"page":"267-273","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":95,"title":["Long-Term Follow-Up After Catheter Ablation of Paroxysmal Atrial Fibrillation"],"prefix":"10.1161","volume":"7","author":[{"given":"Masateru","family":"Takigawa","sequence":"first","affiliation":[{"name":"From the Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan (M.T., A.T., T.K., K.O., Y.T., Y.W., K.T., T.F., S.K., H.H.); and Clinical Research Center (M.T.), Heart Rhythm Center (K.H.), and Department of Cardiovascular Medicine (M.T., M.I.), Tokyo Medical and Dental University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan (M.T., A.T., T.K., K.O., Y.T., Y.W., K.T., T.F., S.K., H.H.); and Clinical Research Center (M.T.), Heart Rhythm Center (K.H.), and Department of Cardiovascular Medicine (M.T., M.I.), Tokyo Medical and Dental University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taishi","family":"Kuwahara","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan (M.T., A.T., T.K., K.O., Y.T., Y.W., K.T., T.F., S.K., H.H.); and Clinical Research Center (M.T.), Heart Rhythm Center (K.H.), and Department of Cardiovascular Medicine (M.T., M.I.), Tokyo Medical and Dental University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Okubo","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan (M.T., A.T., T.K., K.O., Y.T., Y.W., K.T., T.F., S.K., H.H.); and Clinical Research Center (M.T.), Heart Rhythm Center (K.H.), and Department of Cardiovascular Medicine (M.T., M.I.), Tokyo Medical and Dental University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihide","family":"Takahashi","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan (M.T., A.T., T.K., K.O., Y.T., Y.W., K.T., T.F., S.K., H.H.); and Clinical Research Center (M.T.), Heart Rhythm Center (K.H.), and Department of Cardiovascular Medicine (M.T., M.I.), Tokyo Medical and Dental University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Watari","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan (M.T., A.T., T.K., K.O., Y.T., Y.W., K.T., T.F., S.K., H.H.); and Clinical Research Center (M.T.), Heart Rhythm Center (K.H.), and Department of Cardiovascular Medicine (M.T., M.I.), Tokyo Medical and Dental University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsumasa","family":"Takagi","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan (M.T., A.T., T.K., K.O., Y.T., Y.W., K.T., T.F., S.K., H.H.); and Clinical Research Center (M.T.), Heart Rhythm Center (K.H.), and Department of Cardiovascular Medicine (M.T., M.I.), Tokyo Medical and Dental University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Fujino","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan (M.T., A.T., T.K., K.O., Y.T., Y.W., K.T., T.F., S.K., H.H.); and Clinical Research Center (M.T.), Heart Rhythm Center (K.H.), and Department of Cardiovascular Medicine (M.T., M.I.), Tokyo Medical and Dental University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeki","family":"Kimura","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan (M.T., A.T., T.K., K.O., Y.T., Y.W., K.T., T.F., S.K., H.H.); and Clinical Research Center (M.T.), Heart Rhythm Center (K.H.), and Department of Cardiovascular Medicine (M.T., M.I.), Tokyo Medical and Dental University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Hikita","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan (M.T., A.T., T.K., K.O., Y.T., Y.W., K.T., T.F., S.K., H.H.); and Clinical Research Center (M.T.), Heart Rhythm Center (K.H.), and Department of Cardiovascular Medicine (M.T., M.I.), Tokyo Medical and Dental University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Tomita","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan (M.T., A.T., T.K., K.O., Y.T., Y.W., K.T., T.F., S.K., H.H.); and Clinical Research Center (M.T.), Heart Rhythm Center (K.H.), and Department of Cardiovascular Medicine (M.T., M.I.), Tokyo Medical and Dental University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenzo","family":"Hirao","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan (M.T., A.T., T.K., K.O., Y.T., Y.W., K.T., T.F., S.K., H.H.); and Clinical Research Center (M.T.), Heart Rhythm Center (K.H.), and Department of Cardiovascular Medicine (M.T., M.I.), Tokyo Medical and Dental University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuaki","family":"Isobe","sequence":"additional","affiliation":[{"name":"From the Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan (M.T., A.T., T.K., K.O., Y.T., Y.W., K.T., T.F., S.K., H.H.); and Clinical Research Center (M.T.), Heart Rhythm Center (K.H.), and Department of Cardiovascular Medicine (M.T., M.I.), Tokyo Medical and Dental University, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199809033391003"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2009.06.014"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000144459.37455.ee"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2007.04.005"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2008.01280.x"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2006.00753.x"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.71.1922"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000074206.52056.2d"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.1.67"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2010.05.017"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000146917.75041.58"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.105.541052"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.110.946806"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.05.061"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2011.04.013"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.112.004549"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eun018"},{"key":"e_1_3_2_19_2","first-page":"137","article-title":"Pulmonary vein antral isolation for paroxysmal atrial fibrillation: results from long-term follow-up.","volume":"22","author":"Medi C","year":"2011","unstructured":"Medi C, Sparks PB, Morton JB, Kistler PM, Halloran K, Rosso R, Vohra JK, Kumar S, Kalman JM. 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