{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T11:22:33Z","timestamp":1789903353149,"version":"4.0.1"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2007,12,11]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background\u2014<\/jats:italic>\n            <\/jats:bold>\n            The coexistence of atrial fibrillation (AF) and atrial flutter (AFL) is well recognized. AF precedes the onset of AFL in almost all instances. We evaluated the effect of 2 ablation strategies in patients with paroxysmal AF (PAF) and AFL.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods and Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            Ninety-eight patients with PAF\/AFL were prospectively recruited to undergo pulmonary vein cryoisolation (PVI). Those with at least 1 episode of sustained common-type AFL were assigned to cavotricuspid isthmus cryoablation followed by a 6-week monitoring period and a subsequent PVI (n=36; group I). Patients with PAF only underwent PVI (n=62; group II). The study included 76 men with a mean age of 50\u00b110 years. Most patients (76 [78%]) had no structural heart disease. When the 2 groups were compared, residual AF after a blanking period of 3 months after PVI occurred in 24 patients (67%) in group I versus 7 (11%) in group II (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.05).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            In patients with PAF and no documented common-type AFL, PVI alone prevented the occurrence of AF in 82%, whereas in patients with AFL\/PAF, cavotricuspid isthmus cryoablation and PVI were used successfully to treat sustained common-type AFL but appeared to be insufficient to prevent recurrences of AF. In this population, AFL can be a sign that non\u2013pulmonary vein triggers are the culprit behind AF or that sufficient electrical remodeling has already occurred in both atria, and thus a strategy that includes substrate modification may be required.\n          <\/jats:p>","DOI":"10.1161\/circulationaha.107.711622","type":"journal-article","created":{"date-parts":[[2007,11,27]],"date-time":"2007-11-27T05:11:02Z","timestamp":1196140262000},"page":"2786-2792","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":41,"title":["Can Common-Type Atrial Flutter Be a Sign of an Arrhythmogenic Substrate in Paroxysmal Atrial Fibrillation?"],"prefix":"10.1161","volume":"116","author":[{"given":"Wendel","family":"Moreira","sequence":"first","affiliation":[{"name":"From the Department of Cardiology, Academic Hospital Maastricht (W.M., C.T., Y.M., S.P., D.P., L.-M.R.) and Cardiovascular Research Institute Maastricht (H.J.J.W.), Maastricht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Timmermans","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Academic Hospital Maastricht (W.M., C.T., Y.M., S.P., D.P., L.-M.R.) and Cardiovascular Research Institute Maastricht (H.J.J.W.), Maastricht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hein J.J.","family":"Wellens","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Academic Hospital Maastricht (W.M., C.T., Y.M., S.P., D.P., L.-M.R.) and Cardiovascular Research Institute Maastricht (H.J.J.W.), Maastricht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Mizusawa","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Academic Hospital Maastricht (W.M., C.T., Y.M., S.P., D.P., L.-M.R.) and Cardiovascular Research Institute Maastricht (H.J.J.W.), Maastricht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Philippens","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Academic Hospital Maastricht (W.M., C.T., Y.M., S.P., D.P., L.-M.R.) and Cardiovascular Research Institute Maastricht (H.J.J.W.), Maastricht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Perez","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Academic Hospital Maastricht (W.M., C.T., Y.M., S.P., D.P., L.-M.R.) and Cardiovascular Research Institute Maastricht (H.J.J.W.), Maastricht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luz-Maria","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Academic Hospital Maastricht (W.M., C.T., Y.M., S.P., D.P., L.-M.R.) and Cardiovascular Research Institute Maastricht (H.J.J.W.), Maastricht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","first-page":"S18","volume":"9","year":"1998","unstructured":"Waldo AL. 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Atrial fibrillation recurrence after drug-induced typical atrial flutter ablation. Ital Heart J. 2005; 6: 584\u2013590.","journal-title":"Ital Heart J"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.99.11.1441"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(98)00992-8"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(98)00975-8"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021328"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.107.711622","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:04:56Z","timestamp":1715580296000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.107.711622"}},"subtitle":["Clinical and Ablative Consequences in Patients With Coexistent Paroxysmal Atrial Fibrillation\/Atrial Flutter"],"short-title":[],"issued":{"date-parts":[[2007,12,11]]},"references-count":32,"journal-issue":{"issue":"24","published-print":{"date-parts":[[2007,12,11]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.107.711622"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.107.711622","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,12,11]]},"assertion":[{"value":"2007-11-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}