{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T08:52:51Z","timestamp":1789203171062,"version":"build-2803163510"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,10,3]]},"abstract":"\n Background<\/jats:title>\n \n It is not clear whether bidirectional block (\n BDB<\/jats:styled-content>\n ) of linear ablations reduces atrial fibrillation (\n AF<\/jats:styled-content>\n ) recurrence after radiofrequency catheter ablation. We hypothesized that\n BDB<\/jats:styled-content>\n of linear ablation has prognostic significance after\n radiofrequency catheter ablation<\/jats:styled-content>\n for persistent\n AF<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Among 1793 consecutive patients in the Yonsei\n AF<\/jats:styled-content>\n ablation cohort, this observational cohort study included 398 patients with persistent AF (75.6% male; age, 59.8\u00b110.3\u00a0years) who underwent catheter ablation with a consistent ablation protocol of the Dallas lesion set: circumferential pulmonary vein isolation; cavotricuspid isthmus ablation (\n CTI<\/jats:styled-content>\n ); roof line (\n RL<\/jats:styled-content>\n ); posterior\u2010inferior line (\n PIL<\/jats:styled-content>\n ); and anterior line (\n AL<\/jats:styled-content>\n ).\n BDB<\/jats:styled-content>\n rates of de novo ablation lines were 100% in circumferential pulmonary vein isolation, 100% in\n CTI<\/jats:styled-content>\n , 84.7% in\n RL<\/jats:styled-content>\n , 44.7% in\n PIL<\/jats:styled-content>\n , and 63.6% in\n AL<\/jats:styled-content>\n . During 29.0\u00b118.4\u00a0months of follow\u2010up, 31.7% (126\/398) of the patients showed clinical recurrence. Left atrial posterior wall (\n LAPW<\/jats:styled-content>\n ) isolation (\n BDB<\/jats:styled-content>\n s of\n RL<\/jats:styled-content>\n and\n PIL<\/jats:styled-content>\n ) was independently associated with lower clinical\n AF<\/jats:styled-content>\n \/atrial tachycardia recurrence (hazard ratio, 0.68; 95% CI, 0.47\u20130.98;\n P<\/jats:italic>\n =0.041; log\u2010rank,\n P<\/jats:italic>\n =0.017), whereas\n BDB<\/jats:styled-content>\n s of\n RL<\/jats:styled-content>\n or\n AL<\/jats:styled-content>\n were not (log\u2010rank,\n P<\/jats:italic>\n =0.178 for\n RL;<\/jats:styled-content>\n P<\/jats:italic>\n =0.764 for\n AL<\/jats:styled-content>\n ). Among 52 patients who underwent repeat procedures (23.0\u00b116.1\u00a0months after de novo procedure), the\n BDB<\/jats:styled-content>\n maintenance rates for\n CTI<\/jats:styled-content>\n ,\n RL<\/jats:styled-content>\n ,\n PIL<\/jats:styled-content>\n , and\n AL<\/jats:styled-content>\n were 94.2% (49 of 52), 63.5% (33 of 47), 62.1% (18 of 29), and 61.8% (21 of 34), respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Although\n PIL<\/jats:styled-content>\n crosses the esophageal contact area,\n LAPW<\/jats:styled-content>\n isolation is important for better clinical outcome in catheter ablation with a linear ablation strategy for patients with persistent AF.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.003894","type":"journal-article","created":{"date-parts":[[2016,10,11]],"date-time":"2016-10-11T17:19:54Z","timestamp":1476206394000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":43,"title":["Challenging Achievement of Bidirectional Block After Linear Ablation Affects the Rhythm Outcome in Patients With Persistent Atrial Fibrillation"],"prefix":"10.1161","volume":"5","author":[{"given":"Tae\u2010Hoon","family":"Kim","sequence":"first","affiliation":[{"name":"Yonsei University Health System, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junbeom","family":"Park","sequence":"additional","affiliation":[{"name":"Ewha Womans University, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae\u2010Sun","family":"Uhm","sequence":"additional","affiliation":[{"name":"Yonsei University Health System, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong\u2010Youn","family":"Kim","sequence":"additional","affiliation":[{"name":"Yonsei University Health System, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyoung","family":"Joung","sequence":"additional","affiliation":[{"name":"Yonsei University Health System, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moon\u2010Hyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Yonsei University Health System, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui\u2010Nam","family":"Pak","sequence":"additional","affiliation":[{"name":"Yonsei University Health System, Seoul, 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