{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T23:16:50Z","timestamp":1770333410850,"version":"3.49.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,2,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Although circumferential pulmonary vein isolation (CPVI) catheter ablation may not be sufficient for long\u2010standing persistent atrial fibrillation (L\u2010PeAF), it is not clear which ablation strategy is beneficial in addition to CPVI. We sought to investigate whether additional complex fractionated atrial electrogram (CFAE)\u2010guided ablation improves clinical outcomes in L\u2010PeAF patients who exhibit continuous atrial fibrillation (AF) after CPVI and linear ablation (Line).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This study enrolled 137 L\u2010PeAF patients (71.4% male, 61.6\u00b110.9\u00a0years old) who underwent radiofrequency catheter ablation. We conducted CPVI+Line based on the Dallas lesion set (posterior box+anterior line) after baseline CFAE mapping in all patients. If AF was defragmented (terminated or changed to atrial tachycardia), the procedure was stopped (AF\u2010Defrag group, n=29). If AF was maintained after CPVI+Line, we mapped the CFAE again and randomly assigned the patient to the CPVI+Line group (n=54) or the additional CFAE ablation group (CPVI+Line+CFAE group, n=54). L\u2010PeAF was defragmented during CPVI+Line in 21.2% of patients (29\/137, AF\u2010Defrag group). The mean CFAE cycle length was prolonged (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and CFAE area (CFAE cycle length &lt;120\u00a0milliseconds) was reduced (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) after CPVI+Line in the remaining patients. Procedure time was longer in the CPVI+Line+CFAE group than the CPVI+Line group (\n              <jats:italic>P<\/jats:italic>\n              =0.023), but procedure\u2010related complication rates did not vary. During 22.3\u00b113.2\u00a0months of follow\u2010up, the clinical recurrence rates were 17.2% in the AF\u2010Defrag group, 18.5% in the CPVI+Line group, and 32.1% in the CPVI+Line+CFAE group (log rank,\n              <jats:italic>P<\/jats:italic>\n              =0.166).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Although CPVI+Line reduces and localizes CFAE area, additional CFAE ablation after CPVI+Line does not improve the clinical outcomes of catheter ablation in patients with L\u2010PeAF.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.116.004811","type":"journal-article","created":{"date-parts":[[2017,2,8]],"date-time":"2017-02-08T02:00:22Z","timestamp":1486519222000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Does Additional Electrogram\u2010Guided Ablation After Linear Ablation Reduce Recurrence After Catheter Ablation for Longstanding Persistent Atrial Fibrillation? A Prospective Randomized Study"],"prefix":"10.1161","volume":"6","author":[{"given":"Tae\u2010Hoon","family":"Kim","sequence":"first","affiliation":[{"name":"Yonsei University Health System, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae\u2010Sun","family":"Uhm","sequence":"additional","affiliation":[{"name":"Yonsei University Health System, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong\u2010Youn","family":"Kim","sequence":"additional","affiliation":[{"name":"Yonsei University Health System, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boyoung","family":"Joung","sequence":"additional","affiliation":[{"name":"Yonsei University Health System, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moon\u2010Hyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Yonsei University Health System, Seoul, 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