{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T18:35:52Z","timestamp":1776278152717,"version":"3.50.1"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,3]]},"abstract":"\n Background<\/jats:title>\n \n The coronary sinus (\n CS<\/jats:styled-content>\n ), as a junction of the atria, contributes to atrial fibrillation (\n AF<\/jats:styled-content>\n ) by developing unstable reentry, and isolating the atria by ablation at the\n CS<\/jats:styled-content>\n could terminate\n AF<\/jats:styled-content>\n . The present study evaluated whether\n AF<\/jats:styled-content>\n activities at the\n CS<\/jats:styled-content>\n in a subset of patients contributed to\n AF<\/jats:styled-content>\n maintenance and predicted clinical outcome of ablation.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We studied 122 consecutive patients who had a first\u2010time radiofrequency ablation for persistent\n AF<\/jats:styled-content>\n . Bipolar electrograms were obtained from multiple regions of the left atrium by a Lasso mapping catheter before ablation. Pulmonary vein isolation terminated\n AF<\/jats:styled-content>\n in 12 patients (9.8%). Sequential stepwise ablation was conducted in pulmonary vein isolation nontermination patients and succeeded in 22 patients (18%). In the stepwise termination group,\n AF<\/jats:styled-content>\n frequency in the proximal\n CS<\/jats:styled-content>\n (\n CS<\/jats:styled-content>\n p) was significantly higher (10.2\u00b12.1\u00a0Hz versus 8.3\u00b11.8\u00a0Hz,\n P<\/jats:italic>\n <0.001), and the ratio of distal\n CS<\/jats:styled-content>\n (\n CS<\/jats:styled-content>\n d) to proximal\n CS<\/jats:styled-content>\n (\n CS<\/jats:styled-content>\n d\/\n CS<\/jats:styled-content>\n p ratio, 56.6%\u00b110.11% versus 70.7%\u00b19.8%,\n P<\/jats:italic>\n <0.001) was significantly lower than that in the nontermination group. The stepwise logistic regression analysis indicated that the\n CS<\/jats:styled-content>\n d\/\n CS<\/jats:styled-content>\n p ratio was an independent predictor with an odds ratio of 1.131 (95%\n CI<\/jats:styled-content>\n 1.053\u20101.214;\n P<\/jats:italic>\n =0.001). With a cutoff of 67%, the patients with lower\n CS<\/jats:styled-content>\n d\/\n CS<\/jats:styled-content>\n p ratios had significantly better index and long\u2010term outcomes than those with higher ratios during a follow\u2010up of 46\u00b118\u00a0months.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Rapid repetitive activities in the musculature of the proximal\n CS<\/jats:styled-content>\n may contribute to maintenance of\n AF<\/jats:styled-content>\n after pulmonary vein isolation alone in persistent\n AF<\/jats:styled-content>\n . A cutoff at 67%, of the\n CS<\/jats:styled-content>\n d\/\n CS<\/jats:styled-content>\n p frequency ratio might be an indicator to stratify the subset of patients who might benefit from\n CS<\/jats:styled-content>\n ablation.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.004869","type":"journal-article","created":{"date-parts":[[2017,3,3]],"date-time":"2017-03-03T02:10:51Z","timestamp":1488507051000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Frequency Gradient Within Coronary Sinus Predicts the Long\u2010Term Outcome of Persistent Atrial Fibrillation Catheter Ablation"],"prefix":"10.1161","volume":"6","author":[{"given":"Xiaomeng","family":"Yin","sequence":"first","affiliation":[{"name":"First Affiliated Hospital of Dalian Medical University Dalian Liaoning 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