{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T14:18:28Z","timestamp":1771510708532,"version":"3.50.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,11,19]]},"abstract":"\n Background<\/jats:title>\n \n We previously reported the benefit of linear ablation from the superior vena cava to the right atrial septum (\n SVC<\/jats:styled-content>\n \u2010L) within a year after circumferential pulmonary vein isolation (\n CPVI<\/jats:styled-content>\n ) in patients with paroxysmal atrial fibrillation (\n AF<\/jats:styled-content>\n ). We explored the long\u2010term effects of\n SVC<\/jats:styled-content>\n \u2010L and its potential related mechanisms.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Among 2140 consecutive patients with\n AF<\/jats:styled-content>\n ablation, we included 614 patients (73.3% male, aged 57.8\u00b110.7\u00a0years, 13.7% with persistent\n AF<\/jats:styled-content>\n ) who did not undergo an extra\u2013pulmonary vein left atrial ablation after propensity score matching; of those, 307 had additional\n SVC<\/jats:styled-content>\n \u2010L and 307 had\n CPVI<\/jats:styled-content>\n alone. We evaluated the heart rate variability and computational modeling study to explore mechanisms. Although the procedure time was longer in the\n SVC<\/jats:styled-content>\n \u2010L group than the\n CPVI<\/jats:styled-content>\n group (\n P<\/jats:italic>\n <0.001), the complication rates did not differ (\n P<\/jats:italic>\n =0.560). During 40.5\u00b124.4\u00a0months of follow\u2010up, the rhythm outcome was significantly better in the\n SVC<\/jats:styled-content>\n \u2010L group than the\n CPVI<\/jats:styled-content>\n group (log rank,\n P<\/jats:italic>\n <0.001). At 2\u2010year follow\u2010up of heart rate variability, a significantly higher mean heart rate (\n P<\/jats:italic>\n =0.018) and a lower ratio of low\/high\u2010frequency components (\n P<\/jats:italic>\n =0.011) were found with\n SVC<\/jats:styled-content>\n \u2010L than\n CPVI<\/jats:styled-content>\n alone. In realistic in silico biatrial modeling, which reflected the electroanatomies of 10 patients,\n SVC<\/jats:styled-content>\n \u2010L significantly reduced biatrial dominant frequency compared with\n CPVI<\/jats:styled-content>\n alone (\n P<\/jats:italic>\n <0.001) and increased\n AF<\/jats:styled-content>\n termination and defragmentation rates (\n P<\/jats:italic>\n =0.033).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n SVC<\/jats:styled-content>\n \u2010L ablation in addition to\n CPVI<\/jats:styled-content>\n significantly improved the long\u2010term rhythm outcome over 2 years after\n AF<\/jats:styled-content>\n catheter ablation by mechanisms involving autonomic modulation and\n AF<\/jats:styled-content>\n organization.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.013985","type":"journal-article","created":{"date-parts":[[2019,11,15]],"date-time":"2019-11-15T10:00:19Z","timestamp":1573812019000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Long\u2010Term Outcome of Additional Superior Vena Cava to Septal Linear Ablation in Catheter Ablation of Atrial Fibrillation"],"prefix":"10.1161","volume":"8","author":[{"given":"Moo\u2010Nyun","family":"Jin","sequence":"first","affiliation":[{"name":"Division of Cardiology Yonsei University Health System Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byounghyun","family":"Lim","sequence":"additional","affiliation":[{"name":"Division of Cardiology Yonsei University Health System Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hee Tae","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Cardiology Yonsei University Health System Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tae\u2010Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology Yonsei University Health System Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae\u2010Sun","family":"Uhm","sequence":"additional","affiliation":[{"name":"Division of Cardiology Yonsei University Health System Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boyoung","family":"Joung","sequence":"additional","affiliation":[{"name":"Division of Cardiology Yonsei University Health System Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moon\u2010Hyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology Yonsei University Health System Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun","family":"Hwang","sequence":"additional","affiliation":[{"name":"Utah Valley Medical Center Provo UT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui\u2010Nam","family":"Pak","sequence":"additional","affiliation":[{"name":"Division of Cardiology Yonsei University Health System Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","first-page":"645","article-title":"The atrial arrhythmia syndrome of vagal origin","volume":"71","author":"Coumel P","year":"1978","unstructured":"Coumel P, Attuel P, Lavallee J, Flammang D, Leclercq JF, Slama R. 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