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Ibutilide may help identify critical ablation targets by modifying the arrhythmia substrate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective single-center study analyzed 367 PsAF patients undergoing ibutilide-guided ablation. After PVI, patients converting directly to sinus rhythm (SR) (PVI group,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200986) received no further ablation. Non-responders (PVI+Linear group,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009281) underwent linear ablation and were categorized by acute termination pattern: Directly to SR (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009109), AFL to SR (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200987), DC to SR (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200975), or Failure (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910). Subgroups based on low-voltage areas (LVZs) and AF duration were analyzed. AF recurrence (&gt;\u200930s post 3-month blanking period) was assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over a mean follow-up, AF-free survival rate was non-significantly higher in the PVI group vs. PVI+Linear group ((73.9% vs. 60.7%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.070). In the PVI+Linear group, success rates differed significantly by acute termination pattern (Direct to SR:67.8%, AFL to SR:72.6%, DC to SR:26.4%, Failure to SR:30.0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), LVZs presence (Absent:63.8% vs. Present:55.8%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), and AF duration (\u2264\u20091\u00a0year:73.9%, 1\u20135\u00a0year:55.3%, \u2265\u20095\u00a0year:44.6%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Female, larger LA diameter, longer AF duration, and DC\/Failure termination patterns independently predicted recurrence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The use of ibutilide may help identify \u201cPVI\u2011sensitive\u201d atrial fibrillation, reducing the extent of ablation without compromising efficacy.Female sex, LA enlargement, prolonged AF duration, and requiring DC\/failing to terminate acutely predict recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s43044-026-00745-4","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T13:50:48Z","timestamp":1778680248000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Individualized dynamic ablation strategy for persistent atrial fibrillation based on ibutilide response"],"prefix":"10.1186","volume":"78","author":[{"given":"Jing","family":"Hu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Xia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Tao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Le","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"Meng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hengli","family":"Lai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ligang","family":"Ding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Yao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"745_CR1","doi-asserted-by":"crossref","unstructured":"Joglar JA, Chung MK, Armbruster AL et al (2024) 2023 ACC\/AHA\/ACCP\/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines(2024).Circulation ;149(1):e1-e156","DOI":"10.1161\/CIR.0000000000001207"},{"key":"745_CR2","doi-asserted-by":"crossref","unstructured":"Tzeis S, European Heart Rhythm Association\/Heart Rhythm Society\/Asia Pacific Heart Rhythm Society\/Latin American Heart (2024) Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation","DOI":"10.1016\/j.hrthm.2024.03.017"},{"issue":"1","key":"745_CR3","first-page":"91","volume":"13","author":"X Yue","year":"2025","unstructured":"Yue X, Zhou L, Zhao CI (2025) Manage Persistent Atr Fibrillation Biomedicines 13(1):91","journal-title":"Manage Persistent Atr Fibrillation Biomedicines"},{"issue":"10","key":"745_CR4","doi-asserted-by":"publisher","first-page":"1585","DOI":"10.1093\/europace\/euac089","volume":"24","author":"J Junarta","year":"2022","unstructured":"Junarta J, Siddiqui MU, Riley JM, Dikdan SJ, Patel A, Frisch DR (2022) Low-voltage area substrate modification for atrial fibrillation ablation: a systematic review and meta-analysis of clinical trials. 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