{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T15:12:14Z","timestamp":1786374734565,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Despite various techniques used in atrial fibrillation ablation, recurrence of atrial arrhythmias still constitutes a clinical problem. The aim of this study was to document the long-term outcomes of pulmonary vein isolation with a ring-shaped ablation catheter (PVAC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All consecutive patients presenting with paroxysmal or persistent atrial fibrillation (pxAF or perAF, respectively) treated with PVAC (first generation) were enrolled. After standard follow-up during the first year, all patients were contacted for long-term follow-up. In addition to the patient's medical history, 3-day Holter monitoring was performed. Endpoints were atrial fibrillation-related symptoms, ECG documentation of atrial fibrillation or other left atrial arrhythmias and reablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 125 patients (78% with pxAF) were enrolled. All but two pulmonary veins (0.4% of 485 pulmonary veins) could be successfully isolated. At 12 months, 83% of patients in the pxAF group and 53% of patients in the perAF group were free from symptoms. The mean long-term follow-up was 51\u200a\u00b1\u200a14 months. Regarding long-term efficacy, 56% of patients in the pxAF group and 28% of patients in the perAF group were free from any recurrence at 72 months. Independent predictors of event-free survival were perAF (hazard ratio 2.76,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u200a=\u200a0.001) and the existence of mild valvular disease (hazard ratio 2.69,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u200a=\u200a0.001). No significant complication due to PVAC occurred, especially no ischemic stroke.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Long-term follow-up indicated for the first time in such a considerable cohort that pulmonary vein isolation with PVAC is a safe and very efficient method for treating pxAF \u2013 despite known microembolism issues. Patients with perAF receive less benefit from PVAC and ablation therapy should be reserved to pxAF. Significantly, even mild valvular disease was an independent predictor of atrial fibrillation recurrence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2459\/jcm.0000000000000631","type":"journal-article","created":{"date-parts":[[2018,2,11]],"date-time":"2018-02-11T07:53:41Z","timestamp":1518335621000},"page":"148-154","source":"Crossref","is-referenced-by-count":7,"title":["Long-term outcomes and predictors of recurrence after pulmonary vein isolation with multielectrode ablation catheter in patients with atrial fibrillation"],"prefix":"10.2459","volume":"19","author":[{"given":"Sabine","family":"Fredersdorf","sequence":"first","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Innere Medizin II"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin","family":"Fenzl","sequence":"additional","affiliation":[{"name":"Zahn\u00e4rztliche Fakult\u00e4t, University Hospital Regensburg, Regensburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Jungbauer","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Innere Medizin II"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Weber","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Innere Medizin II"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"von Bary","sequence":"additional","affiliation":[{"name":"Rotkreuzklinikum M\u00fcnchen, Rotkreuzplatz, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Dietl","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Innere Medizin II"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Seegers","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Innere Medizin II"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars S.","family":"Maier","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Innere Medizin II"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekrem","family":"\u00dccer","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Innere Medizin II"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230817","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1056\/NEJM199809033391003","article-title":"Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins","volume":"339","author":"Ha\u00efssaguerre","year":"1998","journal-title":"N Engl J Med"},{"key":"R2-20230817","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1093\/europace\/euq350","article-title":"Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC)","volume":"12","author":"Camm","year":"2010","journal-title":"Europace"},{"key":"R3-20230817","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1093\/europace\/eus027","article-title":"2012 HRS\/EHRA\/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design","volume":"14","author":"Calkins","year":"2012","journal-title":"Europace"},{"key":"R4-20230817","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1161\/CIRCEP.109.859116","article-title":"Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation","volume":"31","author":"Cappato","year":"2010","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"R5-20230817","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.jacc.2010.05.061","article-title":"Catheter ablation for atrial fibrillation: are results maintained at 5 years of follow-up?","volume":"57","author":"Weerasooriya","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"R6-20230817","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1161\/CIRCEP.111.962100","article-title":"Natural history and long term outcomes of ablated atrial fibrillation","volume":"4","author":"Hussein","year":"2011","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"R7-20230817","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1093\/europace\/euv439","article-title":"Five-year efficacy of pulmonary vein antrum isolation as a primary ablation strategy for atrial fibrillation: a single-centre cohort study","volume":"18","author":"Teunissen","year":"2016","journal-title":"Europace"},{"key":"R8-20230817","first-page":"34","article-title":"Five-year follow-up outcome after catheter ablation of persistent atrial fibrillation using a sequential biatrial linear defragmentation approach: what does atrial fibrillation termination during the procedure imply?","volume":"14","author":"Miyazaki","year":"2017","journal-title":"Heart Rtythm"},{"key":"R9-20230817","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1136\/heartjnl-2016-309781","article-title":"Long-term efficacy of catheter ablation as first-line therapy for paroxysmal atrial fibrillation: 5-year outcome in a randomised clinical trial","volume":"103","author":"Nielsen","year":"2017","journal-title":"Heart"},{"key":"R10-20230817","doi-asserted-by":"crossref","first-page":"e000394","DOI":"10.1136\/openhrt-2015-000394","article-title":"Long-term outcomes after ablation of persistent atrial fibrillation: an observational study over 6 years","volume":"3","author":"Wynn","year":"2016","journal-title":"Open Heart"},{"key":"R11-20230817","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1111\/jce.12849","article-title":"The impact of age on 5-year outcomes after atrial fibrillation catheter ablation","volume":"27","author":"Bunch","year":"2016","journal-title":"J Cardiovasc Electrophysiol"},{"key":"R12-20230817","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.amjcard.2009.03.044","article-title":"Five-year outcomes after segmental pulmonary vein isolation for paroxysmal atrial fibrillation","volume":"104","author":"Sawhney","year":"2009","journal-title":"Am J Cardiol"},{"key":"R13-20230817","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1111\/j.1540-8167.2009.01501.x","article-title":"Safe and rapid isolation of pulmonary veins using a novel circular ablation catheter and duty-cycled RF generator","volume":"20","author":"Fredersdorf","year":"2009","journal-title":"J Cardiovasc Electrophysiol"},{"key":"R14-20230817","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1093\/europace\/euq023","article-title":"Efficacy of multielectrode duty-cycled radiofrequency ablation for pulmonary vein disconnection in patients with paroxysmal and persistent atrial fibrillation","volume":"12","author":"Beukema","year":"2010","journal-title":"Europace"},{"key":"R15-20230817","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1093\/europace\/eus010","article-title":"Freedom from paroxysmal atrial fibrillation after successful pulmonary vein isolation with pulmonary vein ablation catheter-phased radiofrequency energy: 2-year follow-up and predictors of failure","volume":"14","author":"Mulder","year":"2012","journal-title":"Europace"},{"key":"R16-20230817","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s10840-012-9744-8","article-title":"Long-term outcomes (>2 years) of atrial fibrillation ablation using a multielectrode ablation catheter in patients with paroxysmal atrial fibrillation","volume":"36","author":"Looi","year":"2013","journal-title":"J Interv Card Electrophysiol"},{"key":"R17-20230817","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/s10840-016-0199-1","article-title":"A 5-year clinical follow-up after duty-cycled phased RF ablation of paroxysmal atrial fibrillation","volume":"48","author":"Lepillier","year":"2017","journal-title":"J Interv Card Electrophysiol"},{"key":"R18-20230817","doi-asserted-by":"crossref","first-page":"e004549","DOI":"10.1161\/JAHA.112.004549","article-title":"Long-term outcomes of catheter ablation of atrial fibrillation: a systematic review and meta-analysis","volume":"2","author":"Ganesan","year":"2013","journal-title":"J Am Heart Assoc"},{"key":"R19-20230817","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1056\/NEJMoa1408288","article-title":"Approaches to catheter ablation for persistent atrial fibrillation","volume":"372","author":"Verma","year":"2015","journal-title":"N Engl J Med"},{"key":"R20-20230817","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.hrthm.2014.02.003","article-title":"Very long-term outcome after initially successful catheter ablation of atrial fibrillation","volume":"11","author":"Steinberg","year":"2014","journal-title":"Heart Rhythm"},{"key":"R21-20230817","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1111\/j.1540-8167.2010.01786.x","article-title":"Long-term outcome of atrial fibrillation ablation: impact and predictors of very late recurrence","volume":"21","author":"Wokhlu","year":"2010","journal-title":"J Cardiovasc Electrophysiol"},{"key":"R22-20230817","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1093\/europace\/eus420","article-title":"Duty-cycled bipolar\/unipolar radiofrequency ablation for symptomatic atrial fibrillation induces significant pulmonary vein narrowing at long-term follow-up","volume":"15","author":"Compier","year":"2013","journal-title":"Europace"},{"key":"R23-20230817","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1161\/CIRCEP.111.973453","article-title":"Microembolism and catheter ablation I: a comparison of irrigated radiofrequency and multielectrode-phased radiofrequency catheter ablation of pulmonary vein ostia","volume":"6","author":"Haines","year":"2013","journal-title":"Circ Arrhythm Electrophysiol"}],"container-title":["Journal of Cardiovascular Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01244665-201804000-00003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:15:05Z","timestamp":1786371305000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01244665-201804000-00003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.2459\/jcm.0000000000000631","relation":{},"ISSN":["1558-2027","1558-2035"],"issn-type":[{"value":"1558-2027","type":"print"},{"value":"1558-2035","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4]]}}}