ArticleFrontiers in cardiovascular medicine2026
Intraprocedural atrial flutter transition predicts arrhythmia-free survival after "2C3L Plus" ablation for long-standing persistent atrial fibrillation.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Long-standing persistent atrial fibrillation (LSPAF) remains a challenge of catheter ablation. The efficiency and optimal procedural endpoints of "2C3L plus" approach-a strategy combining pulmonary vein isolation (PVI) with linear and complex fractionated atrial electrogram (CFAEs) ablation-is unclear. Methods: This single-center, retrospective cohort study included 260 consecutive patients with LSPAF (defined as continuous AF lasting > 12 months) who underwent Results: Intraprocedural atrial fibrillation (AF) termination was achieved in 103 of 260 (39.6%) patients and 90 (34.6%) patients converted to atrial flutter (AFL) during ablation. Acute termination of AF directly to sinus rhythm (SR) was not associated with a lower risk of recurrence (adjusted HR: 0.765, 95% CI: 0.410-1.428, Conclusion: In patients with LSPAF undergoing extensive "2C3L Plus" substrate ablation, the intraprocedural organization of AF-AFL-SR, rather than AF termination itself, emerged as a powerful independent predictor of 1-year arrhythmia-free survival, suggesting its value as a more meaningful prognostic endpoint.
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