{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T07:57:12Z","timestamp":1790582232280,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The superior vena cava (SVC) is a common non\u2010pulmonary vein (non\u2010PV) trigger site in atrial fibrillation (AF), but its triggers are frequently underdetected without systematic mapping and provocation maneuvers. This study aimed to assess the temporal trend in SVC trigger detection rates and compare the efficacy and safety of cryoballoon\u2010based targeted SVC isolation combined with pulmonary vein isolation (PVI) versus PVI alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 990 consecutive patients who underwent cryoballoon ablation for AF between January 2020 and December 2024. Annual SVC trigger detection rates were assessed using the Cochran\u2010Armitage trend test. After excluding redo cases and performing 1:1 propensity score matching, 55 matched pairs were compared in terms of procedural outcomes, complications, and 12\u2010month freedom from atrial tachyarrhythmias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      SVC trigger detection rates increased significantly over the study period, from 6.8% in 2020 to 21.3% in 2024 (P for trend\u2009=\u20090.023). After matching, the PVI\u2009+\u2009SVCI group showed significantly higher 12\u2010month freedom from atrial tachyarrhythmias compared to the PVI\u2010only group (90.9% vs. 76.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037). Procedural time was modestly longer in the PVI\u2009+\u2009SVCI group (93\u2009\u00b1\u200926\u2009min vs. 80\u2009\u00b1\u200920\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), but fluoroscopy time (12\u2009\u00b1\u20095\u2009min vs. 10\u2009\u00b1\u20094\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.276) and complication rates (5.5% vs. 3.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.500) were comparable between groups, both with low overall complication rates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cryoballoon\u2010based targeted SVC isolation guided by systematic mapping and provocation maneuvers significantly enhances freedom from atrial tachyarrhythmias without compromising safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70469","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:01:51Z","timestamp":1788933711000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Targeted Superior Vena Cava Isolation Combined With Pulmonary Vein Isolation Versus Pulmonary Vein Isolation Alone Using Cryoballoon Ablation for Atrial Fibrillation"],"prefix":"10.1002","volume":"49","author":[{"given":"Yanxin","family":"Han","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6847-6393","authenticated-orcid":false,"given":"Yangyang","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0821-8931","authenticated-orcid":false,"given":"Yun","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingzhi","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyou","family":"Ling","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenqi","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine Shanghai 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Sinus Tachycardia After Superior Vena Cava Isolation in Addition To Pulmonary Veins Isolatin of Paroxysmal Atrial Fibrillation Cryoballoon Ablation","volume":"8","author":"Sucu M.","year":"2015","journal-title":"Journal of Atrial Fibrillation"},{"key":"e_1_2_13_31_1","first-page":"208","article-title":"Case Images: Electrical Isolation of Superior Vena Cava as Well as Pulmonary Vein Isolation With Cryoballoon Technique in a Young Patient With Persistent Atrial Fibrillation","volume":"45","author":"Canpolat U.","year":"2017","journal-title":"Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.5543\/tkda.2023.32970"}],"container-title":["Clinical 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