{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T19:29:16Z","timestamp":1784662156624,"version":"3.55.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2020,8,23]],"date-time":"2020-08-23T00:00:00Z","timestamp":1598140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To assess the value of high-density mapping (HDM) in revealing undetected incomplete pulmonary vein isolation (PVI) after the fourth-generation cryoballoon (CB4G) ablation compared to the previous cryoballoon\u2019s versions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Consecutive patients with paroxysmal or early-persistent atrial fibrillation (AF) undergoing CB ablation as the index procedure, assisted by HDM, were retrospectively included in this study. A total of 68 patients (52 males; mean age: 60\u2009\u00b1\u200912\u2009years, 58 paroxysmal AF) were included, and a total of 272 veins were mapped. Fourth-generation cryoballoon with the new spiral mapping catheter (SMC) was used in 35 patients (51%). Time to PVI was determined in 102\/132 (77%) and in 112\/140 (80%) veins during second-generation cryoballoon\/third-generation cryoballoon (CB2G\/CB3G) and CB4G ablation, respectively (P\u2009=\u20090.66). There was a statistically significant difference in terms of discrepancy rate between the SMC and the mini-basket catheter in PV detection after CB4G and CB2G\/CB3G ablation(1.4% vs. 7.6%; P\u2009=\u20090.01). A total of 57 patients (84%) remained free of symptomatic AF during a mean follow-up of 9.8\u2009\u00b1\u20094.6\u2009months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>High-density mapping after cryoballoon ablation using CB4G and the new SMC identifies incomplete PVI, not detected by the new SMC, in a significantly lower proportion of veins compared to HDM performed after the other generation CB ablation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euaa160","type":"journal-article","created":{"date-parts":[[2020,5,22]],"date-time":"2020-05-22T11:50:17Z","timestamp":1590148217000},"page":"1653-1658","source":"Crossref","is-referenced-by-count":11,"title":["High-density mapping in patients undergoing ablation of atrial fibrillation with the fourth-generation cryoballoon and the new spiral mapping catheter"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2248-3456","authenticated-orcid":false,"given":"Giulio","family":"Conte","sequence":"first","affiliation":[{"name":"Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland"},{"name":"Centre for Computational Medicine in Cardiology, Faculty of Informatics, Universit\u00e0 della Svizzera Italiana, Lugano, Switzerland"},{"name":"Faculty of Biomedical Sciences, USI, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoko","family":"Soejima","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kyorin University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"de Asmundis","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel - Postgraduate Program Cardiac Electrophysiology and Pacing, Vrije Universiteit Brussel, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolie","family":"Bruno","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Cattaneo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian-Battista","family":"Chierchia","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel - Postgraduate Program Cardiac Electrophysiology and Pacing, Vrije Universiteit Brussel, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Miwa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kyorin University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luce","family":"Caputo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Sieira","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel - Postgraduate Program Cardiac Electrophysiology and Pacing, Vrije Universiteit Brussel, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Regoli","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziano","family":"Moccetti","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Brugada","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel - Postgraduate Program Cardiac Electrophysiology and Pacing, Vrije Universiteit Brussel, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Auricchio","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiocentro Ticino, Lugano, Switzerland"},{"name":"Centre for Computational Medicine in Cardiology, Faculty of Informatics, Universit\u00e0 della Svizzera Italiana, Lugano, Switzerland"},{"name":"Faculty of Biomedical Sciences, USI, Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,8,23]]},"reference":[{"key":"2020111111424485600_euaa160-B1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/europace\/eux274","article-title":"2017 HRS\/EHRA\/ECAS\/APHRS\/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation","volume":"20","author":"Calkins","year":"2018","journal-title":"Europace"},{"key":"2020111111424485600_euaa160-B2","doi-asserted-by":"crossref","first-page":"2235","DOI":"10.1056\/NEJMoa1602014","article-title":"Cryoballoon or radiofrequency ablation for paroxysmal atrial fibrillation","volume":"374","author":"Kuck","year":"2016","journal-title":"N Engl J Med"},{"key":"2020111111424485600_euaa160-B3","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1253\/circj.CJ-16-1334","article-title":"Three-year clinical outcome after 2nd-generation cryoballoon-based pulmonary vein isolation for the treatment of paroxysmal and persistent atrial fibrillation - a 2-center experience","volume":"81","author":"Heeger","year":"2017","journal-title":"Circ J"},{"key":"2020111111424485600_euaa160-B4","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.ijcard.2018.05.135","article-title":"Value of high-resolution mapping in optimizing cryoballoon ablation of atrial fibrillation","volume":"270","author":"Conte","year":"2018","journal-title":"Int J Cardiol"},{"key":"2020111111424485600_euaa160-B5","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.ijcard.2018.07.093","article-title":"Making the invisible visible - ultra-high-resolution mapping to identify residual pulmonary vein conduction immediately after cryoballoon-based pulmonary vein isolation","volume":"270","author":"Saguner","year":"2018","journal-title":"Int J Cardiol"},{"key":"2020111111424485600_euaa160-B6","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1111\/j.1540-8167.2009.01549.x","article-title":"Cryoballoon pulmonary vein isolation with real-time recordings from the pulmonary veins","volume":"20","author":"Chun","year":"2009","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2020111111424485600_euaa160-B7","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1093\/europace\/eus041","article-title":"Pulmonary vein isolation during cryoballoon ablation using the novel Achieve inner lumen mapping catheter: a feasibility study","volume":"14","author":"Chierchia","year":"2012","journal-title":"Europace"},{"key":"2020111111424485600_euaa160-B8","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1093\/europace\/eut366","article-title":"Real-time assessment of pulmonary vein disconnection during cryoablation of atrial fibrillation: can it be \u2018achieved\u2019 in almost all cases?","volume":"16","author":"Boveda","year":"2014","journal-title":"Europace"},{"key":"2020111111424485600_euaa160-B9","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/j.hrthm.2016.12.014","article-title":"Individualized cryoballoon energy pulmonary vein isolation guided by real-time pulmonary vein recordings, the randomized ICE-T trial","volume":"14","author":"Chun","year":"2017","journal-title":"Heart Rhythm"},{"key":"2020111111424485600_euaa160-B10","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.ipej.2019.06.004","article-title":"The assessment of pulmonary vein potentials using the new achieve advance during cryoballoon ablation of atrial fibrillation","volume":"19","author":"Mugnai","year":"2019","journal-title":"Indian Pacing Electrophysiol J"},{"key":"2020111111424485600_euaa160-B11","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1111\/jce.13927","article-title":"The fourth cryoballoon generation with a shorter tip to facilitate real-time pulmonary vein potential recording: feasibility and safety results","volume":"30","author":"Straube","year":"2019","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2020111111424485600_euaa160-B12","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.hrthm.2016.11.023","article-title":"Second-generation cryoballoon ablation without the use of real-time recordings: a novel strategy based on a temperature-guided approach to ablation","volume":"14","author":"Iacopino","year":"2017","journal-title":"Heart Rhythm"},{"key":"2020111111424485600_euaa160-B13","doi-asserted-by":"crossref","first-page":"1927","DOI":"10.1016\/j.hrthm.2015.05.019","article-title":"Pulmonary vein isolation using the Rhythmia mapping system: verification of intracardiac signals using the Orion mini-basket catheter","volume":"12","author":"Anter","year":"2015","journal-title":"Heart Rhythm"},{"key":"2020111111424485600_euaa160-B14","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1093\/europace\/eux129","article-title":"Pulmonary vein re-mapping after cryoballoon ablation for atrial fibrillation","volume":"20","author":"Yokoyama","year":"2018","journal-title":"Europace"},{"key":"2020111111424485600_euaa160-B15","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1093\/europace\/18.suppl_1.i169b","article-title":"Procedural characteristics of pulmonary vein isolation using the novel third-generation cryoballoon","volume":"18","author":"F\u00fcrnkranz","year":"2016","journal-title":"Europace"},{"key":"2020111111424485600_euaa160-B16","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1161\/CIRCEP.115.003007","article-title":"Once isolated, always isolated? Incidence and characteristics of pulmonary vein reconduction after second-generation cryoballoon-based pulmonary vein isolation","volume":"8","author":"Heeger","year":"2015","journal-title":"Circ Arrhythm Electrophysiol"}],"container-title":["EP Europace"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/europace\/article-pdf\/22\/11\/1653\/34247377\/euaa160.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/europace\/article-pdf\/22\/11\/1653\/34247377\/euaa160.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T16:43:45Z","timestamp":1605113025000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/22\/11\/1653\/5896132"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,23]]},"references-count":16,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,8,23]]},"published-print":{"date-parts":[[2020,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euaa160","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,11]]},"published":{"date-parts":[[2020,8,23]]}}}