{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:06:59Z","timestamp":1784268419976,"version":"3.55.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T00:00:00Z","timestamp":1664236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,16]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>There is an increasing trend evaluating the role of non-pulmonary vein (PV) triggers to improve ablation outcomes in persistent atrial fibrillation (AF) as pulmonary vein isolation (PVI) strategy alone has modest outcomes. We investigated the long-term safety and efficacy of left atrial appendage isolation (LAAi) in addition to PVI using cryoballoon (CB) in persistent AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>In this multicentre retrospective analysis, we included a total of 193 persistent AF patients (mean age: 60 \u00b1 11 years, 50.3% females) who underwent PVI and LAAi using CB. Baseline and follow-up data including electrocardiography (ECG), 24 h Holter ECGs, and echocardiography were recorded for all patients. Atrial tachyarrhythmia (ATa) recurrence was defined as the detection of AF, atrial flutter, or atrial tachycardia (\u226530 s) after a 3-month blanking period. At a median follow-up of 55 (36.5\u201360.0) months, 85 (67.9%) patients with PVI + LAAi were in sinus rhythm after the index procedure. Ischaemic stroke\/transient ischemic attack occurred in 14 (7.2%) patients at a median of 24 (2\u201353) months following catheter ablation. Multivariate regression analysis revealed heart failure with preserved ejection fraction [hazard ratio (HR) 2.29, 95% confidence interval (CI) 1.04\u20135.02; P = 0.038], male gender (HR 0.53, 95% CI 0.29\u20130.96; P = 0.037), and LA area (HR 1.04, 95% CI 0.53\u20131.32; P = 0.023) as independent predictors of ATa recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings demonstrated that the LAAi + PVI strategy using CB had acceptable long-term outcomes in patients with persistent AF. Systemic thrombo-embolic events are an important concern throughout the follow-up, which were mostly observed in case of non-adherence to anticoagulants.<\/jats:p><\/jats:sec>","DOI":"10.1093\/europace\/euac167","type":"journal-article","created":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T08:08:05Z","timestamp":1664266085000},"page":"366-373","source":"Crossref","is-referenced-by-count":10,"title":["Long-term outcomes of left atrial appendage isolation using cryoballoon in persistent atrial fibrillation"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7673-229X","authenticated-orcid":false,"given":"Hikmet","family":"Yorgun","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, Hacettepe University , Ankara 06230 , Turkey"},{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+ , Maastricht , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5151-5133","authenticated-orcid":false,"given":"Yusuf Ziya","family":"\u015eener","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, Hacettepe University , Ankara 06230 , Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikita","family":"Tanese","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinique Pasteur , Toulouse , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3332-9112","authenticated-orcid":false,"given":"Ahmet","family":"Keresteci","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, Hacettepe University , Ankara 06230 , Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6386-7045","authenticated-orcid":false,"given":"Burak","family":"Sezen\u00f6z","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, Gazi University , Ankara , Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5520-7103","authenticated-orcid":false,"given":"Cem","family":"\u00c7\u00f6teli","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, Hacettepe University , Ankara 06230 , Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet Hakan","family":"Ate\u015f","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, Hacettepe University , Ankara 06230 , Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1280-7042","authenticated-orcid":false,"given":"Serge","family":"Boveda","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Clinique Pasteur , Toulouse , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kudret","family":"Aytemir","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, Hacettepe University , Ankara 06230 , Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,9,27]]},"reference":[{"key":"2023041412154838500_","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the Task Force for the diagnosis and management 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