{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T21:14:14Z","timestamp":1783718054042,"version":"3.55.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T00:00:00Z","timestamp":1566518400000},"content-version":"vor","delay-in-days":1,"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":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Pulmonary vein isolation (PVI) alone in persistent atrial fibrillation (AF) is not as successful as in paroxysmal AF, and recent data indicate the key role of non-PV triggers. We aimed to assess the long-term safety and efficacy of left atrial appendage isolation (LAAi) as an adjunct to PVI using cryoballoon (CB) in persistent AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>We compared 144 persistent AF patients (59\u2009\u00b1\u200910\u2009years, 51% females) who underwent PVI combined with LAAi with a propensity-score matched cohort of 138 persistent AF patients (59\u2009\u00b1\u20096\u2009years, 52% female) in whom PVI-only was performed. Baseline and follow-up data including electrocardiography (ECG), 24-h Holter ECG\u2019s, and echocardiography were recorded for all patients. Atrial tachyarrhythmia (ATa) recurrence was defined as detection of AF, atrial flutter, or atrial tachycardia (\u226530\u2009s) after a 3-month blanking period. At a mean of 30.5\u2009\u00b1\u20095.6\u2009months follow-up, 85 (61.6%) patients in the PVI-only group and 109 (75.7%) patients in the PVI+LAAi group were free of ATa after the index procedure (P\u2009=\u20090.008). Ischaemic stroke\/transient ischaemic attack was detected in 4 (2.9%) patients in PVI-only group and in 5 (3.5%) patients in the PVI+LAAi group (P\u2009=\u20090.784). Cox regression analysis revealed that the PVI-only strategy was found as a significant predictor for recurrence (hazard ratio 3.01, 95% confidence interval 1.81\u20135.03; P\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings indicated that CB-based LAAi+PVI was associated with a favourable efficacy compared to PVI-only strategy in patients with persistent AF. Although ischaemic event rates were similar between the groups, rigorous adherence to anticoagulation regime is paramount in order to prevent thrombo-embolic complications.<\/jats:p><\/jats:sec>","DOI":"10.1093\/europace\/euz232","type":"journal-article","created":{"date-parts":[[2019,7,29]],"date-time":"2019-07-29T19:10:57Z","timestamp":1564427457000},"page":"1653-1662","source":"Crossref","is-referenced-by-count":31,"title":["Long-term outcomes of cryoballoon-based left atrial appendage isolation in addition to pulmonary vein isolation in persistent atrial fibrillation"],"prefix":"10.1093","volume":"21","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, S\u0131hh\u0131ye,Ankara, Turkey"},{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U\u011fur","family":"Canpolat","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, Hacettepe University, S\u0131hh\u0131ye,Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Metin","family":"Ok\u015ful","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, Hacettepe University, S\u0131hh\u0131ye,Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuf Ziya","family":"\u015eener","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, Hacettepe University, S\u0131hh\u0131ye,Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet Hakan","family":"Ate\u015f","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, Hacettepe University, S\u0131hh\u0131ye,Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry J G M","family":"Crijns","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kudret","family":"Aytemir","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Cardiology, Hacettepe University, S\u0131hh\u0131ye,Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,22]]},"reference":[{"key":"2019110403561733100_euz232-B1","doi-asserted-by":"crossref","first-page":"2071","DOI":"10.1161\/CIR.0000000000000040","article-title":"2014 AHA\/ACC\/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of 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