{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T08:53:56Z","timestamp":1789203236003,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,5,2]],"date-time":"2014-05-02T00:00:00Z","timestamp":1398988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:title>Second\u2010generation Cryoballoon Ablation and Pulmonary Vein Reconnections<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Longer observational time and adenosine challenge have proven to be able to detect pulmonary vein (PV) reconnections. The aim of this study was to assess incidence of spontaneous and adenosine\u2010induced PV reconnection after ablation with second\u2010generation cryoballoon (CB\u2010Adv).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Fifty consecutive patients (76% male, mean age 60.5 \u00b1 11.9 years) having undergone PV isolation (PVI) using the CB\u2010Adv were enrolled. After isolation, reconnections were evaluated using the Achieve catheter over 30 minutes observation and adenosine administration during isoproterenol infusion (adenosine challenge). Among 200 PVs, isolation was achieved in 190 (95%) during the first application. Lower nadir temperature and longer rewarming time were associated with successful PVI (P = 0.02 and 0.04). Spontaneous (4 veins) and adenosine\u2010induced (4 veins) PV reconnections occurred in the 4% of initially isolated veins (8 veins) in 6 patients (12%). At receiver\u2013operator curve analysis, nadir temperature &lt;\u201351 \u00b0C and rewarming time &gt;28 seconds identified absence of reconnections (sensitivity 100% and 87%, area under the curve 0.75 and 0.72). Patients with right\u2010sided early branching frequently experienced reconnections (P &lt; 0.01). After a mean follow\u2010up of 7.0 \u00b1 1.7 months, 86% of patients were free from atrial fibrillation. None of those with PV reconnections experienced recurrences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The incidence of spontaneous and adenosine\u2010induced PV reconnection following ablation with the novel CB\u2010Adv is very low occurring in 4% of initially isolated veins. Nadir temperature &lt;\u221251 \u00b0C and rewarming time &gt;28 seconds identified absence of acute reconnections, thus avoiding prolonged waiting time and adenosine challenge in such cases.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.12421","type":"journal-article","created":{"date-parts":[[2014,3,28]],"date-time":"2014-03-28T22:23:05Z","timestamp":1396045385000},"page":"845-851","source":"Crossref","is-referenced-by-count":46,"title":["Spontaneous and Adenosine\u2010Induced Pulmonary Vein Reconnection After Cryoballoon Ablation with the Second\u2010Generation Device"],"prefix":"10.1111","volume":"25","author":[{"given":"GIUSEPPE","family":"CICONTE","sequence":"first","affiliation":[{"name":"Heart Rhythm Management Centre UZ Brussel\u2010VUB  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GIAN\u2010BATTISTA","family":"CHIERCHIA","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre UZ Brussel\u2010VUB  Brussels 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