{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:04:39Z","timestamp":1790363079708,"version":"4.1.0"},"reference-count":8,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,8,4]],"date-time":"2019-08-04T00:00:00Z","timestamp":1564876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background:<\/jats:bold> The utility of pressure waveform analyses to assess pulmonary vein (PV) occlusions has been reported in cryoballoon PV isolation (CB\u2010PVI) using first\u2010generation CBs. This prospective randomized study compared the procedural and clinical outcomes of pressure\u2010guided and conventional CB\u2010PVI.<\/jats:p><jats:p><jats:bold>Methods and Results:<\/jats:bold> Sixty patients with paroxysmal atrial fibrillation underwent CB\u2010PVI with 28\u2010mm second\u2010generation CBs. PV occlusions were assessed either by real\u2010time pressure waveforms without contrast utilization (pressure\u2010guided group) or contrast injections (conventional group) and randomly assigned. Before the randomization, 24 patients underwent pressure\u2010guided CB\u2010PVIs. In the derivation study, a vein occlusion was obtained in 88\/96 (91.7%) PVs among which 86 (97.7%) were successfully isolated by the application. In the validation study, the nadir balloon temperature and total freezing time did not significantly differ per PV between the two groups. The positive predictive value of the vein occlusion for predicting successful acute isolations was similar (93 of 103 [90.2%] and 89 of 98 [90.8%] PVs; <jats:italic>P<\/jats:italic>\u2009=\u20091.000), but the negative predictive value was significantly higher in pressure\u2010guided than angiographical occlusions (14 of 17 [82.3%] vs 7 of 22 [31.8%]; <jats:italic>P<\/jats:italic>\u2009=\u2009.003). Both the procedure (57.7\u2009\u00b1\u200914.2 vs 62.6\u2009\u00b1\u200915.8\u2009minutes; <jats:italic>P<\/jats:italic>\u2009=\u2009.526) and fluoroscopic times (16.3\u2009\u00b1\u20096.4 vs 20.1\u2009\u00b1\u20096.1; <jats:italic>P<\/jats:italic>\u2009=\u2009.732) were similar between the two groups, however, the fluoroscopy dose (130.6\u2009\u00b1\u200997.7 vs 353.2\u2009\u00b1\u2009231.4\u2009mGy; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and contrast volume used (0 vs 17.5\u2009\u00b1\u20097.7\u2009mL; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) were significantly smaller in the pressure\u2010guided than conventional group. During 27.8 (5\u201039) months of follow\u2010up, the single procedure arrhythmia freedom was similar between the two groups (<jats:italic>P<\/jats:italic>\u2009=\u2009.438).<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Pressure\u2010guided second\u2010generation CB\u2010PVIs were similarly effective and as safe as conventional CB\u2010PVIs. This technique required no contrast utilization and significantly reduced radiation exposure more than conventional CB\u2010PVIs.<\/jats:p>","DOI":"10.1111\/jce.14080","type":"journal-article","created":{"date-parts":[[2019,7,22]],"date-time":"2019-07-22T05:24:17Z","timestamp":1563773057000},"page":"1841-1847","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Pressure\u2010guided second\u2010generation cryoballoon pulmonary vein isolation: Prospective comparison of the procedural and clinical outcomes with the conventional strategy"],"prefix":"10.1111","volume":"30","author":[{"given":"Kanae","family":"Hasegawa","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0230-0934","authenticated-orcid":false,"given":"Shinsuke","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Kaseno","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaori","family":"Hisazaki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Amaya","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Miyahara","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Aiki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eri","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moe","family":"Mukai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisetsu","family":"Aoyama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Shiomi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Tama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitomo","family":"Fukuoka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7225-2819","authenticated-orcid":false,"given":"Tetsuji","family":"Morishita","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyasu","family":"Uzui","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Tada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,4]]},"reference":[{"key":"e_1_2_7_1_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joa.2017.08.001"},{"key":"e_1_2_7_1_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602014"},{"key":"e_1_2_7_1_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12157"},{"key":"e_1_2_7_1_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2009.01600.x"},{"key":"e_1_2_7_1_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.02.050"},{"key":"e_1_2_7_1_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13078"},{"key":"e_1_2_7_1_8_1","first-page":"e50247","article-title":"Direct pressure monitoring accurately predicts pulmonary vein occlusion during cryoballoon ablation","volume":"72","author":"Kosmidou I","year":"2013","journal-title":"J Vis 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