{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:01:16Z","timestamp":1778216476469,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,25]],"date-time":"2019-11-25T00:00:00Z","timestamp":1574640000000},"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":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Left atrial (LA) roof ablation using the cryoballoon technique, combined with pulmonary vein isolation (PVI), has been reported to be beneficial for ablation therapy in patients with persistent atrial fibrillation (AF). Left posterior wall ablation also results in improved patient outcomes. However, the contribution of these techniques to the success of cryoballoon ablation (CBA) treatment of AF is not known. The present study examined the influence of the roofline block and isolation area on outcomes after CBA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>We enrolled 78 patients with persistent AF. LA roof ablation was performed using a 28\u2010mm cryoballoon with a single freezing of 3\u2009minutes at each region (median number of freezes: 4) after PVI. After CBA, bipolar voltage amplitude mapping was performed during sinus rhythm using the NavX mapping system. Patients were divided into two subgroups according to the voltage and activation map: the roof\u2010conduction (n\u2009=\u200946) and roofline\u2010block groups (n\u2009=\u200932). Atrial tachyarrhythmia recurred in 20 patients of the conduction group and 4 patients of the roofline\u2010block group. The rate of 12\u2010month freedom from tachyarrhythmia after a single ablation procedure was 78% (95% confidence interval [CI], 60%\u201089%) in the roofline\u2010block group and 45% (95% CI, 30%\u201060%) in the conduction group (<jats:italic>P<\/jats:italic>\u2009=\u2009.048). Cox proportional hazard analysis revealed that the isolated area was not a significant predictor of recurrence (hazard ratio, 0.94; 95% CI, 0.86\u20101.02; <jats:italic>P<\/jats:italic>\u2009=\u2009.15).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Creating a complete roofline block is the major factor predicting the maintenance of sinus rhythm in patients with persistent AF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14281","type":"journal-article","created":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T05:19:06Z","timestamp":1574227146000},"page":"119-127","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Important factors in left atrial posterior wall isolation using 28\u2010mm cryoballoon ablation for persistent atrial fibrillation\u2014Block line or isolation area?"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7590-5029","authenticated-orcid":false,"given":"Tadafumi","family":"Nanbu","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Hokko Memorial Hospital Sapporo\u2010shi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiko","family":"Yotsukura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Hokko Memorial Hospital Sapporo\u2010shi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8235-4221","authenticated-orcid":false,"given":"George","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Hokko Memorial Hospital Sapporo\u2010shi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Ishidoya","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Hokko Memorial Hospital Sapporo\u2010shi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumihiko","family":"Sano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Hokko Memorial Hospital Sapporo\u2010shi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Izumi","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Hokko Memorial Hospital Sapporo\u2010shi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Sakurai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Hokko Memorial Hospital Sapporo\u2010shi 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