{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T09:22:54Z","timestamp":1772184174139,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T00:00:00Z","timestamp":1576454400000},"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>Pulmonary vein isolation (PVI) using cryoballoon is effective for patients with paroxysmal atrial fibrillation (PAF); however, few reports have evaluated the non\u2010pulmonary vein (PV) foci after cryoballoon ablation. We aimed to evaluate the characteristics of non\u2010PV foci and predictors of atrial fibrillation (AF) recurrence after cryoballoon ablation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>This was a single\u2010center retrospective study of 647 patients with PAF who underwent initial PVI using a second\u2010generation cryoballoon. After PVI, all patients underwent high\u2010dose isoproterenol infusion to assess the existence of non\u2010PV foci. Non\u2010PV foci were observed in 211 patients (32.6%), which were most frequently observed in the superior vena cava. Higher age (odds ratio [OR]\u2009=\u20091.02; 95% confidence interval [CI]\u2009=\u20091.00\u20101.04; <jats:italic>P<\/jats:italic>\u2009=\u2009.025), female sex (OR\u2009=\u20091.65; 95% CI\u2009=\u20091.13\u20102.41; <jats:italic>P<\/jats:italic>\u2009=\u2009.009), and lower body mass index (OR\u2009=\u20090.95; 95% CI\u2009=\u20090.89\u20101.00; <jats:italic>P<\/jats:italic>\u2009=\u2009.049) were significantly associated with non\u2010PV foci. The existence of non\u2010PV foci was an independent predictor of AF recurrence (Hazard's ratio\u2009=\u20091.70; 95% CI\u2009=\u20091.12\u20102.60; <jats:italic>P<\/jats:italic>\u2009=\u2009.014). When non\u2010PV foci were mappable and successfully ablated, patients with non\u2010PV foci showed similar outcomes with those without non\u2010PV foci (1\u2010year AF\u2010free survival rates of 88.5% vs 91.5%; <jats:italic>P<\/jats:italic>\u2009=\u2009.338). Conversely, when we failed to detect and eliminate non\u2010PV foci because they had multiple origins and were not consistently inducible (multichanging non\u2010PV foci), the 1\u2010year AF\u2010free survival rate was 56.4% even after substrate modification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Non\u2010PV foci were observed in one\u2010third of patients with PAF after cryoballoon ablation and were associated with AF recurrence. Catheter ablation for non\u2010PV foci was effective when they were mappable; however, multichanging non\u2010PV foci were associated with worse prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14314","type":"journal-article","created":{"date-parts":[[2019,12,12]],"date-time":"2019-12-12T04:18:18Z","timestamp":1576124298000},"page":"174-184","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Characteristics of the nonpulmonary vein foci induced after second\u2010generation cryoballoon ablation for paroxysmal atrial fibrillation"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7939-6102","authenticated-orcid":false,"given":"Nobutaka","family":"Kato","sequence":"first","affiliation":[{"name":"Department of Cardiology Japanese Red Cross Saitama Hospital  Saitama Japan"},{"name":"Department of Cardiovascular Medicine Tokyo Medical and Dental University  Tokyo 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Hospital  Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2179-3786","authenticated-orcid":false,"given":"Osamu","family":"Inaba","sequence":"additional","affiliation":[{"name":"Department of Cardiology Japanese Red Cross Saitama Hospital  Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Negi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Japanese Red Cross Saitama Hospital  Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0335-996X","authenticated-orcid":false,"given":"Yoshihide","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiko","family":"Goya","sequence":"additional","affiliation":[{"name":"Department of 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