{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T22:02:54Z","timestamp":1773093774501,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"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":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Recurrence rates of atrial fibrillation (AF) remain high even after complete wide area circumferential pulmonary vein isolation (PVI). In recent years adjunct posterior wall isolation (PWI) has been performed in patients with more persistent forms of AF but the benefits remain unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The objective of this meta\u2010analysis was to evaluate the efficacy of adjunct posterior wall isolation in reducing recurrence rates of AF using cryoballoon ablation (CBA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched PubMed, Google Scholar, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/Clinicaltrials.gov\">Clinicaltrials.gov<\/jats:ext-link> and Cochrane CENTRAL. We included studies comparing PVI to PVI\u2009+\u2009PWI in patients with either persistent or paroxysmal AF (PAF) undergoing CBA. After data extraction and quality assessment of the studies, we assessed recurrence rates of atrial tachy\u2010arrhythmias (AF, atrial flutter, and atrial tachycardia) as well as total ablation time and procedural adverse events. Risk ratio (RR), mean difference (MD), and 95% confidence interval (CI) were calculated using Review Manager.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Concomitant PWI exhibited a substantial reduction in the risk of AF recurrence (RR: 0.51; 95% CI: 0.42\u20130.63, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.00001), as well as all atrial arrhythmias (RR: 0.58; 95% CI: 0.49\u20130.68, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.00001). On subgroup analysis, in patients with only PAF, adjunct PWI resulted in significant reduction in recurrence risk of AF (RR: 0.56; 95% CI: 0.41\u20130.76, <jats:italic>p<\/jats:italic>\u2009=\u2009.0002) as well. There was no significant difference in adverse events between both groups (RR: 0.90; 95% CI: 0.44\u20131.86; <jats:italic>p<\/jats:italic>\u2009=\u2009.78), whereas total ablation time was significantly increased in PVI\u2009+\u2009PWI group (MD: 21.75; 95% CI: 11.13\u201332.37, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Adjunct PWI when compared to PVI alone decreases recurrence rates of atrial fibrillation after CBA of patients with persistent as well as paroxysmal atrial fibrillation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16028","type":"journal-article","created":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T11:20:36Z","timestamp":1690888836000},"page":"2043-2052","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Adjunct posterior wall isolation reduces the recurrence of atrial fibrillation in patients undergoing cryoballoon ablation: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9007-9610","authenticated-orcid":false,"given":"Mishal","family":"Mumtaz","sequence":"first","affiliation":[{"name":"Department of medicine, Quaid\u2010e\u2010Azam Medical College Bahawalpur Affiliated with University of Health Sciences Lahore Lahore Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sidra","family":"Jabeen","sequence":"additional","affiliation":[{"name":"Department of medicine, Liaquat National Hospital and Medical College Affiliated with Jinnah Sindh Medical University Karachi Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1223-2648","authenticated-orcid":false,"given":"Ahmad","family":"Danial","sequence":"additional","affiliation":[{"name":"Department of medicine, Quaid\u2010e\u2010Azam Medical College Bahawalpur Affiliated with University of Health Sciences Lahore Lahore Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Tayyab Muzaffar","family":"Chaychi","sequence":"additional","affiliation":[{"name":"Department of medicine, Quaid\u2010e\u2010Azam Medical College Bahawalpur Affiliated with University of Health Sciences Lahore Lahore Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Kashan","family":"Zaheer","sequence":"additional","affiliation":[{"name":"Department of medicine, Liaquat National Hospital and Medical College Affiliated with Jinnah Sindh Medical University Karachi Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aymen","family":"Mumtaz","sequence":"additional","affiliation":[{"name":"Department of medicine, CMH Lahore Medical and Dental College Affiliated with National University of Medical Sciences  Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tayebah","family":"Mumtaz","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular St. Elizabeth's Medical Centre Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8645-4817","authenticated-orcid":false,"given":"Bengt","family":"Herweg","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, University of South Florida Morsani College of Medicine, Heart &amp; 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