{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T08:47:55Z","timestamp":1771490875738,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,3,31]],"date-time":"2024-03-31T00:00:00Z","timestamp":1711843200000},"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":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Recent studies have reported the efficacy of the cryoballoon (CB)\u2010guided left atrial roof block line (LARB) creation in patients with persistent atrial fibrillation (AF). However, it can be technically challenging to attach the balloon to the left atrial (LA) roof due to its anatomical variations. We designed a new procedure called the \u201cRaise\u2010up Technique,\u201d which may facilitate the firm adhesion of the CB to the LA roof during freezing. This study aimed to evaluate the efficacy of the Raise\u2010up technique in LARB creation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>In total, 100 consecutive patients with persistent AF who underwent CB\u2010LARB creation were enrolled. Fifty\u2010seven patients underwent LARB creation using the Raise\u2010up technique (Raise\u2010up group), and the remaining 43 did not use it (control group). The Raise\u2010up technique was performed as follows: An Achieve catheter was inserted as deeply as possible into the upper branch of the right superior pulmonary vein to anchor the CB. The balloon was placed below the targeted site on the LA roof and frozen. When the temperature of the CB reached approximately \u221210\u00b0C and the CB was easier to attach to the LA tissue, the CB was raised and pressed against the LA roof immediately by sheath advancement. Then the balloon could be in firm contact with the target site on the roof. If necessary, additional sheath advancement after sufficient freezing (\u221220\u00b0C to \u221230\u00b0C) was allowed the CB to have more firm and broad contact with the target site. LARB creation without touch\u2010up ablation was achieved in 54 of 57 patients (94.7%) in the Raise\u2010up group and 33 of 43 patients (76.7%) in the control group (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). The lesion size of the LARB in the Raise\u2010up group was significantly larger than that in the control group (15.2\u2009cm<jats:sup>2<\/jats:sup> vs. 12.8\u2009cm<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). Moreover, the width of the LARB lesion in the Raise\u2010up group was wider than that in the control group (32.0\u2009mm vs. 26.6\u2009mm, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The Raise\u2010up technique enabled the creation of seamless and thick LARB lesions with a single stroke. In addition, the CB\u2010LARB lesions created using the Raise\u2010up technique tended to be large, resulting in extensive debulking of the LA posterior wall arrhythmia substrates. In CB ablation for persistent AF, the Raise\u2010up technique can be considered one of the key strategies for LARB creation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16267","type":"journal-article","created":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T05:00:02Z","timestamp":1711947602000},"page":"1129-1139","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Raise\u2010up technique for the creation of left atrial roof lesion: A useful technique with cryoballoon for persistent atrial fibrillation"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5011-9654","authenticated-orcid":false,"given":"Hirofumi","family":"Kujiraoka","sequence":"first","affiliation":[{"name":"Department of Cardiology Tokyo Yamate Medical Center Tokyo 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