{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T04:37:53Z","timestamp":1788583073771,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T00:00:00Z","timestamp":1744934400000},"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":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Data on sex\u2010related outcomes of pulmonary vein isolation (PVI) of cryoballoon ablation (CBA) in atrial fibrillation (AF) are sparse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare sex\u2010differences in PV reconnection, strategy and outcome of repeat ablations after CBA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Repeat procedures were performed using radiofrequency ablation guided by 3D mapping. PV reconnection characteristics were compared in 229 patients (77 (33.6%) females). In durable PVI patients, we compared left atrial voltage maps, ablation strategy and 1\u2010year outcome. Clinical success was defined as freedom of documented AF or atrial tachycardia (AT)\u2009&gt;\u200930\u2009s.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Female patients had a lower overall number of PV reconnections (0.8\u2009\u00b1\u20090.9 vs 1.2\u2009\u00b1\u20091.0, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) driven by less reconnected left PVs: 13\/77 (16.9%) vs 51\/152 (33,6%), <jats:italic>p<\/jats:italic>\u2009=\u20090.008 and 7\/77 (9.1%) vs 39\/152 (25.7%), <jats:italic>p<\/jats:italic>\u2009=\u20090.003 for LSPV and LIPV, respectively. Durable PVI was more frequent in women (34\/77 (44.1%) vs 37\/152 (24.4%), <jats:italic>p<\/jats:italic>\u2009=\u20090.001). Female sex was the only independent predictor for durable PVI (HR\u2009=\u20092.003; 95% CI 1.090\u20133.682; <jats:italic>p<\/jats:italic>\u2009=\u20090.025). In durable PVI patients, substrate ablation was more frequently performed in women (21\/35 (60%) vs 13\/35 (37.1%), <jats:italic>p<\/jats:italic>\u2009=\u20090.044), mainly targeting the higher prevalent atrial low\u2010voltage zones (21\/35 (60.0%) vs 12\/36 (33.3%), <jats:italic>p<\/jats:italic>\u2009=\u20090.017). At 1 year, recurrence of AF\/AT did not differ between sexes: 6\/35 (17.1%) versus 8\/35 (22.9%), <jats:italic>p<\/jats:italic>\u2009=\u20090.591.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The higher persistence of durable PVI in women points to a sex difference in AF recurrence driver after CBA. In durable PVI patients, a higher prevalence of low\u2010voltage regions results in more substrate ablation in women. Despite sex differences in ablation strategy, 1\u2010year outcome was similar.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16651","type":"journal-article","created":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T14:05:27Z","timestamp":1744985127000},"page":"1395-1405","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Recurrence of Atrial Fibrillation After Cryoballoon Ablation in Women Is Less Pulmonary Vein Mediated as Compared to Men: Lessons From Repeat Ablation Procedures"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2700-2543","authenticated-orcid":false,"given":"Maxime","family":"Tijskens","sequence":"first","affiliation":[{"name":"Department of Cardiology ZAS Heart Centre Middelheim Antwerp Belgium"},{"name":"Department of Cardiology AZ Rivierenland Hospital Rumst Antwerp Belgium"},{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel\u2010Vrije Universiteit Brussel, European Reference Networks Guard\u2010Heart Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3960-770X","authenticated-orcid":false,"given":"Juan Pablo","family":"Abugattas","sequence":"additional","affiliation":[{"name":"CHU UCL Namur, Site Sainte\u2010Elisabeth Namur Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Wolf","sequence":"additional","affiliation":[{"name":"Department of Cardiology ZAS Heart Centre Middelheim Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Schwagten","sequence":"additional","affiliation":[{"name":"Department of Cardiology ZAS Heart Centre Middelheim Antwerp Belgium"},{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel\u2010Vrije Universiteit Brussel, European Reference Networks Guard\u2010Heart Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"De Greef","sequence":"additional","affiliation":[{"name":"Department of Cardiology ZAS Heart Centre Middelheim Antwerp Belgium"},{"name":"Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel\u2010Vrije Universiteit Brussel, European Reference Networks Guard\u2010Heart Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eum144"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.12.101"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.118.006204"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-019-00601-3"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.893553"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2019.12.013"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euz225"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.01.040"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2020.04.032"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13709"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euz179"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2016.02.003"},{"issue":"6","key":"e_1_2_12_14_1","first-page":"961","article-title":"Pulmonary Vein Reconnection Predicts Good Clinical Outcome After Second Catheter Ablation for Atrial Fibrillation","volume":"19","author":"Kim T. 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