{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T22:03:42Z","timestamp":1780351422368,"version":"3.54.1"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,6]],"date-time":"2025-04-06T00:00:00Z","timestamp":1743897600000},"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>POLARx FIT is a size\u2010adjustable cryoballoon, but its effect on isolation area and phrenic nerve injury (PNI) is not fully understood. This study aimed to compare the effects of 28 and 31\u2009mm cryoballoon on the left atrium (LA), superior vena cava (SVC), and PNI incidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Thirty\u2010one cases of paroxysmal atrial fibrillation treated with POLARx FIT were analyzed. SVC voltage mapping and septal sleeve length measurements were performed before pulmonary vein (PV) isolation. A 28\u2009mm balloon was used to isolate four PVs, followed by SVC and LA mapping. Additional ablation of the superior PVs was performed with a 31\u2009mm balloon, and remapping was conducted. The isolation area of the LA, SVC sleeve length, and PNI incidence were compared before treatment, after the 28\u2009mm treatment, and after the 31\u2009mm treatment. The residual LA posterior wall area was significantly smaller with the 31\u2009mm balloon compared to the 28\u2009mm balloon (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), with a significant increase in isolation area on the right side of the PVs after 31\u2009mm treatment (<jats:italic>p<\/jats:italic>\u2009=\u20090.03). SVC sleeve length progressively shortened with increasing balloon size, showing a significant reduction between pretreatment and after the 31\u2009mm treatment (<jats:italic>p<\/jats:italic>\u2009=\u20090.02). No consistent association was observed between balloon size and PNI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The larger cryoballoon expanded the LA posterior wall isolation area and had a greater effect on the SVC. Balloon size and PNI have shown inconsistent results.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16673","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T05:56:49Z","timestamp":1744005409000},"page":"1314-1322","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of Increased Cryoballoon Size on the Left Atrium, Superior Vena Cava, and Phrenic Nerve"],"prefix":"10.1111","volume":"36","author":[{"given":"Yukihiro","family":"Inamura","sequence":"first","affiliation":[{"name":"Department of Cardiology Japanese Red Cross Saitama Hospital Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6734-0569","authenticated-orcid":false,"given":"Takamitsu","family":"Takagi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Japanese Red Cross Saitama Hospital Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhei","family":"Isonaga","sequence":"additional","affiliation":[{"name":"Department of Cardiology Japanese Red Cross Saitama Hospital Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3413-2629","authenticated-orcid":false,"given":"Shinichi","family":"Tachibana","sequence":"additional","affiliation":[{"name":"Department of Cardiology Japanese Red Cross Saitama Hospital Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Ohya","sequence":"additional","affiliation":[{"name":"Department of Cardiology Japanese Red Cross Saitama Hospital Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Cardiology Japanese Red Cross Saitama Hospital Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0230-0934","authenticated-orcid":false,"given":"Shinsuke","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Institute of Science Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Nitta","sequence":"additional","affiliation":[{"name":"Department of Cardiology Sakakibara Heart Institute Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3582-6104","authenticated-orcid":false,"given":"Tetsuo","family":"Sasano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Institute of Science Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602014"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euw262"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13718"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2029980"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2029554"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.115.003879"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14065"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-023-01645-2"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13051259"},{"issue":"50","key":"e_1_2_9_11_1","article-title":"Initial Clinical Experience With the Novel POLARx FIT Cryoballoon System for Pulmonary Vein Isolation in Patients With Atrial Fibrillation","volume":"18","author":"Fukunaga H.","year":"2023","journal-title":"International Journal of Cardiology. 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