{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:42:17Z","timestamp":1789486937697,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Reconnection of the pulmonary veins (PVs) is the primary cause of atrial fibrillation (AF) episodes after pulmonary vein isolation (PVI). Cryoballoon ablation does not always include the isolation of the carina due to anatomic variants and carina width has been associated with increased re\u2010ablation rate in previous radiofrequency ablation studies. Aim of our study was to assess the impact of carina width on the re\u2010ablation rate after cryoballoon\u2010PVI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 518 patients who underwent cryoballoon ablation for AF between 2015 and 2022. Each patient underwent contrast enhanced chest computed tomography (CT) scan prior to ablation. We measured the shortest distance between the superior and inferior PV (carina width) and the size of the left atrium in CT images. In patients referred to re\u2010ablation due to recurring symptomatic and ECG documented AF we defined the reconnected veins. The minimum follow up after prior PVI was 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In all patients the right carina was wider than the left (8.04\u2009\u00b1\u20094.49\u2009mm vs. 5.25\u2009\u00b1\u20093.03\u2009mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.059). One fifth (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009102) of the patients underwent re\u2010ablation for AF. Left carina width was significantly associated with re\u2010ablation rate (in re\u2010ablation group 6.4\u2009\u00b1\u20092.7\u2009mm vs. in no re\u2010ablation group 4.9\u2009\u00b1\u20093.0\u2009mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) whereas right carina width was not (8.3\u2009\u00b1\u20093.0\u2009mm vs. 7.9\u2009\u00b1\u20093.6\u2009mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.421, respectively). Left atrium (LA) was larger in the re\u2010ablation group, but the size of the LA did not correlate with the left carina width (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.075;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.111). However, there was a significant correlation between the size of the LA and the width of the right carina (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.251,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Also, in the re\u2010ablation group a significant correlation between right carina width and reconnection of the right PV's (RPV) was detected, which was not seen in the left PV's (LPV) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.360, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The left carina width and LA size are associated with the success rate of primary cryoballoon\u2010PVI. However, there was a correlation between the right carina width and the reconnection of the RPV's leading to re\u2010ablation. It seems that recognition of anatomical variants could be useful in the decision of ablation technique, but further studies are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70430","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T22:06:30Z","timestamp":1782857190000},"page":"1947-1955","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Carina Width on Re\u2010Ablation Rate of Atrial Fibrillation After Primary Cryoballoon\u2010Ablation"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7828-0056","authenticated-orcid":false,"given":"Miriam","family":"M\u00fcller","sequence":"first","affiliation":[{"name":"Heart Center Oulu University Hospital Oulu Finland"},{"name":"Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu University of Oulu and Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marja","family":"Hedman","sequence":"additional","affiliation":[{"name":"Heart Center Kuopio University Hospital Kuopio Finland"},{"name":"Institute of Clinical Medicine University of Eastern Finland Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Heikkil\u00e4","sequence":"additional","affiliation":[{"name":"Heart Center Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juhani","family":"Junttila","sequence":"additional","affiliation":[{"name":"Heart Center Oulu University Hospital Oulu Finland"},{"name":"Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu University of Oulu and Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu001"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.0693"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.467"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.08.037"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2016-309781"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.0335"},{"key":"e_1_2_11_9_1","first-page":"215","article-title":"Radiofrequency Ablation as Initial Therapy in Paroxysmal Atrial Fibrillation: Results on Health\u2010Related Quality of Life and Symptom Burden. The MANTRA\u2010PAF Trial","volume":"17","author":"Walfridsson H.","year":"2015","journal-title":"Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology: Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602014"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2029554"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.064"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.016871"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-016-0172-z"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.15821"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acvd.2016.03.006"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.12672"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.12710"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.06.019"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eux376"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.12601"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eus243"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14544"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeac255"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.70011"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eur364"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70430","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.70430","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70430","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:39:08Z","timestamp":1789479548000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.70430"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":25,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/jce.70430"],"URL":"https:\/\/doi.org\/10.1111\/jce.70430","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]},"assertion":[{"value":"2025-11-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}