{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T12:41:45Z","timestamp":1773837705689,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T00:00:00Z","timestamp":1649030400000},"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":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Additional benefit of cryoballoon left atrial roof line ablation (CB\u2010RA) beyond cryoballoon pulmonary vein isolation (CB\u2010PVI) is suggested in patients with persistent atrial fibrillation (PsAF). We sought to investigate the feasibility of CB\u2010RA for PsAF and to determine the ablation area.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Fifty\u2010three PsAF patients (67[58.5\u201375.5] years, 36 men, 11 longstanding PsAF) underwent CB\u2010PVI. Subsequently, 44(83.0%) out of 53 patients underwent additional CB\u2010RA. Voltage maps were created in all patients with a high\u2010resolution mapping system. The total number and duration of CB\u2010RAs were 3.9 \u00b1 0.7 and 468 \u00b1 84 s. LA roof areas were complete low voltage areas (LVAs) \/scar in 37\/44(84.1%) patients (\u201ccomplete roof modification\u201d). The normal LA posterior wall (LAPW) voltage area was 6.1(4.1\u20138.4) cm<jats:sup>2<\/jats:sup>, and the %LAPW isolation area was 61.0(47.2\u201371.7)%. The %LAPW isolation area was significantly greater in CB\u2010RA patients than those without (64.0[54.2\u201373.2] vs. 45.0[39.5\u201350.5]%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.041) despite significantly larger LAs in the former group. The %LAPW isolation area was significantly greater in patients with transverse LA diameters\u00a0&lt;\u00a045\u00a0mm than those\u00a0\u2265\u00a045\u00a0mm (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.0001). The single procedure 1\u2010year AF freedom was 87.4% (22.5% on antiarrhythmic drug) and tended to be higher in CB\u2010RA patients than those without. Among the 44 CB\u2010RA patients, it was significantly higher in patients with a complete roof modification than those without (94.4%\u00a0vs. 75.0%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.0049). One CB\u2010RA patient experienced a delayed cardiac tamponade requiring drainage at 4\u2010months post\u2010procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CB\u2010RA significantly expanded the LAPW isolation area, and a complete roof modification resulted in a high arrhythmia freedom in PsAF patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.14345","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T15:25:46Z","timestamp":1629818746000},"page":"589-597","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Cryoballoon left atrial roof ablation for persistent atrial fibrillation\u2014Analysis with high\u2010resolution mapping system"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0230-0934","authenticated-orcid":false,"given":"Shinsuke","family":"Miyazaki","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui  Fukui Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanae","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui  Fukui Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moe","family":"Mukai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui  Fukui Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisetsu","family":"Aoyama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui  Fukui Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minoru","family":"Nodera","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui  Fukui Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyasu","family":"Uzui","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui  Fukui Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Tada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medical Sciences University of Fukui  Fukui Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,4,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.05.012"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.01.002"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602014"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2018.11.006"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.11.012"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.115.003879"},{"key":"e_1_2_9_8_1","first-page":"30603","article-title":"Cryoballoon ablation of pulmonary veins for persistent atrial fibrillation: results from the multicenter STOP persistent AF trial","volume":"1547","author":"Su WW","journal-title":"Heart 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