{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T01:15:31Z","timestamp":1789694131010,"version":"4.0.1"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Successful left atrial posterior wall isolation (LAPWI) using only the cryoballoon (CB) is technically challenging for the treatment of atrial fibrillation (AF). This study aimed to evaluate the efficacy of the cross\u2010over technique, wherein an overlapped ablation is performed by placing the CB from both directions in contact with the LAPW.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single\u2010center, retrospective, observational study of 194 consecutive patients with persistent atrial fibrillation (PerAF) who underwent a first\u2010time procedure of pulmonary vein isolation (PVI)\u00a0+\u00a0PWI (108 patients) or PVI\u2010only (86 patients) using the CB. The cross\u2010over technique was applied in all LAPWI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For ablation of the LA roof and bottom, respectively, a mean of 8.6\u00a0\u00b1\u00a01.0 (right to left [R\u2192L] 4.3\u00a0\u00b1\u00a01.1 and left to right [L\u2192R] 4.3\u00a0\u00b1\u00a01.1) and 9.1\u00a0\u00b1\u00a01.2 (R\u2192L 4.6\u00a0\u00b1\u00a01.6 and L\u2192R 4.5\u00a0\u00b1\u00a01.2) CB applications were delivered. LAPW was successfully isolated solely using the CB in 99.1% of patients. Although the PVI\u00a0+\u00a0PWI group had significantly longer procedure time, no severe adverse events were observed in either group. During a median follow\u2010up of 19 months, freedom from recurrence of all atrial tachyarrhythmias was achieved in 93.5% of the PVI\u00a0+\u00a0PWI group and 72.9% of the PVI\u2010only group (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.011).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>LAPWI performed solely with the CB using the cross\u2010over technique is feasibly, safe, and was independently associated with a significantly higher freedom from recurrence of atrial tachyarrhythmias compared with PVI alone in patients with PerAF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.15058","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T12:41:33Z","timestamp":1723466493000},"page":"1326-1337","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical impact of cryoballoon posterior wall isolation using the cross\u2010over technique in persistent atrial fibrillation"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7268-1134","authenticated-orcid":false,"given":"Fuminori","family":"Odagiri","sequence":"first","affiliation":[{"name":"Department of Cardiology Juntendo University Urayasu Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Tokano","sequence":"additional","affiliation":[{"name":"Department of Cardiology Juntendo University Urayasu Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Cardiology Juntendo University Urayasu Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Hirabayashi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Juntendo University Urayasu Hospital  Chiba 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