{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:32:24Z","timestamp":1753889544502,"version":"3.41.2"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,5,18]]},"abstract":"\n Background<\/jats:title>\n \n Cryoballoon (\n CB<\/jats:styled-content>\n ) ablation is widely performed for pulmonary vein isolation (\n PVI<\/jats:styled-content>\n ) in patients with atrial fibrillation (\n AF<\/jats:styled-content>\n ). Anatomic variations in patient pulmonary vein (\n PV)<\/jats:styled-content>\n anatomy are believed to impact short\u2010 and long\u2010term procedural success of\n CB PVI<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We hypothesized that failure of initial\n PV<\/jats:styled-content>\n isolation with a standard technique (ie, requiring >2 freeze cycles per\n PV<\/jats:styled-content>\n and\/or radiofrequency ablation [RFA] to achieve\n PV<\/jats:styled-content>\n isolation) during index\n CB PVI<\/jats:styled-content>\n procedures would be associated with decreased freedom from\n AF<\/jats:styled-content>\n . We examined a cohort of 177 consecutive patients with drug\u2010refractory\n AF<\/jats:styled-content>\n who underwent CB\n PVI<\/jats:styled-content>\n with a 28\u2010mm balloon second\u2010generation\n CB<\/jats:styled-content>\n device. Mean follow\u2010up time was 19\u00b19\u00a0months. Forty\u2010three patients had\n AF<\/jats:styled-content>\n recurrence after the 90\u2010day blanking period after ablation. In 40 patients, acute isolation of one or more\n PV<\/jats:styled-content>\n s could not be achieved by\n CB<\/jats:styled-content>\n ablation with the standard technique (single freeze with or without bonus freeze). To obtain complete acute\n PVI<\/jats:styled-content>\n , 15 patients received extra freeze applications, 20 required supplemental\n RFA<\/jats:styled-content>\n , and 5 received both extra freeze applications and supplemental\n RFA<\/jats:styled-content>\n . Multivariate regression analysis revealed supplemental\n RFA<\/jats:styled-content>\n use during index CB\n PVI<\/jats:styled-content>\n procedures was independently associated with a threefold increased risk of\n AF<\/jats:styled-content>\n recurrence (adjusted hazard ratio, 3.01; 1.45\u201310.87;\n P<\/jats:italic>\n =0.003).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Use of supplemental\n RFA<\/jats:styled-content>\n during\n CB PVI<\/jats:styled-content>\n procedures to assist with isolation of one or more\n PV<\/jats:styled-content>\n s was independently associated with increased risk of\n AF<\/jats:styled-content>\n recurrence. Use of additional freezes to achieve\n PVI<\/jats:styled-content>\n did not increase the risk for recurrent\n AF<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.120.015979","type":"journal-article","created":{"date-parts":[[2020,5,12]],"date-time":"2020-05-12T09:50:59Z","timestamp":1589277059000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Supplemental Radiofrequency Ablation After Acutely Unsuccessful Cryoballoon Pulmonary Vein Isolation is Associated With Increased Risk of Recurrent Atrial Fibrillation"],"prefix":"10.1161","volume":"9","author":[{"given":"Henry D.","family":"Huang","sequence":"first","affiliation":[{"name":"Division of Cardiology Rush University Medical Center Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grzegorz","family":"Pietrasik","sequence":"additional","affiliation":[{"name":"Division of Cardiology Rush University Medical Center Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qurrat\u2010ul\u2010ain","family":"Abid","sequence":"additional","affiliation":[{"name":"Division of Cardiology Rush University Medical Center Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parikshit S.","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Cardiology Rush University Medical Center Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kousik","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Division of Cardiology Rush University Medical Center Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy R.","family":"Larsen","sequence":"additional","affiliation":[{"name":"Division of Cardiology Rush University Medical Center Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard G.","family":"Trohman","sequence":"additional","affiliation":[{"name":"Division of Cardiology Rush University Medical Center Chicago IL"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"doi-asserted-by":"publisher","key":"e_1_3_1_2_2","DOI":"10.1056\/NEJMoa1602014"},{"doi-asserted-by":"publisher","key":"e_1_3_1_3_2","DOI":"10.1016\/j.hrthm.2015.03.021"},{"doi-asserted-by":"publisher","key":"e_1_3_1_4_2","DOI":"10.1016\/j.hrthm.2017.06.020"},{"doi-asserted-by":"publisher","key":"e_1_3_1_5_2","DOI":"10.1161\/CIRCEP.117.005318"},{"doi-asserted-by":"publisher","key":"e_1_3_1_6_2","DOI":"10.1161\/CIRCEP.115.002966"},{"doi-asserted-by":"publisher","key":"e_1_3_1_7_2","DOI":"10.1161\/CIRCEP.118.006989"},{"doi-asserted-by":"publisher","key":"e_1_3_1_8_2","DOI":"10.1111\/jce.12003"},{"doi-asserted-by":"publisher","key":"e_1_3_1_9_2","DOI":"10.1007\/s11596-018-1874-5"},{"doi-asserted-by":"publisher","key":"e_1_3_1_10_2","DOI":"10.1161\/CIR.0000000000000665"},{"doi-asserted-by":"publisher","key":"e_1_3_1_11_2","DOI":"10.1056\/NEJM199809033391003"},{"doi-asserted-by":"publisher","key":"e_1_3_1_12_2","DOI":"10.1093\/europace\/euq388"},{"doi-asserted-by":"publisher","key":"e_1_3_1_13_2","DOI":"10.1016\/j.jacep.2019.08.003"},{"doi-asserted-by":"publisher","key":"e_1_3_1_14_2","DOI":"10.4022\/jafib.1620"},{"doi-asserted-by":"publisher","key":"e_1_3_1_15_2","DOI":"10.1016\/j.jacep.2016.01.009"},{"doi-asserted-by":"publisher","key":"e_1_3_1_16_2","DOI":"10.1093\/europace\/eur036"},{"doi-asserted-by":"publisher","key":"e_1_3_1_17_2","DOI":"10.1253\/circj.CJ-16-1161"},{"doi-asserted-by":"publisher","key":"e_1_3_1_18_2","DOI":"10.1161\/CIRCEP.111.966523"},{"doi-asserted-by":"publisher","key":"e_1_3_1_19_2","DOI":"10.1111\/j.1540-8167.1999.tb00211.x"},{"doi-asserted-by":"publisher","key":"e_1_3_1_20_2","DOI":"10.1016\/j.hrthm.2018.11.017"},{"doi-asserted-by":"publisher","key":"e_1_3_1_21_2","DOI":"10.1007\/s10840-008-9205-6"},{"doi-asserted-by":"publisher","key":"e_1_3_1_22_2","DOI":"10.1161\/CIRCEP.114.002137"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.015979","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:55:50Z","timestamp":1715601350000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.015979"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,18]]},"references-count":21,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2020,5,18]]}},"alternative-id":["10.1161\/JAHA.120.015979"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.015979","relation":{},"ISSN":["2047-9980"],"issn-type":[{"type":"electronic","value":"2047-9980"}],"subject":[],"published":{"date-parts":[[2020,5,18]]},"assertion":[{"value":"2020-01-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e015979"}}