Pace-Pacing and Clinical Electrophysiology最新文献

{"title":"Implantable Cardioverter Defibrillator in Nonischemic Versus Ischemic Cardiomyopathy: Real-World Primary Prevention Study.","authors":"Fankun Ma, Yang Gao, Haibo Yu, Guoqing Xu, Min Wu, Xinrui Hao, Yangfan Cui, Xiao Peng, Yanchun Liang","doi":"10.1111/pace.15142","DOIUrl":"10.1111/pace.15142","url":null,"abstract":"<p><strong>Background: </strong>The evidence in the primary prevention of sudden cardiac death (SCD) by using implantable cardioverter defibrillators (ICD) in patients with ischemic cardiomyopathy (ICM) is well-established but remains controversial for those with nonischemic cardiomyopathy (NICM). This study evaluates whether prognostic differences exist between ICM and NICM patients after ICD implantation.</p><p><strong>Methods: </strong>Patients initially undergoing ICD implantation as primary SCD prevention were retrospectively enrolled from January 2017 to May 2023. Malignant ventricular arrhythmic and/or SCD were set as the primary endpoint, whereas all-cause mortality was the secondary endpoint. Patients were grouped by heart failure etiology (ICM vs. NICM) and then by primary endpoint events occurrence. Outcomes analyses were performed between the NICM and ICM patients.</p><p><strong>Results: </strong>The final cohort had 342 patients, 213 (62.3%) with NICM and 129 (37.7%) with ICM. At a median follow-up of 23.0 (10.7, 33.2) months, 51 patients (14.9%) encountered primary endpoint events. No statistically significant disparities in primary endpoint events (log rank p = 0.413), all-cause death (log rank p = 0.208), cardiovascular mortality (log rank p = 0.218), or appropriate ICD therapy (log rank p = 0.250) between the two groups were indicated by Kaplan-Meier survival analysis. Moreover, the COX-adjusted models further demonstrated the absence of any significant differences between the two groups.</p><p><strong>Conclusion: </strong>In real-world settings, primary prevention of SCD with ICD implantation yields similar outcomes for ICM and NICM patients, including probabilities of SCD and/or malignant ventricular arrhythmias, all-cause mortality, appropriate ICD therapy, and cardiovascular mortality.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"169-179"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lesion Formation in Cardiac Pulsed-Field Ablation: Acute to Chronic Cellular Level Changes.","authors":"Kara Garrott, Savannah Bifulco, David Ramirez, Brendan Koop","doi":"10.1111/pace.15154","DOIUrl":"https://doi.org/10.1111/pace.15154","url":null,"abstract":"<p><p>As pulsed-field ablation (PFA) emerges as a promising therapy for atrial arrhythmias, an understanding of the cellular injury to cardiac tissue is critical to evaluating and interpreting results for each PFA system. This review aims to detail the mechanism of cell death for PFA, compare the cell death mechanism to thermal ablation modalities, clarify common histology markers, detail the progression of PFA lesions from the acute, to subacute, to chronic maturation states, and discuss clinical indicators of PFA lesions.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Warfarin and Aspirin Versus Warfarin Alone in Patients With HeartMate 3 Left Ventricular Assist Device: A Systematic Review and Meta-Analysis.","authors":"Patricia Viana, Lucca Moreira Lopes, Thamiris Dias Delfino Cabral, Jorge Persson, Vanessa de Oliveira Tapioca, Camila Veronica S Freire, Jessica Hoffmann Relvas, Yasmin Mesquita, Isabela Reis Marques, Wilton Francisco Gomes","doi":"10.1111/pace.15110","DOIUrl":"10.1111/pace.15110","url":null,"abstract":"<p><strong>Background and aims: </strong>HeartMate 3 (HM3), a fully magnetically levitated ventricular assist device (LVAD), has been associated with reduced thromboembolic events compared to HeartMate II. However, bleeding events remained significant. Among patients undergoing HM3 implantation, the standard antithrombotic regimen comprises both warfarin and aspirin (ASA), but there is a lack of evidence on the optimum antithrombotic therapy. We performed a systematic review and meta-analysis assessing the impact of combined ASA and warfarin therapy compared to warfarin alone on the incidence of non-surgical bleeding events in patients with HM3 LVAD.</p><p><strong>Methods: </strong>MEDLINE, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs) and observational studies comparing warfarin alone with warfarin combined with ASA in patients with HM3 LVAD. Binary endpoints were analyzed using computed risk ratios (RRs) with 95% confidence intervals (CIs). A random-effect model was applied for all endpoints.</p><p><strong>Results: </strong>Five studies (one RCT and four observational) encompassing 869 patients were included, with 424 (48.8%) prescribed warfarin alone, and 662 (76.2%) being male. Compared with the combined anticoagulation regimen, warfarin alone significantly reduced non-surgical bleeding (RR 0.30; 95% CI 0.09-0.95; p = 0.04) and gastrointestinal bleeding (RR 0.26; 95% CI 0.12-0.58; p < 0.001). There was no statistically significant difference between the groups for all-cause mortality (RR 1.02; 95% CI 0.45-2.32; p = 0.963).</p><p><strong>Conclusions: </strong>Our findings indicate that the use of warfarin alone for anticoagulation in HM3 patients is associated with a reduced risk of bleeding events when compared to the combined therapy with ASA.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"53-58"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinguishing Wolff-Parkinson-White Syndrome From Fasciculoventricular Pathway Using QRS-T Angle Analysis.","authors":"Ryo Nakagawa, Kazuhisa Sato, Yoko Yoshida, Tsugutoshi Suzuki, Yoshihide Nakamura","doi":"10.1111/pace.15114","DOIUrl":"10.1111/pace.15114","url":null,"abstract":"<p><strong>Background: </strong>Wolff-Parkinson-White (WPW) syndrome and fasciculoventricular pathway (FVP) present electrocardiographic manifestations characterized by delta waves, differentiating these two is challenging. Specifically, WPW type B with QRS width ≤120 ms, resembles typical FVP features. Because of the presence of repolarization abnormalities in WPW syndrome, our hypothesis centered on the potential utility of the QRS-T angle for distinguishing WPW syndrome from FVP. To determine the discriminative value of the QRS-T angle for delineating WPW syndrome from FVP.</p><p><strong>Methods: </strong>We included cases of WPW syndrome treated with catheter ablation and FVP diagnosed via adenosine triphosphate administration between 2007 and 2023. We excluded cases with WPW type A, QRS width >120 ms, intermittent WPW, congenital heart disease or myocardial damage, ablation history, tachycardia, palpitations within 3 months, and WPW syndrome featuring an accessory pathway on the left lateral wall. Eventually, we identified 40 and 54 patients from the WPW and FVP groups, respectively. The QRS-T angle was compared between the WPW and FVP cohorts.</p><p><strong>Results: </strong>The QRS-T angle in the WPW group was significantly larger than in the FVP group (45.7 ± 46.3° vs. 17.8 ± 13.9°, p < 0.001). Receiver operating characteristic curve analysis with a sensitivity and specificity of 65.0% and 72.6%, respectively, demonstrated that the optimal cut-off value for the QRS-T angle was 22° for distinguishing WPW from FVP. Remarkably, all cases with a QRS-T angle >65° were within the WPW group.</p><p><strong>Conclusions: </strong>The QRS-T angle can offer promising utility in differentiating WPW syndrome from FVP.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"114-118"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal His Pacing Promotes Reverse Remodeling in a Child With Conventional Pacing-Induced Ventricular Dysfunction.","authors":"Giaccardi Marzia, Zampieri Mattia, Crudeli Elena, Cartei Stella, Chechi Tania, Cipani Simone, Passantino Silvia, Porcedda Giulio","doi":"10.1111/pace.15117","DOIUrl":"10.1111/pace.15117","url":null,"abstract":"<p><p>Children with indications of pacing often require epicardial pacemakers with generators implanted in the abdominal wall due to small body size or challenging anatomy because of congenital heart diseases. However, left ventricle (LV) systolic dyssynchrony induced by epicardial pacing may result in adverse remodeling and LV dysfunction. Recently, distal His bundle pacing (dHBP) has been shown to restore normal ventricular function in adult patients with pacemaker induced ventricular dysfunction. Nevertheless, the effects and relevance of HBP in pediatric patients are largely unresolved, with only limited data analyzing the feasibility and efficacy of HBP in the pediatric population. We report the case of a young girl with congenital atrioventricular (AV) block who developed LV dysfunction induced by prolonged epicardial stimulation. After upgrading to dHBP, she improved her LV ejection fraction from 40% to 60% and maintained stable pacing-sensing parameters over-time. We here provide a review of existing literature on the topic.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"72-78"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maintenance of Sinus Rhythm Is Associated With Lower Incidence of Stroke in Patients With Drug-Refractory Atrial Fibrillation.","authors":"Soohyun Kim, Kyung An Kim, Soyoon Park, Hwajung Kim, Young Choi, Yong-Seog Oh, Sung-Hwan Kim","doi":"10.1111/pace.15105","DOIUrl":"10.1111/pace.15105","url":null,"abstract":"<p><strong>Background and objectives: </strong>Recent studies have demonstrated that early rhythm control for first-line treatment of atrial fibrillation (AF) improved cardiovascular outcomes. However, there is limited data regarding the long-term outcome of patients who failed antiarrhythmic drugs and who refuse radiofrequency catheter ablation (RFCA).</p><p><strong>Methods: </strong>Patients with AF who were refractory to antiarrhythmic drugs and had refused further rhythm control attempts via RFCA were retrospectively identified and propensity-score (PS) matched with those who had been treated with RFCA. The primary outcome of interest was all-cause mortality or ischemic stroke.</p><p><strong>Results: </strong>A total of 169 patients who refused rhythm control with RFCA and PS matched 169 patients who had been treated with RFCA were included for analysis. During a mean follow-up of 4.3 (2.3;6.9) years, maintenance of sinus rhythm was more achieved in RFCA group (7 [4.1%] in Refuse group vs. 133 [78.7%] in RFCA group, p < 0.001). The incidence of ischemic stroke was significantly higher in patients who refused RFCA compared with patients who underwent RFCA (2.96 per 100 person-years in the Refused group vs. 0.74 per 100 person-years in the RFCA group, log-rank p < 0.001), but all-cause mortality was not significantly different (log-rank p = 0.8). Refusal of attempted rhythm control via RFCA was an independent risk factor for ischemic stroke on multivariate Cox analysis (hazard ratio [HR] 3.2; 95% confidence interval [CI] 1.2-8.53, p = 0.02).</p><p><strong>Conclusion: </strong>In patients with antiarrhythmic drug-refractory AF, the risk of stroke was significantly higher in patients who refused rhythm control via RFCA compared with that of those treated with RFCA.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"106-113"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Localization and Spread of Challenging Conduction Gaps of Pulmonary Veins for Atrial Fibrillation Cryoablation.","authors":"Keita Miki, Koji Fukuda, Michinori Hirano, Koichi Sato, Shohei Ikeda, Mariko Shinozaki, Morihiko Takeda","doi":"10.1111/pace.15133","DOIUrl":"10.1111/pace.15133","url":null,"abstract":"<p><strong>Background: </strong>Cryoballoon ablation has been widely performed in patients with paroxysmal atrial fibrillation (AF). In some challenging pulmonary veins (PVs), the procedure requires additional touch-up applications against the residual conduction gaps. It implies that there could exist difficult sites to cover with standard cryoballoon applications (CBAs), resulting in resistant conduction gaps (RCGs). This study aims to characterize the RCGs after initial CBAs.</p><p><strong>Methods: </strong>We retrospectively enrolled 90 consecutive paroxysmal AF patients in our institute from January 2018 to December 2021 (66.5 ± 8.9 [SD] year-old, male/female 58/32). The RCGs after initial CBAs were mapped and analyzed with a high-resolution mapping (HRM) catheter. The PVs isolated using HRM were classified as HRM group. The PVs isolated without HRM, if isolated with a total of one or two CBAs, were classified as Control group.</p><p><strong>Results: </strong>Whereas 325 PVs were isolated without HRM, 29 PVs had RCGs which were mapped and identified with HRM (HRM group): 15 right inferior pulmonary veins (RIPVs), 11 left superior PVs (LSPVs), and 3 left inferior PVs (LIPVs). In HRM group, the rate of broad RCGs in each PV extending over 2 or 3 segments of PV was almost double that of one-segment RCGs. The width of RCGs significantly correlated with nadir balloon temperature (R = 0.42; p = 0.021) and iTT₁₅ (R = -0.44; p = 0.015).</p><p><strong>Conclusions: </strong>After standard CBAs, most RCGs were demonstrated to spread from the bottom to the posterior wall of RIPV and from the roof to the anterior wall of LSPV. The width of the RCGs was found to be correlated with parameters of balloon temperature, such as T_nadir and iTT₁₅.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"21-29"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multistep Algorithm to Predict RVOT PVC Site of Origin for Successful Ablation Using Available Criteria: A Two-Center Cross-Validation Study.","authors":"Muhammad Rafdi Amadis, Li-Wei Lo, Simon Salim, Muhammad Yamin, Yenn-Jiang Lin, Shih-Lin Chang, Yu-Feng Hu, Fa-Po Chung, Rubiana Sukardi, Chin-Yu Lin, Ting-Yung Chang, Ling Kuo, Angga Pramudita, Chih-Min Liu, Shin-Huei Liu, Cheng-I Wu, Yu-Shan Huang, Dinh Son Ngoc Nguyen, Dat Cao Tran, Shih-Ann Chen","doi":"10.1111/pace.15118","DOIUrl":"10.1111/pace.15118","url":null,"abstract":"<p><strong>Background: </strong>Predicting premature ventricular contraction (PVC) origin pre-ablation is a fundamental step, as right ventricular outflow tract (RVOT) PVC often leads to higher success rates.</p><p><strong>Objective: </strong>To compare nine published ECG criteria to differentiate between RVOT and non-RVOT origins of PVCs and develop a stepwise algorithm using those criteria to better determine PVC origin to predict ablation success.</p><p><strong>Methods: </strong>Two centers were involved in this study, the derivation group and the validation group. The derivation group included 65 patients with PVC left bundle branch block (LBBB) pattern morphology (predominantly negative in lead V₁) and inferior axis (predominantly positive in leads II and III), who underwent ablation at Cipto Mangunkusumo Hospital (RSCM) (2017-2022). The validation group included 291 patients who underwent ablation at the Taipei Veteran General Hospital (2020-2023). We calculated and compared six diagnostic accuracy measures from nine previously published ECG morphology criteria to develop an algorithm to enhance the accuracy of predicting RVOT PVC origin for successful ablation.</p><p><strong>Results: </strong>Our multistep algorithm using Criteria 5, 8, and 1 enhanced diagnostic performance compared to using each criterion alone. The accuracy, sensitivity, and specificity in the derivation group were 86.2%, 93.6%, and 66.7%, respectively; those in the validation group were 85.9%, 90.8%, and 64.7%, respectively. The ROC curve AUCs were 0.802 and 0.775, respectively.</p><p><strong>Conclusion: </strong>In cases of inferior axis and LBBB pattern PVCs, a multistep algorithm using multiple criteria increases the accuracy of predicting RVOT PVC origin instead of using a single criterion.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"128-136"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Simple Way to Exclude a Lethal Complication Following Atrial Fibrillation Radiofrequency Ablation: A Case Report.","authors":"Georgios Leventopoulos, Angeliki Papageorgiou, Angelos Perperis, Ioanna Koniari, Grigorios Tsigkas, Periklis Davlouros","doi":"10.1111/pace.15132","DOIUrl":"10.1111/pace.15132","url":null,"abstract":"<p><p>Esophageal injury is a serious complication following atrial fibrillation catheter ablation procedures. It may manifest as atrio-esophageal fistula, pericardio-esophageal fistula (PEF), or restricted perforation, with high mortality rate if left unoperated. Chest computed tomography with intravenous contrast is the mainstay of diagnosis; however, a definite imaging diagnosis is often delayed and may worsen patient outcomes. This case demonstrates that pericardial fluid amylase detection may contribute to early differential diagnosis of PEF versus restricted esophageal perforation combined with inflammatory pericarditis, in patients with relevant symptoms who present with pericardial effusion and may guide either conservative-as our case-or surgical approach.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"83-86"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of Arctic Front Advance Pro and POLARx Cryoballoons for Linear Ablation of the Left Atrial Roof.","authors":"Takatoshi Shigeta, Yuichiro Sagawa, Hirofumi Arai, Atsuhito Oda, Koji Sudo, Kazuya Murata, Kaoru Okishige, Manabu Kurabayashi, Masahiko Goya, Tetsuo Sasano, Yasuteru Yamauchi","doi":"10.1111/pace.15112","DOIUrl":"10.1111/pace.15112","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of cryoballoon ablation (CBA) of the left atrial (LA) roof in addition to pulmonary vein isolation (PVI) using a novel cryoballoon catheter, POLARx, remains unclear.</p><p><strong>Methods: </strong>This study compared the efficacy of LA roof line ablation and PVI using POLARx (Boston Scientific) or AFA-Pro (Medtronic) in 100 patients with persistent atrial fibrillation. The right superior pulmonary vein (PV) anchoring and raise-up techniques were consistently used for LA roof line ablation, and rapid right ventricular pacing was applied if the cryoballoon temperature did not reach -40°C.</p><p><strong>Results: </strong>Complete conduction block at the LA roof could be obtained in all patients with POLARx and in 98.0% of patients with AFA-Pro. Rapid right ventricular pacing was needed in 64.0% of patients with AFA-Pro and in no patients with POLARx. During LA roof line ablation, the nadir cryoballoon temperature was significantly lower with POLARx than with AFA-Pro (right: -54.2°C ± 4.4°C vs. -46.0°C ± 5.4°C; central: -56.8°C ± 4.4°C vs. -45.7°C ± 4.8°C; left: -56.1°C ± 4.3°C vs. -46.1°C ± 5.7°C), and the cryoballoon temperature reached -40°C earlier with POLARx than with AFA-Pro (right: 30.8 ± 7.4 s vs. 74.1 ± 37.7 s; central: 28.2 ± 5.2 s vs. 62.9 ± 30.9 s; left: 29.8 ± 5.8 s vs. 69.6 ± 40.7 s).</p><p><strong>Conclusion: </strong>The nadir cryoballoon temperature with POLARx was approximately 10°C lower than with AFA-Pro, consistently dropping below -40°C during LA roof line CBA. Thus, a complete conduction block of the LA roof line can be easily accomplished using right superior PV anchoring and the raise-up techniques without the need for rapid right ventricular pacing with POLARx.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"119-127"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}