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Predictors of a successful “crosstalk” ablation technique during second-generation cryoballoon ablation in patients with atrial fibrillation
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  • Tatsuhiko Hirao,
  • Yasuteru Yamauchi,
  • Rena Nakamura,
  • Takatoshi Shigeta,
  • Hiroshi Yoshida,
  • Shinichi Tachibana,
  • Atsuhito Oda,
  • Aki Ito,
  • Mitsutoshi Asano,
  • Hidetoshi Suzuki,
  • Tsukasa Shimura,
  • Manabu Kurabayashi,
  • Masahiko Goya,
  • Kaoru Okishige,
  • Tetsuo Sasano
Tatsuhiko Hirao
Yokohama City Minato Red Cross Hospital
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Yasuteru Yamauchi
Yokohama City Minato Red Cross Hospital
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Rena Nakamura
Yokohama City Minato Red Cross Hospital
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Takatoshi Shigeta
Yokohama City Minato Red Cross Hospital
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Hiroshi Yoshida
Yokohama City Minato Red Cross Hospital
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Shinichi Tachibana
Yokohama City Minato Red Cross Hospital
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Atsuhito Oda
Yokohama City Minato Red Cross Hospital
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Aki Ito
Yokohama City Minato Red Cross Hospital
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Mitsutoshi Asano
Yokohama City Minato Red Cross Hospital
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Hidetoshi Suzuki
Yokohama City Minato Red Cross Hospital
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Tsukasa Shimura
Yokohama City Minato Red Cross Hospital
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Manabu Kurabayashi
Yokohama City Minato Red Cross Hospital
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Masahiko Goya
Tokyo Medical and Dental University
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Kaoru Okishige
Yokohama City Minato Red Cross Hospital
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Tetsuo Sasano
Tokyo Medical and Dental University
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Abstract

Introduction: The “crosstalk” (CST) ablation technique has been reported to reduce unnecessary ablation during cryoballoon (CB) ablation (CBA). Nevertheless, it is unclear which situations will necessitate the adoption of the technique. Methods and Results: The effect of the technique was analyzed in AF patients underwent CBA from July 2017 to February 2020. The balloon occlusion status and nadir temperature (NT) were compared, and all ablated PVs were categorized into three groups according to the necessity and effectiveness of the technique. Of 1082 superior PVs (SPVs), 16, 40, and 1026 were identified in the CST success group, CST failure group, and control group, respectively. The proportion of SPVs ablated with complete occlusion with CB was significantly higher in the CST success group (100%) than in the CST failure group (16.7%) or control group (49.4%) (CST success group vs. CST failure group, p<0.001; CST success group vs. control group, p<0.002). The proportion of SPVs ablated with NT ≤-46°C was higher in the CST success group (100%) than in the CST failure group (56.7%) (p<0.05). The CST ablation technique was always effective if CBA of the SPVs was performed with both complete occlusion and NT ≤-46°C and was almost always ineffective if it did not meet these two criteria (sensitivity, 100%; specificity, 93%). Conclusion: Successful CST ablation was highly predicted if complete PV occlusion and NT ≤-46°C during CBA of the SPVs were achieved, which could be useful when adopting the technique targeting inferior PVs to reduce unnecessary freezing during SPV isolation.