{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T22:44:36Z","timestamp":1776897876618,"version":"3.51.2"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2025,4]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Paroxysmal atrial fibrillation (PAF) is commonly treated with pharmacological therapies, but these may be insufficient for symptom control. Radiofrequency and cryoballoon ablation have emerged as alternative strategies. This study aimed to compare the efficacy of cryoballoon ablation, radiofrequency ablation, and anti\u2010arrhythmic drugs as initial therapies for symptomatic PAF based on randomized trial data.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Data were extracted from randomized trials, and individual patient data were reconstructed from Kaplan\u2013Meier curves using artificial intelligence techniques. Time\u2010to\u2010event analysis was performed to evaluate arrhythmia recurrence, with hazard ratios (HRs) as the primary measure of efficacy. A heterogeneity analysis was conducted to assess variability between studies.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Five randomized trials were included in the analysis. Significant between\u2010trial heterogeneity was observed. Both cryoballoon ablation (HR 0.48; 95% CI: 0.36\u20130.63;\n p<\/jats:italic>\n \u2009<\u2009.001) and radiofrequency ablation (HR 0.54; 95% CI: 0.37\u20130.80;\n p<\/jats:italic>\n \u2009=\u2009.002) demonstrated superior efficacy compared to anti\u2010arrhythmic drug therapy in reducing arrhythmia recurrence.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Cryoballoon and radiofrequency ablation are more effective than anti\u2010arrhythmic drugs for initial therapy in symptomatic PAF. These findings support the use of ablation techniques as preferred interventions in this patient population.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/joa3.70054","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T12:46:58Z","timestamp":1743598018000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Radiofrequency or cryoablation or medical therapy for paroxysmal atrial fibrillation: An indirect comparison of effectiveness"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5614-9870","authenticated-orcid":false,"given":"Roberto","family":"Brunoro","sequence":"first","affiliation":[{"name":"Department of Pharmacy University of Milano Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1048-5166","authenticated-orcid":false,"given":"Lorenzo","family":"Di Spazio","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy Department, Santa Chiara Trento Hospital Azienda Provinciale per i Servizi Sanitari (APSS) Trento Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8541-539X","authenticated-orcid":false,"given":"Melania","family":"Rivano","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy Department Azienda Ospedaliero Universitaria Cagliari Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6409-4195","authenticated-orcid":false,"given":"Luca","family":"Cancanelli","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy Department Azienda Ulss 2 Marca Trevigiana Treviso Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara Nunzia Fasano","family":"Celentano","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy Department Azienda Ulss 3 Serenissima Mirano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1374-1505","authenticated-orcid":false,"given":"Daniele","family":"Mengato","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy Department Azienda Ospedale\u2010Universit\u00e0 Padova Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5829-107X","authenticated-orcid":false,"given":"Andrea","family":"Messori","sequence":"additional","affiliation":[{"name":"Health Technology Assessment (HTA) Unit, Regione Toscana Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000757"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.2029"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.064"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2029980"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2029554"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.467"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.21.2634"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euab029"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874\u2010021\u201001308\u20108"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15061633"},{"key":"e_1_2_9_12_1","unstructured":"MessoriA.Reconstruction of individual\u2010patient data from the analysis of Kaplan\u2010Meier curves: this method is widely used in oncology and cardiology \u2013List of 53 studies in oncology and 61 in cardiology (preprint) Open Science Framework.2024[cited 2024 Dec 10]. Available from:https:\/\/osf.io\/zcf4r.https:\/\/doi.org\/10.17605\/OSF.IO\/SRTCA"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euae043"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.65113"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15061633"}],"container-title":["Journal of Arrhythmia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/joa3.70054","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T14:57:35Z","timestamp":1764169055000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/joa3.70054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1002\/joa3.70054"],"URL":"https:\/\/doi.org\/10.1002\/joa3.70054","archive":["Portico"],"relation":{},"ISSN":["1880-4276","1883-2148"],"issn-type":[{"value":"1880-4276","type":"print"},{"value":"1883-2148","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-12-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70054"}}