{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T08:43:25Z","timestamp":1771490605118,"version":"3.50.1"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,11,14]],"date-time":"2020-11-14T00:00:00Z","timestamp":1605312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Medtronic AF Solutions"},{"name":"Medtronic Limited"},{"name":"Cardiac Risk in the Young"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Restoring sinus rhythm (SR) by ablation alone is an endpoint used in radiofrequency (RF) ablation for long-standing persistent atrial fibrillation (AF) but not with cryotherapy. The simultaneous use of two cryotherapy catheters can improve ablation efficiency; we compared this with RF ablation in chronic persistent AF aiming for termination to SR by ablation alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Consecutive patients undergoing their first ablation for persistent AF of &amp;gt;6\u2009months duration were screened. A total of 100 participants were randomized 1:1 to multi-catheter cryotherapy or RF. For cryotherapy, a 28-mm Arctic Front Advance was used in tandem with focal cryoablation catheters. Open-irrigated, non-force sensing catheters were used in the RF group with a 3D mapping system. Pulmonary vein (PV) isolation and non-PV triggers were targeted. Participants were followed up at 6 and 12\u2009months, then yearly. Acute PVI was achieved in all cases. More patients in the multi-catheter cryotherapy group were restored to SR by ablation alone, with a shorter procedure duration. Sinus rhythm continued to the last available follow-up in 16\/49 patients (33%) in the multi-catheter at 3.0\u2009\u00b1\u20091.6\u2009years post-ablation and in 12\/50 patients (24%) in the RF group at 4.0\u2009\u00b1\u20091.2\u2009years post-ablation. The yearly rate of arrhythmia recurrence was similar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Multi-catheter cryotherapy can restore SR by ablation alone in more cases and more quickly than RF ablation. Long-term success is difficult to achieve by either methods and is similar with both.<\/jats:p><\/jats:sec>","DOI":"10.1093\/europace\/euaa289","type":"journal-article","created":{"date-parts":[[2020,9,4]],"date-time":"2020-09-04T19:14:10Z","timestamp":1599246850000},"page":"370-379","source":"Crossref","is-referenced-by-count":16,"title":["Multi-catheter cryotherapy compared with radiofrequency ablation in long-standing persistent atrial fibrillation: a randomized clinical trial"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6333-6420","authenticated-orcid":false,"given":"Mark M","family":"Gallagher","sequence":"first","affiliation":[{"name":"Cardiology Clinical Academic Group, St. George\u2019s University Hospitals NHS Foundation Trust, St. George\u2019s University of London, Blackshaw Road, London SW17 0QT, 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