{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T13:23:27Z","timestamp":1774445007438,"version":"3.50.1"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T00:00:00Z","timestamp":1626652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Pulmonary vein isolation (PVI) using cryoballoon ablation (CBA) is an established procedure for treating symptomatic paroxysmal and persistent atrial fibrillation (AF). The safety and efficacy of PVI performed at community hospitals are unknown. We aimed to determine the safety and acute efficacy of PVI using CBA performed at community hospitals with limited annual case numbers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>This registry study included 1004 consecutive patients who had PVI performed for symptomatic paroxysmal (n\u2009=\u2009563) or persistent AF (n\u2009=\u2009441) from January 2019 to September 2020 at 20 hospitals. Each hospital performed fewer than 100 CBA\u2013PVI procedures\/year according to local standards. Procedural data, efficacy, and complication rates were determined. The mean number of CBA procedures performed\/year at each centre was 59\u2009\u00b1\u200925. The average procedure time was 90.1\u2009\u00b1\u200931.6\u2009min and the average fluoroscopy time was 19.2\u2009\u00b1\u200911.4\u2009min. Isolation of all pulmonary veins was documented in 97.9% of patients. The most frequent reason for not achieving complete isolation was development of phrenic nerve palsy. No hospital deaths were observed. Two patients (0.2%) suffered a clinical stroke. Pericardial effusion occurred in six patients (0.6%), two of whom (0.2%) required pericardial drainage. Vascular complications occurred in 24 patients (2.4%), two of whom (0.2%) required vascular surgery. Phrenic nerve palsy occurred in 48 patients (4.8%) and persisted up to hospital discharge in six patients (0.6%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Pulmonary vein isolation procedures for paroxysmal or persistent AF using CBA can be performed at community hospitals with high acute efficacy and low complication rates.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euab132","type":"journal-article","created":{"date-parts":[[2021,5,2]],"date-time":"2021-05-02T11:06:55Z","timestamp":1619953615000},"page":"1744-1750","source":"Crossref","is-referenced-by-count":13,"title":["Safety and acute efficacy of cryoballoon ablation for atrial fibrillation at community hospitals"],"prefix":"10.1093","volume":"23","author":[{"given":"Rainer","family":"Hoffmann","sequence":"first","affiliation":[{"name":"Department of Cardiology, Angiology and Sleep Medicine, Bonifatius Hospital Lingen, Wilhelmstr. 13 49808 Lingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulli","family":"Parade","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rems-Murr-Klinikum Winnenden, Winnenden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hansj\u00f6rg","family":"Bauerle","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Klinikum Friedrichshafen, Friedrichshafen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus-Dieter","family":"Winter","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hermann-Josef-Krankenhaus Erkelenz, Erkelenz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Rauschenbach","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ev. Luth. Diakonissenanstalt Flensburg, Flensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl","family":"Mischke","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leopoldina Krankenhaus Schweinfurt, Schweinfurt, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl","family":"Schaefer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Elbe Kliniken Stade-Buxtehude, Buxtehude, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus-J\u00fcrgen","family":"Gutleben","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Klinikum Herford, Herford, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Obaida R","family":"Rana","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Helios St. Marienberg-Klinik Helmstedt, Helmstedt, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Willich","sequence":"additional","affiliation":[{"name":"Kardiologische Gemeinschaftspraxis Brilon, Brilon, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Schl\u00f6\u00dfer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Dreifaltigkeits-Hospital Lippstadt, Lippstadt, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfons","family":"R\u00f6tzer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, medius KLINIK Ostfildern, Ostfildern, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ole A","family":"Breithardt","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Agaplesion Diakonie Kliniken Kassel, Kassel, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Middendorf","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mathias-Spital Rheine, Rheine, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berndt","family":"Waldecker","sequence":"additional","affiliation":[{"name":"Department of Cardiology, GRN Klinik Schwetzingen, Schwetzingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rainer","family":"Grove","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Josefs-Hospital Cloppenburg, Cloppenburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg","family":"Mosa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Krankenhaus Freudenstadt, Freudenstadt, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim","family":"Krug","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Klinikum Fulda, Fulda, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2839-4454","authenticated-orcid":false,"given":"Guram","family":"Imnadze","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Klinikum Osnabr\u00fcck, Osnabr\u00fcck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erol","family":"Saygili","sequence":"additional","affiliation":[{"name":"Department of Cardiology, St. Antonius Krankenhaus, K\u00f6ln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jochen","family":"Michaelsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Sleep Medicine, Bonifatius Hospital Lingen, Wilhelmstr. 13 49808 Lingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,7,19]]},"reference":[{"key":"2021110907005735800_euab132-B1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS)","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur Heart J"},{"key":"2021110907005735800_euab132-B2","doi-asserted-by":"crossref","first-page":"e1-160","DOI":"10.1093\/europace\/eux274","article-title":"2017 HRS\/EHRA\/APHRS\/SOLAECE expert consensus statement on catheter and surgical ablation of atrial 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cryoballoon ablation: results from the Sustained PV Isolation with Arctic Front Advance (SUPIR) Study","volume":"26","author":"Reddy","year":"2015","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2021110907005735800_euab132-B6","doi-asserted-by":"crossref","first-page":"2235","DOI":"10.1056\/NEJMoa1602014","article-title":"Cryoballoon or radiofrequency ablation for paroxysmal atrial fibrillation","volume":"374","author":"Kuck","year":"2016","journal-title":"N Engl J Med"},{"key":"2021110907005735800_euab132-B7","doi-asserted-by":"crossref","first-page":"2104","DOI":"10.1161\/CIRCULATIONAHA.113.003862","article-title":"In-hospital complications associated with catheter ablation of atrial fibrillation in the United States between 2000 and 2010. Analysis of 93801 procedures","volume":"128","author":"Deshmukh","year":"2013","journal-title":"Circulation"},{"key":"2021110907005735800_euab132-B8","doi-asserted-by":"crossref","first-page":"4020","DOI":"10.1093\/eurheartj\/ehy452","article-title":"Incidence of complications related to catheter ablation of atrial fibrillation and atrial flutter: a nationwide in-hospital analysis of administrative data for Germany in 2014","volume":"39","author":"Steinbeck","year":"2018","journal-title":"Eur Heart J"},{"key":"2021110907005735800_euab132-B9","first-page":"48","article-title":"Results from a multicentre comparison of cryoballoon vs. radiofrequency ablation for paroxysmal atrial fibrillation: is cryoablation more reproducible?","volume":"19","author":"Providencia","year":"2017","journal-title":"Europace"},{"key":"2021110907005735800_euab132-B10","first-page":"154","article-title":"Complications in catheter ablation of atrial fibrillation in 3000 consecutive procedures","volume":"3","author":"Chun","year":"2017","journal-title":"J Am Coll Cardiol EP"},{"key":"2021110907005735800_euab132-B11","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1056\/NEJMoa2019422","article-title":"Early rhythm-control therapy in patients with atrial fibrillation","volume":"383","author":"Kirchhof","year":"2020","journal-title":"N Engl J Med"},{"key":"2021110907005735800_euab132-B12","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1056\/NEJMoa2029980","article-title":"Cryoablation or drug therapy for initial treatment of atrial fibrillation","volume":"384","author":"Andrade","year":"2021","journal-title":"N Engl J Med"},{"key":"2021110907005735800_euab132-B13","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s12181-017-0146-0","article-title":"Quality criteria for performing catheter ablation of atrial fibrillation. 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