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Initial data demonstrated high safety and efficacy. Data on long-term PVI durability and reconduction patterns in comparison to established energy sources for PVI are scarce. We compare findings in repeat ablation procedures after a first PFA to findings in repeat ablation procedures after a first cryoballoon ablation (CBA) based PVI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and result<\/jats:title>\n                    <jats:p>A total of 550 consecutively enrolled patients underwent PFA or CBA index PVI. Repeat ablations in patients with symptomatic atrial arrhythmia recurrences were analysed. A total of 22\/191 (12%) patients after index PFA-PVI and 44\/359 (12%) after CBA-PVI underwent repeat ablation. Reconduction of any pulmonary vein (PV) was detected by multipolar spiral mapping catheter at each PV with careful evaluation of PV potentials and by 3D-mapping in 16\/22 patients (73%) after PFA-PVI and in 33\/44 (75%) after CBA-PVI (P = 1.000). Of 82 initially isolated PVs after PFA-PVI, 31 (38%) were reconducting; of 169 isolated PVs after CBA-PVI, 63 (37%) were reconducting (P = 0.936). Clinical atrial tachycardia occurred similarly in patients after PFA (5\/22; 23%) and CBA (7\/44; 16%; P = 0.515). Roof lines were set more often after PFA- (8\/22; 36%) compared with CBA-PVI (5\/44; 11%; P = 0.023). Repeat procedure duration [PFA: 87 (76, 123) min; CBA: 93 (75, 128) min; P = 0.446] was similar and fluoroscopy time [PFA: 11 (9, 14) min; CBA: 11 (8, 14) min; P = 0.739] equal between groups at repeat ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>During repeat ablation after previous PFA- or CBA-based PVI, electrical PV-reconduction rates and patterns were similar.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euae221","type":"journal-article","created":{"date-parts":[[2024,8,18]],"date-time":"2024-08-18T02:35:13Z","timestamp":1723948513000},"source":"Crossref","is-referenced-by-count":32,"title":["Pulsed-field- vs. cryoballoon-based pulmonary vein isolation: lessons from repeat procedures"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3799-7962","authenticated-orcid":false,"given":"Marc D","family":"Lemoine","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3905-0203","authenticated-orcid":false,"given":"Julius","family":"Obergassel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4951-5383","authenticated-orcid":false,"given":"Sandro","family":"Jaeckle","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9384-4151","authenticated-orcid":false,"given":"Moritz","family":"Nies","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Taraba","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celine","family":"Mencke","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5595-4391","authenticated-orcid":false,"given":"Jan","family":"Rie\u00df","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1676-4633","authenticated-orcid":false,"given":"Ilaria","family":"My","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1389-8564","authenticated-orcid":false,"given":"Laura","family":"Rottner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7310-6111","authenticated-orcid":false,"given":"Fabian","family":"Moser","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8709-0448","authenticated-orcid":false,"given":"Djemail","family":"Ismaili","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Rei\u00dfmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5292-1758","authenticated-orcid":false,"given":"Feifan","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1881-0197","authenticated-orcid":false,"given":"Paulus","family":"Kirchhof","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]},{"name":"Institute of Cardiovascular Sciences, University of Birmingham , Birmingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3457-0936","authenticated-orcid":false,"given":"Andreas","family":"Rillig","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6818-6396","authenticated-orcid":false,"given":"Andreas","family":"Metzner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK) , Partner Site Hamburg\/Kiel\/L\u00fcbeck ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,8,21]]},"reference":[{"key":"2024093009383032900_euae221-B1","doi-asserted-by":"crossref","first-page":"euae043","DOI":"10.1093\/europace\/euae043","article-title":"2024 European Heart Rhythm Association\/Heart Rhythm Society\/Asia Pacific Heart 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with atrial fibrillation","volume":"12","author":"Avgil Tsadok","year":"2015","journal-title":"Heart Rhythm"},{"key":"2024093009383032900_euae221-B5","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1161\/CIR.0000000000001193","article-title":"2023 ACC\/AHA\/ACCP\/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology\/American Heart Association joint committee on clinical practice guidelines","volume":"149","author":"Joglar","year":"2024","journal-title":"Circulation"},{"key":"2024093009383032900_euae221-B6","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1161\/CIRCEP.114.001473","article-title":"One-year clinical outcome after pulmonary vein isolation using the second-generation 28-mm cryoballoon","volume":"7","author":"Metzner","year":"2014","journal-title":"Circ Arrhythm 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A quantitative temporal analysis of pulmonary vein isolation","volume":"18","author":"Kawamura","year":"2021","journal-title":"Heart Rhythm"},{"key":"2024093009383032900_euae221-B13","doi-asserted-by":"crossref","first-page":"e02","DOI":"10.15420\/aer.2023.16","article-title":"Endocardial pulsed field ablation and the oesophagus: are atrio-oesophageal fistulas now history?","volume":"13","author":"Nies","year":"2024","journal-title":"Arrhythmia Electrophysiol Rev"},{"key":"2024093009383032900_euae221-B14","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1038\/s41591-024-03114-3","article-title":"Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study","volume":"30","author":"Ekanem","year":"2024","journal-title":"Nat Med"},{"key":"2024093009383032900_euae221-B15","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1093\/europace\/euac250","article-title":"Erratum to: multi-national survey on the methods, efficacy, 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characteristics following cryoballoon- compared to radiofrequency-based PVI","author":"Obergassel","year":"2024","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2024093009383032900_euae221-B22","doi-asserted-by":"crossref","first-page":"euad185","DOI":"10.1093\/europace\/euad185","article-title":"EUropean real-world outcomes with pulsed field ablatiOn in patients with symptomatic atRIAl fibrillation: lessons from the multi-centre EU-PORIA registry","volume":"25","author":"Schmidt","year":"2023","journal-title":"Europace"},{"key":"2024093009383032900_euae221-B23","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":"2024093009383032900_euae221-B24","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.1007\/s10840-023-01554-4","article-title":"Impact of pulmonary vein anatomy 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