{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:08:03Z","timestamp":1790932083842,"version":"4.1.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["493623784"],"award-info":[{"award-number":["493623784"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Gerhard Domagk Nachwuchsf\u00f6rderprogramm"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Ablation modalities differ in their mechanisms of action, tissue specificity, and collateral effects\u2014particularly on the cardiac autonomic nervous system. This study aimed to compare the autonomic effects of pulsed field ablation (PFA) vs. thermal ablation (TA) in patients with atrial fibrillation (AF) through a pooled analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A systematic search of PubMed and Embase was conducted through 5 April 2025, to identify comparative studies. The primary outcome was increase in heart rate (IHR) after ablation, and the secondary outcome was increase in serum S100B (IS100B), a marker of neural injury. Eight studies involving 1007 AF patients were included (mean age: 63.39 \u00b1 10.75 years; 36.3% female; maximum follow-up: 12 months). Baseline characteristics, including the use of antiarrhythmic drugs, were similar between the PFA and TA groups. Pooled analysis showed that PFA was associated with a significantly lower IHR compared to TA (PFA: 4.41 \u00b1 8.86 bpm vs. TA: 10.81 \u00b1 10.46 bpm; P &amp;lt; 0.00001). This difference persisted at midterm (3\u20136 months) and long-term (12 months) follow-up and remained consistent across age, sex, and different TA modalities (cryoballoon vs. radiofrequency). Correspondingly, the IS100B was significantly less pronounced after PFA (PFA: 33.27 \u00b1 9.46\u2005pg\/mL vs. TA: 97.53 \u00b1 31.88\u2005pg\/mL; P &amp;lt; 0.00001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PFA-based pulmonary vein isolation in patients with AF results in a smaller post-procedural IHR and less S100B release, suggesting reduced neural damage and less disruption of the autonomic nervous system compared to TA. These effects are sustained through mid- to long-term follow-up and may have potential implications for patient selection and individualized ablation strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euaf242","type":"journal-article","created":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T11:52:17Z","timestamp":1758973937000},"source":"Crossref","is-referenced-by-count":10,"title":["Peri-procedure and Mid-Long Term Effects of Pulsed Field Ablation vs. Thermal Ablation (Cryo- or Radiofrequency) on Autonomic Nervous System Function in Atrial Fibrillation: A Systematic and Quantitative Pooled-Analysis with Potential Implications for Patient Selection (The PULSE-COLD-HEAT-ANS Collaboration)"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4592-1096","authenticated-orcid":false,"given":"Sebastian","family":"Graeger","sequence":"first","affiliation":[{"name":"Department of Internal Medicine B (Cardiology, Angiology, Pneumology and Internal Intensive Care Medicine), German Centre for Cardiovascular Research (DZHK), University Medicine Greifswald , Greifswald ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7552-5053","authenticated-orcid":false,"given":"Sanjiv M","family":"Narayan","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Cardiovascular Institute, Center for Arrhythmia Research, Stanford University , Stanford, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0217-3960","authenticated-orcid":false,"given":"Christian","family":"Meyer","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Angiology and Intensive Care, cardiac Neuro- and Electrophysiology Rsrch Consortium (cNEP), EVK D\u00fcsseldorf, Heinrich Heine University D\u00fcsseldorf , D\u00fcsseldorf ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4893-0824","authenticated-orcid":false,"given":"Dominik","family":"Linz","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen ,","place":["Denmark"]},{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , Maastricht ,","place":["The Netherlands"]}],"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, German Center for Cardiovascular Research (DZHK), University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9373-8132","authenticated-orcid":false,"given":"Maura M","family":"Zylla","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heidelberg Center of Heart Rhythm Disorders, Medical University Hospital, University of Heidelberg , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramin","family":"Ebrahimi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B (Cardiology, Angiology, Pneumology and Internal Intensive Care Medicine), German Centre for Cardiovascular Research (DZHK), University Medicine Greifswald , Greifswald ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4748-0158","authenticated-orcid":false,"given":"Firat","family":"Duru","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center, University Hospital Zurich , Zurich ,","place":["Switzerland"]},{"name":"Center for Translational and Experimental Cardiology (CTEC), University of Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4322-1183","authenticated-orcid":false,"given":"Laura","family":"Perrotta","sequence":"additional","affiliation":[{"name":"Arrhythmia Unit, Department of Cardiology, Careggi University Hospital , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2075-8113","authenticated-orcid":false,"given":"Kars","family":"Neven","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Alfried Krupp Krankenhaus Essen, and Witten\/Herdecke University , Essen 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