{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T09:03:52Z","timestamp":1784624632501,"version":"3.55.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Inselspital University Hospital Bern and the University Hospital Basel"},{"DOI":"10.13039\/100016242","name":"Boston Scientific","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016242","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The SINGLE SHOT CHAMPION multicentre trial compared the effectiveness of pulsed-field ablation (PFA) and cryoballoon ablation (CBA) for pulmonary-vein isolation (PVI) in patients with paroxysmal atrial fibrillation (AF). In a prespecified substudy, post-ablation three-dimensional electroanatomic mapping (3D-EAM) was performed, and repeat-procedure mapping data were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Patients were randomized 1:1 to fluoroscopy-guided PVI with PFA or CBA. The first 25 patients in each group underwent high-density 3D-EAM immediately after ablation. Acute PV isolation and lesion geometry were assessed using bipolar voltage thresholds of 0.1, 0.2, and 0.5\u2005mV. Lesion durability was evaluated at clinically indicated repeat ablation. In acute post-ablation mapping, residual PV conduction was seen in 4\/25 (16%) CBA patients and 0\/25 PFA patients (P = 0.11). Inadvertent posterior wall conduction block occurred after PFA in 3 (12%) patients with small atria (mean LA volume 30.7\u2005mL). PFA created larger left-sided lesions (antral area &amp;lt;0.5\u2005mV: 5.7\u2005mm2 [IQR 4.6\u20136.5] vs. 4.4\u2005mm2 [IQR 2.5\u20135.5], P = 0.026) and narrower posterior wall channels (14.0\u2005mm [IQR 10.5\u201320.6] vs. 24.0\u2005mm [IQR 19.1\u201326.9], P &amp;lt; 0.001), indicating wide-antral isolation. At redo (n = 48), durable PVI was seen in 4\/26 (15%) PFA and 3\/22 (14%) CBA patients and in 63\/102 (62%) veins after PFA and 52\/82 (63%) after CBA (P = 0.88).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Fluoroscopy- and electrocardiogram-guided PVI can result in incomplete PV isolation after CBA or unintentional posterior wall block after PFA. In the acute mapping cohort, PFA yielded broader left-sided lesions than CBA; in a separate redo cohort, chronic PV durability was similar for both modalities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euag167","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:49:12Z","timestamp":1782992952000},"source":"Crossref","is-referenced-by-count":0,"title":["Pulsed field or cryoballoon ablation for paroxysmal atrial fibrillation\u2014insights from acute and chronic electroanatomic remapping in the randomized SINGLE-SHOT CHAMPION trial"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3553-4945","authenticated-orcid":false,"given":"Thomas","family":"Kueffer","sequence":"first","affiliation":[{"name":"Department of Cardiology, Inselspital, Bern University Hospital, University of Bern , Bern ,","place":["Switzerland"]},{"name":"SITEM Center for Translational Medicine and Biomedical Entrepreneurship, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7122-021X","authenticated-orcid":false,"given":"Sven","family":"Knecht","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University Basel , Basel CH-4031 ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Ayadi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University Basel , Basel CH-4031 ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0356-2394","authenticated-orcid":false,"given":"David","family":"Spreen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University Basel , Basel CH-4031 ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6361-1130","authenticated-orcid":false,"given":"Salik ur Rehman","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital, Bern University Hospital, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Thalmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital, Bern University Hospital, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9751-0557","authenticated-orcid":false,"given":"Patrick","family":"Badertscher","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University Basel , Basel CH-4031 ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4442-8941","authenticated-orcid":false,"given":"Jens","family":"Maurhofer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital, Bern University Hospital, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4367-2363","authenticated-orcid":false,"given":"Philipp","family":"Krisai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University Basel , Basel CH-4031 ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2086-3690","authenticated-orcid":false,"given":"Nikola","family":"Kozhuharov","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital, Bern University Hospital, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5985-0670","authenticated-orcid":false,"given":"Peter","family":"J\u00fcni","sequence":"additional","affiliation":[{"name":"Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford , Oxford ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"Jufer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital, Bern University Hospital, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2887-8707","authenticated-orcid":false,"given":"Helge","family":"Servatius","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital, Bern University Hospital, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9722-5617","authenticated-orcid":false,"given":"Hildegard","family":"Tanner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital, Bern University Hospital, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2937-3711","authenticated-orcid":false,"given":"Michael","family":"K\u00fchne","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University Basel , Basel CH-4031 ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0827-1329","authenticated-orcid":false,"given":"Laurent","family":"Roten","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital, Bern University Hospital, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7197-8415","authenticated-orcid":false,"given":"Tobias","family":"Reichlin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital, Bern University Hospital, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8428-7050","authenticated-orcid":false,"given":"Christian","family":"Sticherling","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Basel, University Basel , Basel CH-4031 ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"2026072104262030700_euag167-B1","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1056\/NEJMoa2307291","article-title":"Pulsed field or conventional thermal ablation for paroxysmal atrial fibrillation","volume":"389","author":"Reddy","year":"2023","journal-title":"N Engl J Med"},{"key":"2026072104262030700_euag167-B2","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1056\/NEJMoa2502280","article-title":"Pulsed field or cryoballoon ablation for paroxysmal atrial fibrillation","volume":"392","author":"Reichlin","year":"2025","journal-title":"N Engl J Med"},{"key":"2026072104262030700_euag167-B3","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 rhythm society\/Latin American heart rhythm society expert consensus statement on catheter and surgical ablation of atrial fibrillation","volume":"26","author":"Tzeis","year":"2024","journal-title":"Europace"},{"key":"2026072104262030700_euag167-B4","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-025-02179-5","article-title":"Unintended lesion formation and conduction block in the posterior left atrium during pulmonary vein isolation using a pentaspline pulsed field ablation catheter","author":"Nakamura","year":"2025","journal-title":"J Interv Card Electrophysiol"},{"key":"2026072104262030700_euag167-B5","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1093\/europace\/euaa160","article-title":"High-density mapping in patients undergoing ablation of atrial fibrillation with the fourth-generation cryoballoon and the new spiral mapping catheter","volume":"22","author":"Conte","year":"2020","journal-title":"Europace"},{"key":"2026072104262030700_euag167-B6","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1093\/europace\/eux129","article-title":"Pulmonary vein re-mapping after cryoballoon ablation for atrial fibrillation","volume":"20","author":"Yokoyama","year":"2018","journal-title":"Europace"},{"key":"2026072104262030700_euag167-B7","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1016\/j.hrthm.2017.06.020","article-title":"Verification of a novel atrial fibrillation cryoablation dosing algorithm guided by time-to-pulmonary vein isolation: results from the cryo-DOSING study (cryoballoon-ablation DOSING based on the assessment of time-to-effect and pulmonary vein isolation guidance)","volume":"14","author":"Aryana","year":"2017","journal-title":"Heart Rhythm"},{"key":"2026072104262030700_euag167-B8","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1016\/j.jacep.2024.03.021","article-title":"Polarx vs Arctic front for cryoballoon ablation of paroxysmal AF: the randomized COMPARE CRYO study","volume":"10","author":"Reichlin","year":"2024","journal-title":"JACC Clin Electrophysiol"},{"key":"2026072104262030700_euag167-B9","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1161\/01.CIR.0000061951.81767.4E","article-title":"Pulmonary vein anatomy in patients undergoing catheter ablation of atrial fibrillation","volume":"107","author":"Kato","year":"2003","journal-title":"Circulation"},{"key":"2026072104262030700_euag167-B10","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1161\/CIRCEP.111.969923","article-title":"Quantitative analysis of isolation area and rhythm outcome in patients with paroxysmal atrial fibrillation after circumferential pulmonary vein antrum isolation using the pace-and-ablate technique","volume":"5","author":"Kiuchi","year":"2012","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2026072104262030700_euag167-B11","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.hrthm.2014.11.012","article-title":"Quantification of the cryoablation zone demarcated by pre- and postprocedural electroanatomic mapping in patients with atrial fibrillation using the 28-mm second-generation cryoballoon","volume":"12","author":"Kenigsberg","year":"2015","journal-title":"Heart Rhythm"},{"key":"2026072104262030700_euag167-B12","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.115.003879","article-title":"Quantitative analysis of the isolation area during the chronic phase after a 28-mm second-generation cryoballoon ablation demarcated by high-resolution electroanatomic mapping","volume":"9","author":"Miyazaki","year":"2016","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2026072104262030700_euag167-B13","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1093\/europace\/euab150","article-title":"How does the level of pulmonary venous isolation compare between pulsed field ablation and thermal energy ablation (radiofrequency, cryo, or laser)?","volume":"23","author":"Kawamura","year":"2021","journal-title":"Europace"},{"key":"2026072104262030700_euag167-B14","doi-asserted-by":"crossref","first-page":"euae134","DOI":"10.1093\/europace\/euae134","article-title":"State-of-the-art pulsed field ablation for cardiac arrhythmias: ongoing evolution and future perspective","volume":"26","author":"Chun","year":"2024","journal-title":"Europace"},{"key":"2026072104262030700_euag167-B15","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.123.011914","article-title":"Dynamics of high-density unipolar epicardial electrograms during PFA","volume":"16","author":"Amoros-Figueras","year":"2023","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2026072104262030700_euag167-B16","doi-asserted-by":"crossref","first-page":"euae006","DOI":"10.1093\/europace\/euae006","article-title":"Posterior wall ablation by pulsed-field ablation: procedural safety, efficacy, and findings on redo procedures","volume":"26","author":"Kueffer","year":"2023","journal-title":"Europace"},{"key":"2026072104262030700_euag167-B17","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1016\/j.hrthm.2024.04.045","article-title":"Pulsed-field vs cryoballoon vs radiofrequency ablation: outcomes after pulmonary vein isolation in patients with persistent atrial fibrillation","volume":"21","author":"Kueffer","year":"2024","journal-title":"Heart Rhythm"},{"key":"2026072104262030700_euag167-B18","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1161\/CIRCEP.123.011920","article-title":"Pulsed field versus cryoballoon pulmonary vein isolation for atrial fibrillation: efficacy, safety, and long-term follow-up in a 400-patient cohort","volume":"16","author":"Urbanek","year":"2023","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2026072104262030700_euag167-B19","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1016\/j.hrthm.2025.08.045","article-title":"Beyond the learning curve: how operator experience affects pulsed-field ablation outcomes","volume":"23","author":"Kueffer","year":"2025","journal-title":"Heart Rhythm"},{"key":"2026072104262030700_euag167-B20","doi-asserted-by":"crossref","first-page":"euae075","DOI":"10.1093\/europace\/euae075","article-title":"Role of 3D electro-anatomical mapping on procedural characteristics and outcomes in pulsed-field ablation for atrial fibrillation","volume":"26","author":"Badertscher","year":"2024","journal-title":"Europace"},{"key":"2026072104262030700_euag167-B21","doi-asserted-by":"crossref","first-page":"euaf294","DOI":"10.1093\/europace\/euaf294","article-title":"Pulsed field ablation for atrial fibrillation ablation: a European heart rhythm association survey","volume":"27","author":"Bergonti","year":"2025","journal-title":"Europace"},{"key":"2026072104262030700_euag167-B22","first-page":"284","article-title":"Incidence of long-term pulmonary vein reconnection after a 2-minute cryoballoon freeze for pulmonary vein isolation-invasive insights of TTI-dependent cryoenergy titration","volume":"9","author":"Pott","year":"2022","journal-title":"J Cardiovasc Dev Dis"},{"key":"2026072104262030700_euag167-B23","doi-asserted-by":"crossref","first-page":"euaf012","DOI":"10.1093\/europace\/euaf012","article-title":"Repeat procedures after pulsed field ablation for atrial fibrillation: MANIFEST-REDO study","volume":"27","author":"Scherr","year":"2025","journal-title":"Europace"},{"key":"2026072104262030700_euag167-B24","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1016\/j.jacep.2025.02.026","article-title":"The olive strategy: improved pulmonary vein isolation durability with the pentaspline pulsed field catheter","volume":"11","author":"Schaack","year":"2025","journal-title":"JACC Clin Electrophysiol"},{"key":"2026072104262030700_euag167-B25","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1016\/j.hrthm.2025.07.044","article-title":"Are there pulmonary vein geometrical features associated with reconnection after pulsed field ablation of atrial fibrillation?","volume":"23","author":"Simavonian","year":"2025","journal-title":"Heart Rhythm"},{"key":"2026072104262030700_euag167-B26","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1007\/s10840-022-01330-w","article-title":"Pulmonary vein size is associated with reconnection following cryoballoon ablation of atrial fibrillation","volume":"65","author":"Mugnai","year":"2022","journal-title":"J Interv Card Electrophysiol"},{"key":"2026072104262030700_euag167-B27","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1093\/ehjci\/jeac255","article-title":"Predictors of late pulmonary vein reconnection in patients with arrhythmia recurrence after cryoballoon ablation-per vein analysis including cardiac computed tomography-based anatomic factors","volume":"24","author":"Terasawa","year":"2023","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026072104262030700_euag167-B28","doi-asserted-by":"crossref","first-page":"euae204","DOI":"10.1093\/europace\/euae204","article-title":"Atrial cardiomyopathy revisited-evolution of a concept: a clinical consensus statement of the European heart rhythm association (EHRA) of the ESC, the heart rhythm society (HRS), the Asian Pacific heart rhythm society (APHRS), and the Latin American heart rhythm society (LAHRS)","volume":"26","author":"Goette","year":"2024","journal-title":"Europace"},{"key":"2026072104262030700_euag167-B29","doi-asserted-by":"crossref","first-page":"euaf326","DOI":"10.1093\/europace\/euaf326","article-title":"Controversy: pulsed field ablation is the standard technique for all the candidates for atrial fibrillation ablation","volume":"27","author":"Di Biase","year":"2025","journal-title":"Europace"},{"key":"2026072104262030700_euag167-B30","doi-asserted-by":"crossref","first-page":"2955","DOI":"10.1111\/jce.70078","article-title":"Comparison of two different pulsed field ablation systems: the dual pulse system study","volume":"36","author":"Subin","year":"2025","journal-title":"J Cardiovasc Electrophysiol"}],"container-title":["Europace"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/europace\/advance-article-pdf\/doi\/10.1093\/europace\/euag167\/68686310\/euag167.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/28\/7\/euag167\/68686310\/euag167.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/28\/7\/euag167\/68686310\/euag167.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T08:26:31Z","timestamp":1784622391000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/doi\/10.1093\/europace\/euag167\/8723968"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":30,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,3]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euag167","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,7]]},"article-number":"euag167"}}