{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:25:46Z","timestamp":1791563146265,"version":"4.3.4"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,6,14]],"date-time":"2019-06-14T00:00:00Z","timestamp":1560470400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000860","name":"European Society of Cardiology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000860","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To evaluate the effectiveness and safety of cryoballoon ablation (CBA) compared with radiofrequency ablation (RFA) for symptomatic paroxysmal or drug-refractory persistent atrial fibrillation (AF).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Prospective cluster cohort study in experienced CBA and RFA centres. Primary endpoint was \u2018atrial arrhythmia recurrence\u2019, secondary endpoints were as follows: procedural results, safety, and clinical course. A total of 4189 patients were included: CBA 2329 (55.6%) and RFA 1860 (44.4%). Cryoballoon ablation population was younger, with fewer comorbidities. Procedure time was longer in the RFA group (P\u2009=\u20090.01). Radiation exposure was 2487 (CBA) and 1792 cGycm2 (RFA) (P\u2009&amp;lt;\u20090.001). Follow-up duration was 441 (CBA) and 511\u2009days (RFA) (P\u2009&amp;lt;\u20090.0001). Primary endpoint occurred in 30.7% (CBA) and 39.4% patients (RFA) [adjusted hazard ratio (adjHR) 0.85, 95% confidence interval (CI) 0.70\u20131.04; P\u2009=\u20090.12). In paroxysmal AF, CBA resulted in a lower risk of recurrence (adjHR 0.80, 95% CI 0.64\u20130.99; P\u2009=\u20090.047). In persistent AF, the primary outcome was not different between groups. Major adverse cardiovascular and cerebrovascular event rates were 1.0% (CBA) and 2.8% (RFA) (adjHR 0.53, 95% CI 0.26\u20131.10; P\u2009=\u20090.088). Re-ablations (adjHR 0.46, 95% CI 0.34\u20130.61; P\u2009&amp;lt;\u20090.0001) and adverse events during follow-up (adjHR 0.64, 95% CI 0.48\u20130.88; P\u2009=\u20090.005) were less common after CBA. Higher rehospitalization rates with RFA were caused by re-ablations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The primary endpoint did not differ between CBA and RFA. Cryoballoon ablation was completed rapidly; the radiation exposure was greater. Rehospitalization due to re-ablations and adverse events during follow-up were observed significantly less frequently after CBA than after RFA. Subgroup analysis suggested a lower risk of recurrence after CBA in paroxysmal AF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial Registration<\/jats:title>\n                  <jats:p>ClinicalTrials.gov (NCT01360008), https:\/\/clinicaltrials.gov\/ct2\/show\/NCT01360008.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euz155","type":"journal-article","created":{"date-parts":[[2019,5,3]],"date-time":"2019-05-03T19:16:46Z","timestamp":1556911006000},"page":"1313-1324","source":"Crossref","is-referenced-by-count":106,"title":["Outcomes of cryoballoon or radiofrequency ablation in symptomatic paroxysmal or persistent atrial fibrillation"],"prefix":"10.1093","volume":"21","author":[{"given":"Ellen","family":"Hoffmann","sequence":"first","affiliation":[{"name":"Department of Cardiology and Internal Intensive Care Medicine, Heart Center Munich-Bogenhausen - Munich Municipal Hospital Group, Englschalkinger Str. 77, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4491-5224","authenticated-orcid":false,"given":"Florian","family":"Straube","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Internal Intensive Care Medicine, Heart Center Munich-Bogenhausen - Munich Municipal Hospital Group, Englschalkinger Str. 77, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2974-3142","authenticated-orcid":false,"given":"Karl","family":"Wegscheider","sequence":"additional","affiliation":[{"name":"Department of Medical Biometry and Epidemiology, University Medical Center Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malte","family":"Kuniss","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kerckhoff Clinic, Bad Nauheim, 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