{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:26:54Z","timestamp":1790364414077,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T00:00:00Z","timestamp":1655769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Focal Impulse and Rotor Modulation (FIRM) guided catheter ablation aiming at stable rotors has been investigated as a treatment option in patients with atrial fibrillation (AF). The objective of this study was to compare the safety and efficacy of FIRM\u2010guided ablation with second\u2010generation cryoballoon pulmonary vein isolation (CB2\u2010PVI) in paroxysmal AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients (<jats:italic>n<\/jats:italic>\u2009=\u200922, mean age 60\u2009\u00b1\u200911 years, 59.1% of males) who were treated with a stand\u2010alone FIRM\u2010guided ablation were included in this retrospective single\u2010center study. Procedural data and arrhythmia\u2010free survival at 12 months were compared with <jats:italic>n<\/jats:italic>\u2009=\u200986 consecutive patients (mean age 62\u2009\u00b1\u200913 years, 62.4% of males) who received de\u2010novo CB2\u2010PVI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median procedure duration was significantly longer in the FIRM group than in the CB2\u2010PVI group (152 [IQR 120\u2013176] minutes vs. 122 [110\u2013145] minutes; <jats:italic>p<\/jats:italic>\u2009=\u2009.031). One patient (1.2%) in the CB2\u2010PVI group and five patients (22.7%) in the FIRM group had vascular access complications. Atrial tachyarrhythmias recurred in 15 patients in the FIRM group and 11 in the CB2\u2010PVI group. Kaplan\u2013Meier estimation of single\u2010procedure arrhythmia\u2010free survival at 12 months was 25% (95% confidence interval [CI] 6%\u201344%) in the FIRM group and 87% (95% CI 78%\u201396%) in the CB2\u2010PVI group (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Repeat ablations were performed in 14\/20 (70.0%) patients in the FIRM group and in 12\/85 (14.1%) in the CB2\u2010PVI group (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>De novo ablation of AF using FIRM\u2010guided AF ablation results in shorter arrhythmia\u2010free survival after 12 months compared to CB2\u2010PVI and a need for repeat ablation in the majority of patients to achieve stable sinus rhythm.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15564","type":"journal-article","created":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T08:06:21Z","timestamp":1653552381000},"page":"1678-1686","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Stand\u2010alone Focal Impulse and Rotor Modulation (FIRM) ablation versus second\u2010generation cryoballoon pulmonary vein isolation for paroxysmal atrial fibrillation"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0122-7130","authenticated-orcid":false,"given":"Roland R.","family":"Tilz","sequence":"first","affiliation":[{"name":"Department of Cardiology, Angiology, and Intensive Care Medicine University Heart Center L\u00fcbeck Medical Clinic II, University Hospital Schleswig\u2010Holstein L\u00fcbeck Germany"},{"name":"German Center for Cardiovascular Research (DZHK) Partner Site Hamburg\/Kiel\/L\u00fcbeck L\u00fcbeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5602-0711","authenticated-orcid":false,"given":"Kivanc","family":"Yalin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology, and Intensive Care Medicine University Heart Center L\u00fcbeck Medical Clinic II, University Hospital Schleswig\u2010Holstein L\u00fcbeck Germany"},{"name":"Department of Cardiology Cerrahpasa Faculty of Medicine Istanbul University\u2010Cerrahpasa Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9696-9227","authenticated-orcid":false,"given":"Evgeny","family":"Lyan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology, and Intensive Care Medicine University Heart Center L\u00fcbeck Medical Clinic II, University Hospital Schleswig\u2010Holstein L\u00fcbeck Germany"},{"name":"Heart and Vessel Center Bad Bevensen Clinic for Cardiology Bad Bevensen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian\u2010Hendrik","family":"Heeger","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology, and Intensive Care Medicine University Heart Center L\u00fcbeck Medical Clinic II, University Hospital Schleswig\u2010Holstein L\u00fcbeck Germany"},{"name":"German Center for Cardiovascular Research (DZHK) Partner Site Hamburg\/Kiel\/L\u00fcbeck L\u00fcbeck 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