{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T18:02:55Z","timestamp":1772992975434,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cryoballoon (CB) pulmonary vein isolation (PVI) is a well\u2010established treatment for symptomatic atrial fibrillation (AF). Most centers use application durations of 180 or 240\u2009s. Since freezing\u2010related complications tend to occur later during the application, empirically shortening the duration may reduce procedural risks. A protocol using two consecutive 120\u2010s freezes was proposed. Here, we report its long\u2010term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a long\u2010term follow\u2010up comparison of patients with symptomatic AF undergoing PVI with second\u2010generation CB between 2019 and 2020. The conventional single 240\u2010s freeze protocol (CB240) was compared to a modified double 120\u2010s freeze protocol (CB120). Among 160 consecutive patients, 80 received CB120 and 80 CB240. A total of 140 patients (70\/group) completed follow\u2010up. The primary endpoint was freedom from atrial tachyarrhythmia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Persistent AF was more common in the CB240 group (32%) than in the CB120 group (20%), (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). After a mean follow\u2010up of 948\u2009\u00b1\u2009517 days, freedom from any atrial tachyarrhythmia at 1 year was 90% in the CB120 group and 82% in the CB240 group (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.122). The primary outcome was assessed after a single procedure, including antiarrhythmic drug (AAD) use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The CB120 protocol appears noninferior to the standard CB240 protocol regarding long\u2010term efficacy, while offering a potentially more favorable safety profile. This protocol may represent a viable alternative for optimizing the balance between effectiveness and safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.16746","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T03:19:02Z","timestamp":1748920742000},"page":"1868-1874","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Outcomes of Cryoballoon Pulmonary Vein Isolation Freeze Using a Modified ICE\u2010T Protocol With a Double 120\u2009s Applications (ICE\u2010T 2\u2009\u00d7\u20092)"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8905-0922","authenticated-orcid":false,"given":"Andrea","family":"Urbani","sequence":"first","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien (CCB) Frankfurt am Main, Medizinische Klinik III Agaplesion Markus Krankenhaus Frankfurt am Main Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0282-4658","authenticated-orcid":false,"given":"Stefano","family":"Bordignon","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien (CCB) Frankfurt am Main, Medizinische Klinik III Agaplesion Markus Krankenhaus Frankfurt am Main Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0299-362X","authenticated-orcid":false,"given":"Shota","family":"Tohoku","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien (CCB) Frankfurt am Main, Medizinische Klinik III Agaplesion Markus Krankenhaus Frankfurt am Main Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Schaack","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien (CCB) Frankfurt am Main, Medizinische Klinik III Agaplesion Markus Krankenhaus Frankfurt am Main Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5588-0533","authenticated-orcid":false,"given":"Jun","family":"Hirokami","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien (CCB) Frankfurt am Main, Medizinische Klinik III Agaplesion Markus Krankenhaus Frankfurt am Main Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Steyer","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien (CCB) Frankfurt am Main, Medizinische Klinik III Agaplesion Markus Krankenhaus Frankfurt am Main Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Urbanek","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien (CCB) Frankfurt am Main, Medizinische Klinik III Agaplesion Markus Krankenhaus Frankfurt am Main Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph Antoine","family":"Kheir","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien (CCB) Frankfurt am Main, Medizinische Klinik III Agaplesion Markus Krankenhaus Frankfurt am Main Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5347-9906","authenticated-orcid":false,"given":"Boris","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien (CCB) Frankfurt am Main, Medizinische Klinik III Agaplesion Markus Krankenhaus Frankfurt am Main Germany"},{"name":"Klinik f\u00fcr Kardiologie Medizinische Klinik 3, Universit\u00e4tsklinikum Frankfurt Frankfurt am Main Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. R.","family":"Julian Chun","sequence":"additional","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien (CCB) Frankfurt am Main, Medizinische Klinik III Agaplesion Markus Krankenhaus Frankfurt am Main Germany"},{"name":"Die Sektion Medizin Universit\u00e4t zu L\u00fcbeck L\u00fcbeck Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001193"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw285"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.016871"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euaa406"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.05.012"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.115.002725"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13626"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.042622"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-19-1144"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.14299"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12358"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.02.021"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eux219"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.114.002137"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.117.005318"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2016.12.014"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2019.03.012"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12114"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.16746","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.16746","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.16746","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T14:23:26Z","timestamp":1772979806000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.16746"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,3]]},"references-count":18,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/jce.16746"],"URL":"https:\/\/doi.org\/10.1111\/jce.16746","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,3]]},"assertion":[{"value":"2025-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}