{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T14:18:51Z","timestamp":1771510731072,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,3,5]],"date-time":"2019-03-05T00:00:00Z","timestamp":1551744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004374","name":"Medtronic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The second\u2010generation cryoballoon significantly improves outcome of pulmonary vein isolation (PVI) but may cause more complications than the first generation. Currently, no consensus regarding optimal cryoballoon application time exists. The 123\u2010study aimed to assess the minimal cryoballoon application duration necessary to achieve PVI (primary endpoint) and the effect of application duration on prevention of phrenic nerve injury (PNI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients &lt;75 years of age with paroxysmal atrial fibrillation, normal PV anatomy, and left atrial size &lt;40\u00a0cc\/m\u00b2 or &lt;50\u00a0mm were randomized to two applications of different duration: \u201cshort,\u201d \u201cmedium,\u201d or \u201clong.\u201d A total of 222 patients were enrolled, 74 per group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Duration per application was 105 (101\u2010108), 164 (160\u2010168), and 224 (219\u2010226) s and isolation was achieved in 79, 89, and 90% (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) of the PVs after two applications in groups short, medium, and long, respectively. Only for the left PVs, the success rate of the short group was significantly less compared to the medium\u2010 and long\u2010duration groups (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). PNI during the procedure occurred in 19 PVs (6.5%) in the medium and in 20 PVs (6.8%) in the long duration groups compared to only five PVs (1.7%) in the short duration group (<jats:italic>P\u00a0&lt;\u00a0<\/jats:italic>0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Short cryoballoon ablation application times, less than 2 min, did affect the success for the left PVs but not for the right PVs and resulted in less PNI. A PV tailored approach with shorter application times for the right PVs might be advocated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.13626","type":"journal-article","created":{"date-parts":[[2019,2,13]],"date-time":"2019-02-13T11:01:32Z","timestamp":1550055692000},"page":"508-514","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Shorter cryoballoon applications times do effect efficacy but result in less phrenic nerve injury: Results of the randomized 123 study"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5658-8905","authenticated-orcid":false,"given":"Marleen M.D.","family":"Molenaar","sequence":"first","affiliation":[{"name":"Medisch Spectrum Twente  Enschede The Netherlands"},{"name":"Universiteit Twente  Enschede The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl 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