{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:53:53Z","timestamp":1787068433051,"version":"build-2736575974"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pulmonary vein isolation (PVI) is a cornerstone of catheter ablation in patients with paroxysmal atrial fibrillation, and balloon-based ablation has been recently performed worldwide. The second-generation cryoballoon (CB2) ablation has proven to be highly effective in achieving freedom from paroxysmal atrial fibrillation. However, there are some debatable questions, including the ideal number of freeze cycles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The AD-Balloon study (Multicenter Study of the Validity of Additional Freeze Cycles for Cryoballoon Ablation) was designed as a prospective, multicenter, and randomized clinical trial for investigation of the optimal strategy of freeze cycles for the CB2 ablation. One hundred and ten consecutive patients (aged 64\u00b111 years) were randomly assigned to 2 groups after achieving a PVI by the CB2 ablation: 3-minute freeze cycles were added to each pulmonary vein (AD group: n=55) or not (non-AD group: n=55). Delayed-enhancement magnetic resonance imaging was also performed 1 to 2 months after the PVI to assess the ablation lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The patient characteristics did not differ between the 2 groups. A complete PVI was achieved in all patients. The total number of freeze cycles and durations for all pulmonary veins were significantly shorter in the non-AD group than in the AD group (5.7\u00b11.6 versus 9.1\u00b11.6 cycles,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001, and 932\u00b1244 versus 1483\u00b1252 seconds,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001). The cumulative freedom from any atrial tachyarrhythmia at 1 year was 87.3% in the AD group and 89.1% in the non-AD group (log-rank test\n                      <jats:italic>P<\/jats:italic>\n                      =0.78). There was no significant difference in the frequency of gaps on the PVI lines in the delayed-enhancement magnetic resonance imaging (46% in the AD group versus 36% in the non-AD group;\n                      <jats:italic>P<\/jats:italic>\n                      =0.38).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>No benefit was found in the patients receiving additional 3-minute freeze cycles after the complete PVI with the CB2 ablation, suggesting that an insurance freeze after achieving a PVI with the CB2 may be unnecessary and time consuming.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.118.006989","type":"journal-article","created":{"date-parts":[[2019,1,10]],"date-time":"2019-01-10T05:00:20Z","timestamp":1547096420000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Multicenter Study of the Validity of Additional Freeze Cycles for Cryoballoon Ablation in Patients With Paroxysmal Atrial Fibrillation"],"prefix":"10.1161","volume":"12","author":[{"given":"Koji","family":"Miyamoto","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine (K.M., T.M., K.N., N.K., T.K., M.W., K.Y., K.I., Y.Y.I., S.N., T.N., T.A., C.I., T.N., S.Y., K.F.K.), National Cerebral and Cardiovascular Center, Suita, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Doi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Japan 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Cardiovascular Medicine (K.M., T.M., K.N., N.K., T.K., M.W., K.Y., K.I., Y.Y.I., S.N., T.N., T.A., C.I., T.N., S.Y., K.F.K.), National Cerebral and Cardiovascular Center, Suita, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Ishibashi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine (K.M., T.M., K.N., N.K., T.K., M.W., K.Y., K.I., Y.Y.I., S.N., T.N., T.A., C.I., T.N., S.Y., K.F.K.), National Cerebral and Cardiovascular Center, Suita, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko Y.","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine (K.M., T.M., K.N., N.K., T.K., M.W., K.Y., K.I., Y.Y.I., S.N., T.N., T.A., C.I., T.N., S.Y., K.F.K.), National Cerebral and Cardiovascular Center, Suita, 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