{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:17:47Z","timestamp":1790572667368,"version":"4.1.0"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Cryoballoon pulmonary vein isolation has become an established treatment for atrial fibrillation (AF). However, data on long-term outcomes beyond 5 years are scarce. This prospective analysis aimed to evaluate the long-term outcome after cryoballoon pulmonary vein isolation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Data from consecutive patients treated with cryoballoon pulmonary vein isolation for symptomatic AF between 2012 and 2018 in 13 institutions were analyzed. Patients with \u22655-year follow-up after the index procedure were included. Arrhythmia recurrence was defined as AF or atrial tachycardia lasting &gt;30 seconds beyond a 3-month blanking period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      A total of 1330 patients were enrolled (28.4% female patients, mean age was 60.1\u00b110.5 years). Patients with paroxysmal AF accounted for 73.1%; the median history of AF was 36.0 (13.0\u201375.0) months. The rate of AF\/atrial tachycardia recurrences progressively increased over time (event rate: 52.5% [49.4%\u201355.8%] at 8-year follow-up). A low incidence of progression to permanent AF was seen in the entire cohort (7.0%). Importantly, 15.7% of patients underwent a redo ablation for AF during follow-up; in 45.9% of these cases, all PVs were isolated at the redo procedure, with a median number of PVs isolated after the index procedure being 3 (1\u20134) veins. Independent predictors of arrhythmia recurrences were AF type (persistent AF: hazard ratio, 1.36 [95% CI, 1.14\u20131.62];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001) and chronic kidney disease (hazard ratio, 1.77 [95% CI, 1.12\u20132.81];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.016) in multivariate analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Cryoballoon pulmonary vein isolation as the index procedure for AF ablation resulted in a favorable long-term outcome in patients with symptomatic AF, with limited progression towards permanent AF during follow-up. Persistent AF was the strongest predictor of recurrences at long-term follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.124.013645","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T09:00:11Z","timestamp":1753434011000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Very Long-Term Follow-Up of Pulmonary Vein Isolation Using Cryoballoon for Catheter Ablation for Atrial Fibrillation: An 8-Year Multicenter Experience"],"prefix":"10.1161","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0720-3380","authenticated-orcid":true,"given":"Marco","family":"Schiavone","sequence":"first","affiliation":[{"name":"Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino IRCCS, Milan, Italy (M.S., G.F., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8287-0461","authenticated-orcid":true,"given":"Giulio","family":"Molon","sequence":"additional","affiliation":[{"name":"Division of Cardiology, IRCCS Ospedale Sacro Cuore Don Calabria Negrar di Valpolicella Ospedale, Verona, Italy (G.M., A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Pieragnoli","sequence":"additional","affiliation":[{"name":"Careggi University Hospital, Firenze, Italy (P.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0266-6493","authenticated-orcid":true,"given":"Giuseppe","family":"Arena","sequence":"additional","affiliation":[{"name":"Ospedale delle Apuane, Massa, Italy (G.A., C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2131-1110","authenticated-orcid":true,"given":"Saverio","family":"Iacopino","sequence":"additional","affiliation":[{"name":"GVM, Cotignola, Italy (S.I., J.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8735-7851","authenticated-orcid":true,"given":"Giovanni Battista","family":"Perego","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano  - IRCCS, Milan, Italy (G.B.P., G.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3471-6379","authenticated-orcid":true,"given":"Enrico","family":"Chieffo","sequence":"additional","affiliation":[{"name":"ASST, Ospedale Maggiore, Crema, Italy (E.C., C.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3878-2904","authenticated-orcid":true,"given":"Emanuele","family":"Bertaglia","sequence":"additional","affiliation":[{"name":"Cardiologia Camposampiero \u2013 AULSS6 Euganea, Italy (E. Bertaglia, R.V., F.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4646-0865","authenticated-orcid":true,"given":"Giuseppe","family":"Stabile","sequence":"additional","affiliation":[{"name":"Clinica Mediterranea, Napoli, Italy (G.S., A.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Manfrin","sequence":"additional","affiliation":[{"name":"Ospedale San Maurizio, Bolzano, Italy (M. Manfrin)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9650-4507","authenticated-orcid":true,"given":"Roberto","family":"Verlato","sequence":"additional","affiliation":[{"name":"Cardiologia Camposampiero \u2013 AULSS6 Euganea, Italy (E. Bertaglia, R.V., F.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Startari","sequence":"additional","affiliation":[{"name":"Fondazione Toscana, Pisa, Italy (U.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4111-1690","authenticated-orcid":true,"given":"Roberto","family":"Rordorf","sequence":"additional","affiliation":[{"name":"Policlinico San Matteo, Fondazione IRCCS, Pavia, Italy (R.R., E. Baldi)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9388-3292","authenticated-orcid":true,"given":"Massimiliano","family":"Marini","sequence":"additional","affiliation":[{"name":"Santa Chiara, Trento, Italy (M. Marini)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0870-012X","authenticated-orcid":true,"given":"Gaetano","family":"Fassini","sequence":"additional","affiliation":[{"name":"Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino IRCCS, Milan, Italy (M.S., G.F., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3875-7194","authenticated-orcid":true,"given":"Alessandro","family":"Costa","sequence":"additional","affiliation":[{"name":"Division of Cardiology, IRCCS Ospedale Sacro Cuore Don Calabria Negrar di Valpolicella Ospedale, Verona, Italy (G.M., A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Bartoli","sequence":"additional","affiliation":[{"name":"Ospedale delle Apuane, Massa, Italy (G.A., C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo","family":"Colella","sequence":"additional","affiliation":[{"name":"GVM, Cotignola, Italy (S.I., J.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5697-3747","authenticated-orcid":true,"given":"Giulia","family":"Girardengo","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano  - IRCCS, Milan, Italy (G.B.P., G.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7666-2516","authenticated-orcid":true,"given":"Cinzia","family":"Dossena","sequence":"additional","affiliation":[{"name":"ASST, Ospedale Maggiore, Crema, Italy (E.C., C.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Rivezzi","sequence":"additional","affiliation":[{"name":"Cardiologia Camposampiero \u2013 AULSS6 Euganea, Italy (E. Bertaglia, R.V., F.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assunta","family":"Iuliano","sequence":"additional","affiliation":[{"name":"Clinica Mediterranea, Napoli, Italy (G.S., A.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6360-224X","authenticated-orcid":true,"given":"Enrico","family":"Baldi","sequence":"additional","affiliation":[{"name":"Policlinico San Matteo, Fondazione IRCCS, Pavia, Italy (R.R., E. Baldi)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8500-8313","authenticated-orcid":true,"given":"Claudio","family":"Tondo","sequence":"additional","affiliation":[{"name":"Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino IRCCS, Milan, Italy (M.S., G.F., C.T.)."},{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy (C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602014"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/circep.117.005767"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circep.115.003660"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/circep.117.005250"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2016.12.023"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.02.010"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.23951"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.02.029"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2029554"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2029980"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-020-00788-w"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2020.03.062"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eut021"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.15512"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/pace.14881"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eux008"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2019.03.028"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/EUROPACE\/EUAD113"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euac143"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.119.007247"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.004742"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14638"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2008.10.024"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.12.028"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.10.065"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euy034"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.8831"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.07.770"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01860217"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.112.002097"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.03.418"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euad257"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytac361"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euab090"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euad185"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.064959"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.033146"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hjc.2022.03.006"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.042622"}],"container-title":["Circulation: Arrhythmia and Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCEP.124.013645","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T14:00:21Z","timestamp":1779458421000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCEP.124.013645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":39,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1161\/CIRCEP.124.013645"],"URL":"https:\/\/doi.org\/10.1161\/circep.124.013645","relation":{},"ISSN":["1941-3149","1941-3084"],"issn-type":[{"value":"1941-3149","type":"print"},{"value":"1941-3084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"2024-12-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}