{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T20:35:00Z","timestamp":1774643700888,"version":"3.50.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T00:00:00Z","timestamp":1634169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Aims:<\/jats:bold> Catheter ablation of paroxysmal atrial fibrillation (PAF) has been shown to be effective and safe. However, recurrence of PAF varies between 10 and 30% for radiofrequency ablation. There have been no reports comparing long-term recurrence rates following radiofrequency ablation, cryoablation, and three-dimensional guided cryoablation plus radiofrequency ablation. The aim of this study was to observe the long-term recurrence rate of PAF when treated by these three catheter ablation methods, and to explore clinical factors that can potentially predict PAF recurrence following catheter ablation.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> There were 238 patients involved in this study, including 106 radiofrequency (RF) ablation cases (RF group), 66 cryoablation cases (Freeze group), and 66 cases treated by three-dimensional guided cryoablation combined with radiofrequency ablation (Freeze-plus-RF group). All patients underwent standardized follow-up. The recurrence rate of atrial fibrillation (AF) in the three groups was calculated. Predictive factors for the recurrence of AF were also investigated.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> At 48 months (the median follow-up period), the sinus rhythm maintenance rate was 77.4% in the RF group, 72.7% in the Freeze group, and 81.8% in the Freeze-plus-RF group. The maintenance rate of sinus rhythm was highest in the Freeze-plus-RF group, but differences among the three groups were not statistically significant. Further analysis found that the preoperative left atrial appendage emptying velocity (LAAEV) (recurrence vs. no recurrence, 56.58 \u00b1 18.37 vs. 65.59 \u00b1 18.83, respectively, <jats:italic>p<\/jats:italic> = 0.003), left atrial (LA) anteroposterior dimension (recurrence vs. no recurrence, 36.56 \u00b1 4.65 vs. 35.00 \u00b1 4.37, respectively; <jats:italic>p<\/jats:italic> = 0.028), and LA vertical dimension (recurrence vs. no recurrence, 56.31 \u00b1 6.96 vs. 53.72 \u00b1 6.52, respectively; <jats:italic>p<\/jats:italic> = 0.035) were related to postoperative recurrence. Multiple Cox regression analysis showed that only LAAEV was predictive of postoperative recurrence of PAF (hazard ratio: 0.979; 95% confidence interval: 0.961\u20130.997).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Our study found that there was no statistically significant difference in long-term recurrence rates among the RF, Freeze, and Freeze-plus-RF groups. Preoperative LAAEV is an independent predictor of postoperative recurrence of PAF.<\/jats:p>","DOI":"10.3389\/fcvm.2021.719452","type":"journal-article","created":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T05:16:28Z","timestamp":1634188588000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["The Long-Term Results of Three Catheter Ablation Methods in Patients With Paroxysmal Atrial Fibrillation: A 4-Year Follow-Up Study"],"prefix":"10.3389","volume":"8","author":[{"given":"Ling","family":"You","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lianxia","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruiqin","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1016\/j.amjcard.2018.05.015","article-title":"The disease burden of atrial fibrillation in china from a national cross-sectional survey","volume":"122","author":"Wang","year":"2018","journal-title":"Am J Cardiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/j.jjcc.2018.02.012","article-title":"Impact of catheter ablation of atrial fibrillation on long-term clinical outcomes in patients with heart failure","volume":"72","author":"Ichijo","year":"2018","journal-title":"J Cardiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1001\/jama.2019.0335","article-title":"Effect of catheter ablation vs antiarrhythmic medication on quality of life in patients with atrial fibrillation: the CAPTAF randomized clinical trial","volume":"321","author":"Blomstr\u00f6m-Lundqvist","year":"2019","journal-title":"JAMA."},{"key":"B4","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1111\/j.1540-8167.2011.02137.x","article-title":"Effect of catheter ablation on progression of paroxysmal atrial fibrillation","volume":"23","author":"Jongnarangsin","year":"2012","journal-title":"J Cardiovasc Electrophysiol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1093\/europace\/euu376","article-title":"Radiofrequency ablation vs. antiarrhythmic drug therapy as first line treatment of symptomatic atrial fibrillation: systematic review and meta-analysis","volume":"17","author":"Hakalahti","year":"2015","journal-title":"Europace."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1636","DOI":"10.1177\/0300060519828522","article-title":"Radiofrequency catheter ablation for paroxysmal atrial fibrillation: outcomes during a 3-year follow-up period","volume":"47","author":"Wang","year":"2019","journal-title":"J Int Med Res."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.hrthm.2017.05.012","article-title":"2017 HRS\/EHRA\/ECAS\/APHRS\/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation","volume":"20","author":"Calkins","year":"2018","journal-title":"Europace."},{"key":"B8","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1111\/jce.13607","article-title":"Atrial fibrillation ablation using cryoballoon technology: recent advances and practical techniques","volume":"29","author":"Chen","year":"2018","journal-title":"J Cardiovasc Electrophysiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.repc.2017.09.008","article-title":"Cryoballoon ablation in atrial fibrillation: advantages and drawbacks","volume":"36","author":"Boveda","year":"2017","journal-title":"Rev Port Cardiol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"725","DOI":"10.2459\/JCM.0000000000000725","article-title":"Comparison of cryoballoon and radiofrequency ablation techniques for atrial fibrillation: a meta-analysis","volume":"19","author":"Maltoni","year":"2018","journal-title":"J Cardiovasc Med (Hagerstown)."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1111\/jce.14420","article-title":"Cryothermal atrial linear ablation in patients with atrial fibrillation: an insight from the comparison with radiofrequency atrial linear ablation","volume":"31","author":"Mukai","year":"2020","journal-title":"J Cardiovasc Electrophysiol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1111\/pace.12582","article-title":"Cryoballoon versus radiofrequency catheter ablation for paroxysmal atrial fibrillation","volume":"38","author":"Wasserlauf","year":"2015","journal-title":"Pacing Clin Electrophysiol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"280","DOI":"10.4330\/wjc.v5.i8.280","article-title":"Catheter ablation of atrial fibrillation: radiofrequency catheter ablation for redo procedures after cryoablation","volume":"5","author":"Kettering","year":"2013","journal-title":"World J Cardiol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"7695","DOI":"10.1038\/s41598-019-44168-5","article-title":"Effects of different ablation strategies on long-term left atrial function in patients with paroxysmal atrial fibrillation: a single-blind randomized controlled trial","volume":"9","author":"You","year":"2019","journal-title":"Sci Rep."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1770","DOI":"10.1016\/j.hrthm.2010.08.028","article-title":"Cryoballoon versus radiofrequency catheter ablation of paroxysmal atrial fibrillation: biomarkers of myocardial injury, recurrence rates, and pulmonary vein reconnection patterns","volume":"7","author":"K\u00fchne","year":"2010","journal-title":"Heart Rhythm."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1111\/j.1540-8167.2009.01560.x","article-title":"Comparison of cryoballoon and radiofrequency ablation of pulmonary veins in 40 patients with paroxysmal atrial fibrillation: a case-control study","volume":"20","author":"Linhart","year":"2009","journal-title":"J Cardiovasc Electrophysiol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1111\/jce.13378","article-title":"Ablation of paroxysmal atrial fibrillation using a second-generation cryoballoon catheter or contact-force sensing radiofrequency ablation catheter: a comparison of costs and long-term clinical outcomes","volume":"29","author":"Yokokawa","year":"2018","journal-title":"J Cardiovasc Electrophysiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1111\/j.1540-8159.2011.03070.x","article-title":"Normal pulmonary veins anatomy is associated with better AF-free survival after cryoablation as compared to atypical anatomy with common left pulmonary vein","volume":"34","author":"Kubala","year":"2011","journal-title":"Pacing Clin Electrophysiol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/j.amjcard.2010.08.069","article-title":"Effect of pulmonary vein anatomy and left atrial dimensions on outcome of circumferential radiofrequency catheter ablation for atrial fibrillation","volume":"107","author":"den Uijl","year":"2011","journal-title":"Am J Cardiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.ijcard.2011.06.094","article-title":"Predictors of late recurrence of atrial fibrillation after catheter ablation","volume":"164","author":"Cai","year":"2013","journal-title":"Int J Cardiol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1016\/j.ijcard.2015.11.073","article-title":"Left ventricular native T1 time and the risk of atrial fibrillation recurrence after pulmonary vein isolation in patients with paroxysmal atrial fibrillation","volume":"203","author":"Kato","year":"2016","journal-title":"Int J Cardiol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1007\/s10840-016-0216-4","article-title":"Association between left atrial appendage emptying velocity, N-terminal plasma brain natriuretic peptide levels, and recurrence of atrial fibrillation after catheter ablation","volume":"48","author":"Ma","year":"2017","journal-title":"J Interv Card Electrophysiol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1111\/echo.13856","article-title":"Transesophageal echocardiography measures left atrial appendage volume and function and predicts recurrence of paroxysmal atrial fibrillation after radiofrequency catheter ablation","volume":"35","author":"He","year":"2018","journal-title":"Echocardiography."},{"key":"B24","doi-asserted-by":"publisher","first-page":"2201","DOI":"10.1053\/euhj.2001.2891","article-title":"Clinical value of left atrial appendage flow velocity for predicting of cardioversion success in patients with non-valvular atrial fibrillation","volume":"22","author":"P\u00e1link\u00e1s","year":"2001","journal-title":"Eur Heart J."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1016\/S0735-1097(02)01800-4","article-title":"Clinical value of left atrial appendage flow for prediction of long-term sinus rhythm maintenance in patients with nonvalvular atrial fibrillation","volume":"39","author":"Antonielli","year":"2002","journal-title":"J Am Coll Cardiol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1620\/tjem.208.243","article-title":"Left atrial appendage-flow velocity predicts cardioversion success in atrial fibrillation","volume":"208","author":"Akdeniz","year":"2006","journal-title":"Tohoku J Exp Med."},{"key":"B27","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1007\/s10554-016-0893-1","article-title":"Relationship between left atrial appendage emptying and left atrial function using cardiac magnetic resonance in patients with atrial fibrillation: comparison with transesophageal echocardiography","volume":"32","author":"Hwang","year":"2016","journal-title":"Int J Cardiovasc Imaging."},{"key":"B28","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1053\/euhj.2000.2441","article-title":"Update on atrial remodelling owing to rate; does atrial fibrillation always 'beget' atrial fibrillation?","volume":"22","author":"Pandozi","year":"2001","journal-title":"Eur Heart J."},{"key":"B29","doi-asserted-by":"publisher","first-page":"2461","DOI":"10.1016\/j.hrthm.2015.07.015","article-title":"Early recurrence of atrial arrhythmias following pulmonary vein antral isolation: timing and frequency of early recurrences predicts long-term ablation success","volume":"12","author":"Liang","year":"2015","journal-title":"Heart Rhythm."},{"key":"B30","doi-asserted-by":"publisher","first-page":"2353","DOI":"10.1253\/circj.CJ-15-0475","article-title":"Clinical significance of early recurrence after pulmonary vein antrum isolation in paroxysmal atrial fibrillation \u2013 insight into the mechanism","volume":"79","author":"Miyazaki","year":"2015","journal-title":"Circ J."},{"key":"B31","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1161\/CIRCEP.111.964809","article-title":"Use of an implantable monitor to detect arrhythmia recurrences and select patients for early repeat catheter ablation for atrial fibrillation: a pilot study","volume":"4","author":"Pokushalov","year":"2011","journal-title":"Circ Arrhythm Electrophysiol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"e003909","DOI":"10.1161\/CIRCEP.115.003909","article-title":"Redefining the blanking period after catheter ablation for paroxysmal atrial fibrillation: insights from the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) Trial","volume":"9","author":"Willems","year":"2016","journal-title":"Circ Arrhythm Electrophysiol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/j.amjcard.2016.06.045","article-title":"Effect and significance of early Reablation for the treatment of early recurrence of atrial fibrillation after catheter ablation","volume":"118","author":"Yanagisawa","year":"2016","journal-title":"Am J Cardiol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.1016\/j.jacc.2010.04.057","article-title":"Prevention of atrial fibrillation recurrence with corticosteroids after radiofrequency catheter ablation: a randomized controlled trial","volume":"56","author":"Koyama","year":"2010","journal-title":"J Am Coll Cardiol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1161\/CIRCEP.113.000876","article-title":"Time course of inflammation, myocardial injury, and prothrombotic response after radiofrequency catheter ablation for atrial fibrillation","volume":"7","author":"Lim","year":"2014","journal-title":"Circ Arrhythm Electrophysiol."}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.719452\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T05:16:29Z","timestamp":1634188589000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.719452\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,14]]},"references-count":35,"alternative-id":["10.3389\/fcvm.2021.719452"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2021.719452","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,14]]},"article-number":"719452"}}