Evidence mapPaperPMID 42300255Full record

Trial reportEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2026

Autonomic effects and ablation success after pulsed field and cryoballoon ablation: a SINGLE SHOT CHAMPION substudy.

Laurent Roten, Thomas Kueffer, Patrick Badertscher, Peter Jüni, Sven Knecht, Gregor Thalmann, Nikola Kozhuharov, Philipp Krisai, Salik Ur Rehman Iqbal, Corinne Jufer and 9 more

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Laurent RotenDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern CH-3010, Switzerland.ORCID 0000-0002-0827-1329
Thomas KuefferDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern CH-3010, Switzerland.ORCID 0000-0003-3553-4945
Patrick BadertscherDepartment of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.ORCID 0000-0001-9751-0557
Peter JüniClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.ORCID 0000-0002-5985-0670
Sven KnechtDepartment of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.ORCID 0000-0001-7122-021X
Gregor ThalmannDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern CH-3010, Switzerland.
Nikola KozhuharovDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern CH-3010, Switzerland.ORCID 0000-0003-2086-3690
Philipp KrisaiDepartment of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.ORCID 0000-0002-4367-2363
Salik Ur Rehman IqbalDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern CH-3010, Switzerland.ORCID 0000-0001-6361-1130
Corinne JuferDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern CH-3010, Switzerland.
Jens MaurhoferDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern CH-3010, Switzerland.ORCID 0000-0003-4442-8941
Dik HegDepartment of Clinical Research, University of Bern, Bern, Switzerland.ORCID 0000-0002-8766-7945
Tiago V PereiraClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Felix MahfoudDepartment of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.ORCID 0000-0002-4425-549X
Helge ServatiusDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern CH-3010, Switzerland.ORCID 0000-0003-2887-8707
Hildegard TannerDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern CH-3010, Switzerland.ORCID 0000-0001-9722-5617
Michael KühneDepartment of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.ORCID 0000-0002-2937-3711
Christian SticherlingDepartment of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.ORCID 0000-0001-8428-7050
Tobias ReichlinDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern CH-3010, Switzerland.ORCID 0000-0002-7197-8415

Funding

Boston ScientificInselspitalUniversity Hospital BaselUniversity Hospital Bern
6 · The paper itself

Abstract

aimsPulmonary vein isolation (PVI) using radiofrequency and cryoballoon ablation (CBA) modulates the cardiac autonomic nervous system (ANS) by affecting epicardial ganglionated plexi. In contrast, pulsed field ablation (PFA) appears to exert minimal autonomic effects. The impact of cardiac ANS modulation on arrhythmia recurrence remains incompletely understood. METHODS AND

resultsIn this multicentre trial substudy, 210 patients with symptomatic paroxysmal atrial fibrillation (AF) were randomized 1:1 to PVI using PFA or CBA. All patients received an implantable cardiac monitor at the time of ablation. Daytime heart rate (DHR), night-time heart rate (NHR), and heart rate variability (HRV) were continuously recorded over 12 months and analysed at Days 1-2, Months 3, 6, 9, and 12 post-ablation, and related to arrhythmia-free outcome. PFA (n = 105) was associated with higher HRV at Days 1-2 compared to CBA [n = 105; 100 (79-122) ms vs. 73 (59-93) ms, P < 0.001]. This trend persisted throughout follow-up. DHR and NHR were also consistently lower in the PFA group. Freedom from arrhythmia recurrence at 12 months was higher with PFA than CBA (63% vs. 49%, P = 0.046). HRV did not differ between PFA patients with and without recurrence. A stronger initial HRV suppression predicted favourable outcomes in CBA patients (67 ms vs. 84 ms in patients without vs. with arrhythmia recurrence, P = 0.002).

conclusionDespite reduced cardiac ANS modulation, PFA was associated with a superior arrhythmia-free outcome compared to CBA. These findings suggest that cardiac ANS modulation may not be critical for the successful ablation of paroxysmal AF.

Indexed as

Atrial FibrillationCatheter AblationPulmonary VeinsAgedAutonomic Nervous SystemCryosurgeryFemaleHeartHeart RateHumansMaleMiddle AgedRecurrenceTime FactorsTreatment OutcomeAutonomic nervous systemCryoballoon ablationGanglionated plexiHeart rate variabilityParoxysmal atrial fibrillationPulmonary vein isolationPulsed field ablationRandomized controlled trial

Identifiers

PMID42300255
PMCPMC13318154

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.