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Background: Pulmonary vein isolation (PVI) is the accepted standard nowadays for atrial fi brillation (AF) ablation. The most widespread ablation techniques are cryoballoon (CB) and point-by-point radiofrequency (RF) ablation. Comparative studies between both techniques have shown their equivalence for the fi rst ablation procedure, but no trial has explored the potential incremental benefi t of crossing over the ablation technique after AF recurrence.

Recurrence of atrial fibrillation after pulmonary vein isolation, should we change the energy and technique?