News from the Cold Chamber: Clinical Experiences of POLARx versus Arctic Front Advance for Single-Shot Pulmonary Vein Isolation.
Denise GuckelPhilipp LucasKhuraman IsgandarovaMustapha El HamritiLeonard BergauThomas FinkVanessa SciaccaGuram ImnadzeMartin BraunMoneeb KhalaphGeorg NölkerPhilipp SommerChristian SohnsPublished in: Journal of cardiovascular development and disease (2022)
Cryoballoon (CB)-guided pulmonary vein isolation (PVI) represents a cornerstone in the treatment of atrial fibrillation (AF). Recently, a novel balloon-guided single shot device (POLARx, Boston Scientific) was designed. Our study aimed to compare the efficacy, safety and characteristics of the novel CB system with the established one (Arctic Front Advance (Pro), AFA, Medtronic). A total number of 596 patients undergoing CB-guided ablation for AF were included. 65 patients (65.0 ± 11.6, 31% female) undergoing PVI with the POLARx were compared to a cohort of 531 consecutive patients (63.0 ± 27.9, 25% female) treated with AFA. Acute PVI was achieved in all patients (n = 596, 100%). Total procedure duration (POLARx 113.3 ± 23.2 min, AFA 100.9 ± 21.3 min; p < 0.001) and fluoroscopy time (POLARx 10.5 ± 5.9 min, AFA 4.8 ± 3.6 min; p < 0.001) were significantly longer in the POLARx group. The POLARx balloon achieved significantly lower nadir temperatures (POLARx -57.7 ± 0.9 °C, AFA -45.1 ± 2.6 °C; p < 0.001) and a significantly higher percentage of pulmonary veins successfully isolated with the first freeze ( p = 0.027 *). One major complication occurred in the POLARx (2%) and three (1%) in the AFA group. Both ablation systems are comparably safe and effective. AF ablation utilizing the POLARx system is associated with longer procedure and fluoroscopy times as well as lower nadir temperatures.
Keyphrases
- atrial fibrillation
- newly diagnosed
- catheter ablation
- ejection fraction
- patients undergoing
- pulmonary hypertension
- heart failure
- minimally invasive
- climate change
- patient reported outcomes
- acute coronary syndrome
- liver failure
- percutaneous coronary intervention
- mitral valve
- anti inflammatory
- acute respiratory distress syndrome
- pulmonary embolism
- drug induced