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Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience
AIMS: Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation for atrial fibrillation (AF). There are limited data on the PolarX Cryoballoon. The study aimed to establish the safety, efficacy, and feasibility of same day discharge for Cryoballoon PVI. METHODS AND RESULTS: Multi-centre...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629714/ https://www.ncbi.nlm.nih.gov/pubmed/37738643 http://dx.doi.org/10.1093/europace/euad286 |
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author | Honarbakhsh, Shohreh Martin, Claire A Mesquita, Joao Herlekar, Rahul Till, Richard Srinivasan, Neil T Duncan, Edward Leong, Fong Dulai, Rajdip Veasey, Rick Panikker, Sandeep Paisey, John Ramgopal, Balasubramanian Das, Moloy Ahmed, Wissam Sahu, Jonathan Earley, Mark J Finlay, Malcolm C Schilling, Richard J Hunter, Ross J |
author_facet | Honarbakhsh, Shohreh Martin, Claire A Mesquita, Joao Herlekar, Rahul Till, Richard Srinivasan, Neil T Duncan, Edward Leong, Fong Dulai, Rajdip Veasey, Rick Panikker, Sandeep Paisey, John Ramgopal, Balasubramanian Das, Moloy Ahmed, Wissam Sahu, Jonathan Earley, Mark J Finlay, Malcolm C Schilling, Richard J Hunter, Ross J |
author_sort | Honarbakhsh, Shohreh |
collection | PubMed |
description | AIMS: Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation for atrial fibrillation (AF). There are limited data on the PolarX Cryoballoon. The study aimed to establish the safety, efficacy, and feasibility of same day discharge for Cryoballoon PVI. METHODS AND RESULTS: Multi-centre study across 12 centres. Procedural metrics, safety profile, and procedural efficacy of the PolarX Cryoballoon with the Arctic Front Advance (AFA) Cryoballoon were compared in a cohort large enough to provide definitive comparative data. A total of 1688 patients underwent PVI with cryoablation (50% PolarX and 50% AFA). Successful PVI was achieved with 1677 (99.3%) patients with 97.2% (n = 1641) performed as day case procedures with a complication rate of <1%. Safety, procedural metrics, and efficacy of the PolarX Cryoballoon were comparable with the AFA cohort. The PolarX Cryoballoon demonstrated a nadir temperature of −54.6 ± 7.6°C, temperature at 30 s of −38.6 ± 7.2°C, time to −40°C of 34.1 ± 13.7 s, and time to isolation of 49.8 ± 33.2 s. Independent predictors for achieving PVI included time to reach −40°C [odds ratio (OR) 1.34; P < 0.001] and nadir temperature (OR 1.24; P < 0.001) with an optimal cut-off of ≤34 s [area under the curve (AUC) 0.73; P < 0.001] and nadir temperature of ≤−54.0°C (AUC 0.71; P < 0.001), respectively. CONCLUSIONS: This large-scale UK multi-centre study has shown that Cryoballoon PVI is a safe, effective day case procedure. PVI using the PolarX Cryoballoon was similarly safe and effective as the AFA Cryoballoon. The cryoablation metrics achieved with the PolarX Cryoballoon were different to that reported with the AFA Cryoballoon. Modified cryoablation targets are required when utilizing the PolarX Cryoballoon. |
format | Online Article Text |
id | pubmed-10629714 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-106297142023-11-08 Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience Honarbakhsh, Shohreh Martin, Claire A Mesquita, Joao Herlekar, Rahul Till, Richard Srinivasan, Neil T Duncan, Edward Leong, Fong Dulai, Rajdip Veasey, Rick Panikker, Sandeep Paisey, John Ramgopal, Balasubramanian Das, Moloy Ahmed, Wissam Sahu, Jonathan Earley, Mark J Finlay, Malcolm C Schilling, Richard J Hunter, Ross J Europace Clinical Research AIMS: Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation for atrial fibrillation (AF). There are limited data on the PolarX Cryoballoon. The study aimed to establish the safety, efficacy, and feasibility of same day discharge for Cryoballoon PVI. METHODS AND RESULTS: Multi-centre study across 12 centres. Procedural metrics, safety profile, and procedural efficacy of the PolarX Cryoballoon with the Arctic Front Advance (AFA) Cryoballoon were compared in a cohort large enough to provide definitive comparative data. A total of 1688 patients underwent PVI with cryoablation (50% PolarX and 50% AFA). Successful PVI was achieved with 1677 (99.3%) patients with 97.2% (n = 1641) performed as day case procedures with a complication rate of <1%. Safety, procedural metrics, and efficacy of the PolarX Cryoballoon were comparable with the AFA cohort. The PolarX Cryoballoon demonstrated a nadir temperature of −54.6 ± 7.6°C, temperature at 30 s of −38.6 ± 7.2°C, time to −40°C of 34.1 ± 13.7 s, and time to isolation of 49.8 ± 33.2 s. Independent predictors for achieving PVI included time to reach −40°C [odds ratio (OR) 1.34; P < 0.001] and nadir temperature (OR 1.24; P < 0.001) with an optimal cut-off of ≤34 s [area under the curve (AUC) 0.73; P < 0.001] and nadir temperature of ≤−54.0°C (AUC 0.71; P < 0.001), respectively. CONCLUSIONS: This large-scale UK multi-centre study has shown that Cryoballoon PVI is a safe, effective day case procedure. PVI using the PolarX Cryoballoon was similarly safe and effective as the AFA Cryoballoon. The cryoablation metrics achieved with the PolarX Cryoballoon were different to that reported with the AFA Cryoballoon. Modified cryoablation targets are required when utilizing the PolarX Cryoballoon. Oxford University Press 2023-09-21 /pmc/articles/PMC10629714/ /pubmed/37738643 http://dx.doi.org/10.1093/europace/euad286 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Clinical Research Honarbakhsh, Shohreh Martin, Claire A Mesquita, Joao Herlekar, Rahul Till, Richard Srinivasan, Neil T Duncan, Edward Leong, Fong Dulai, Rajdip Veasey, Rick Panikker, Sandeep Paisey, John Ramgopal, Balasubramanian Das, Moloy Ahmed, Wissam Sahu, Jonathan Earley, Mark J Finlay, Malcolm C Schilling, Richard J Hunter, Ross J Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience |
title | Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience |
title_full | Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience |
title_fullStr | Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience |
title_full_unstemmed | Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience |
title_short | Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience |
title_sort | atrial fibrillation cryoablation is an effective day case treatment: the uk polarx vs. arctic front advance experience |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629714/ https://www.ncbi.nlm.nih.gov/pubmed/37738643 http://dx.doi.org/10.1093/europace/euad286 |
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