Arrhythmias & electrophysiology

Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience

EuropacePublished Multicentre comparative cohort study

Authors' conclusion

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.

Study context

Population
Patients undergoing cryoballoon pulmonary vein isolation (PVI) for atrial fibrillation (AF), UK50% PolarX, 50% Arctic Front Advance (AFA)
Participants
1,688 patients
Exposure
PolarX Cryoballoon vs Arctic Front Advance Cryoballoon
Outcome
Safety, efficacy and feasibility of same day discharge for Cryoballoon PVI
Methodological details12 centres
  • 12 centres

Main finding

As reported in the abstract

Successful PVI, day case procedure and complications (all patients)

Successful PVI

1677

99.3%

Day case procedures

97.2%

n = 1641

Complication rate

<1%

Observational data: associations, not effects.

Further findings

PolarX cryoablation metrics
−54.6 ± 7.6°C · Nadir temperature · Temperature at 30 s −38.6 ± 7.2°C · Time to −40°C 34.1 ± 13.7 s · Time to isolation 49.8 ± 33.2 s

Independent predictors of achieving PVI

Time to reach −40°C, OR
1.34; P < 0.001
Nadir temperature, OR
1.24; P < 0.001
Time to −40°C cut-off ≤34 s, AUC
0.73; P < 0.001
Nadir temperature cut-off ≤−54.0°C, AUC
0.71; P < 0.001

Safety

Complications (all patients)

Complication rate
<1%
PolarX safety comparable with AFA

Original publication

Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience. Europace. Published 21 September 2023. doi:10.1093/europace/euad286

Summarised from the published abstract; every number is checked against it

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