Arrhythmias & electrophysiologyCohort study
Incidence of phrenic nerve injury during pulmonary vein isolation using different cryoballoons: data from a large prospective ablation registry
- Prospective observational registry study
- multicentre
- 19 centres
- consecutive patients
Authors' conclusion
Our study demonstrated a significantly higher incidence of right PNI and lower touch-up rate for the POLARx-CB than AFA-CB in the real-world clinical practice.
Study context
- Population
- Consecutive atrial fibrillation (AF) patients undergoing pulmonary vein isolation (PVI) by cryoballoon, 19 centres, January 2022–October 2023
- Participants
- 2,555 patients
- Exposure
- POLARx-CB vs AFA-CB for PVI
- POLARx-CBn = 1,197
- AFA-CBn = 1,358reference
- Outcome
- Acute procedural efficacy (touch-up ablation) and safety (right phrenic nerve injury)
Main finding
As reported in the abstract
Touch-up ablation
P = 0.002
- Touch-up ablation overall
- 299(11.7%)
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Touch-up ablation, PAF vs non-PAF · 8.8% vs 17.2% | P < 0.001 |
Touch-up ablation, PAF vs non-PAF
- Touch-up rate similar between the two cryoballoons in non-PAF patients
Safety
Right phrenic nerve injury · right PNI
P < 0.001
Symptomatic PNI
P < 0.001
PNI during RSPV ablation
P < 0.001
- Right phrenic nerve injury — Right phrenic nerve injury (PNI) overall
- 64(2.5%)
- Right phrenic nerve injury — Symptomatic PNI overall
- 22(0.9%)
- Right phrenic nerve injury — PNI during right superior PV (RSPV) ablation overall
- 39(1.5%)
Right phrenic nerve injury
- No significant difference during RIPV ablation
- PNI recovered more quickly with AFA-CB than POLARx-CB
Original publication
Incidence of phrenic nerve injury during pulmonary vein isolation using different cryoballoons: data from a large prospective ablation registry. Europace. Published 8 April 2024. doi:10.1093/europace/euae092
Summarised from the published abstract; every number is checked against it