Arrhythmias & electrophysiology
Pulmonary Vein Isolation Only for Atrial Fibrillation With Heart Failure (POLAR-HF)
Main findingResult — go to the resultHazard ratio 1.01 95% CI -∞ to 1.24Authors' conclusion
In patients with AF undergoing ablation, a PVI-only approach shows noninferior rhythm control efficacy and comparable procedural safety in patients with HFrEF compared with those without HFrEF.
Study context
- Population
- Patients with paroxysmal or persistent atrial fibrillation (AF) undergoing pulmonary vein isolation (PVI)-only cryoballoon ablation1,044 matched, 1:5
- Participants
- 1,420 patients
- Exposure
- Cryoballoon PVI-only in Heart Failure with Reduced Ejection Fraction (HFrEF) vs without HFrEF
- HFrEFn = 174
- Without HFrEFn = 870reference
- Outcome
- First documented recurrence of any atrial arrhythmia after a 90-day blanking period
- Follow-up
- Mean 2 years
Methodological detailsinvestigator-initiated, single-centre, non-inferiority, propensity-score matched
- Investigator-initiated
- Single-centre
- Non-inferiority
- Propensity-score matched
Main finding
As reported in the abstract
Hazard ratio
1.01
95% CI -∞ to 1.24
P = 0.005 for noninferiority
Events by group
HFrEFvs Without HFrEF
HR 1.01 (95% CI -∞ to 1.24); P = 0.005 for noninferiority
Observational data: associations, not effects.
Further findings
All-cause mortality · numerically higher with HFrEF
P = 0.07
Safety
Procedure-related safety events · similar between groups
P = 0.53
Original publication
Pulmonary Vein Isolation Only for Atrial Fibrillation With Heart Failure (POLAR-HF). JACC Clin Electrophysiol. Published 20 November 2025. doi:10.
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