Incidence of phrenic nerve injury during pulmonary vein isolation using different cryoballoons: data from a large prospective ablation registry
Abstract Aims Phrenic nerve injury (PNI) is the most common complication during cryoballoon ablation. Currently, two cryoballoon systems are available, yet the difference is unclear. We sought to compare the acute procedural efficacy and safety of the two cryoballoons. Methods This prospective obser...
Published in: | Europace |
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Format: | Article in Journal/Newspaper |
Language: | English |
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Oxford University Press (OUP)
2024
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Online Access: | http://dx.doi.org/10.1093/europace/euae092 https://academic.oup.com/europace/advance-article-pdf/doi/10.1093/europace/euae092/57184658/euae092.pdf https://academic.oup.com/europace/article-pdf/26/4/euae092/57352477/euae092.pdf |
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croxfordunivpr:10.1093/europace/euae092 2024-05-19T07:36:36+00:00 Incidence of phrenic nerve injury during pulmonary vein isolation using different cryoballoons: data from a large prospective ablation registry Tachibana, Shinichi Miyazaki, Shinsuke Nitta, Junichi Shirai, Yasuhiro Nagata, Yasutoshi Sagawa, Yuichiro Sekiguchi, Yukio Inamura, Yukihiro Sasaki, Takeshi Yamauchi, Yasuteru Inaba, Osamu Ono, Yuichi Suzuki, Makoto Suzuki, Atsushi Iwai, Shinsuke Okada, Hiroyuki Mizukami, Akira Azegami, Koji Hachiya, Hitoshi Handa, Keita Goto, Kentaro Nishimura, Takuro Hirao, Kenzo Takahashi, Atsushi Sasano, Tetsuo 2024 http://dx.doi.org/10.1093/europace/euae092 https://academic.oup.com/europace/advance-article-pdf/doi/10.1093/europace/euae092/57184658/euae092.pdf https://academic.oup.com/europace/article-pdf/26/4/euae092/57352477/euae092.pdf en eng Oxford University Press (OUP) https://creativecommons.org/licenses/by/4.0/ Europace volume 26, issue 4 ISSN 1099-5129 1532-2092 journal-article 2024 croxfordunivpr https://doi.org/10.1093/europace/euae092 2024-05-02T09:30:28Z Abstract Aims Phrenic nerve injury (PNI) is the most common complication during cryoballoon ablation. Currently, two cryoballoon systems are available, yet the difference is unclear. We sought to compare the acute procedural efficacy and safety of the two cryoballoons. Methods This prospective observational study consisted of 2,555 consecutive atrial fibrillation (AF) patients undergoing pulmonary vein isolation (PVI) using either conventional (Arctic Front Advance) (AFA-CB) or novel cryoballoons (POLARx) (POLARx-CB) at 19 centers between January 2022 and October 2023. Results Among 2,555 patients (68.8 ± 10.9 years, 1,740 men, paroxysmal AF[PAF] 1,670 patients), PVIs were performed by the AFA-CB and POLARx-CB in 1,358 and 1,197 patients, respectively. Touch-up ablation was required in 299(11.7%) patients. The touch-up rate was significantly lower for POLARx-CB than AFA-CB (9.5% vs. 13.6%, p = 0.002), especially for right inferior PVs (RIPVs). The touch-up rate was significantly lower for PAF than non-PAF (8.8% vs. 17.2%, P < 0.001) and was similar between the two cryoballoons in non-PAF patients. Right PNI occurred in 64(2.5%) patients and 22(0.9%) were symptomatic. It occurred during the right superior PV (RSPV) ablation in 39(1.5%) patients. The incidence was significantly higher for POLARx-CB than AFA-CB (3.8% vs. 1.3%, P < 0.001) as was the incidence of symptomatic PNI (1.7% vs. 0.1%, P < 0.001). The difference was significant during RSPV (2.5% vs. 0.7%, P < 0.001) but not RIPV ablation. The PNI recovered more quickly for the AFA-CB than POLARx-CB. Conclusions 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. Article in Journal/Newspaper Arctic Oxford University Press Europace 26 4 |
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Open Polar |
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Oxford University Press |
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croxfordunivpr |
language |
English |
description |
Abstract Aims Phrenic nerve injury (PNI) is the most common complication during cryoballoon ablation. Currently, two cryoballoon systems are available, yet the difference is unclear. We sought to compare the acute procedural efficacy and safety of the two cryoballoons. Methods This prospective observational study consisted of 2,555 consecutive atrial fibrillation (AF) patients undergoing pulmonary vein isolation (PVI) using either conventional (Arctic Front Advance) (AFA-CB) or novel cryoballoons (POLARx) (POLARx-CB) at 19 centers between January 2022 and October 2023. Results Among 2,555 patients (68.8 ± 10.9 years, 1,740 men, paroxysmal AF[PAF] 1,670 patients), PVIs were performed by the AFA-CB and POLARx-CB in 1,358 and 1,197 patients, respectively. Touch-up ablation was required in 299(11.7%) patients. The touch-up rate was significantly lower for POLARx-CB than AFA-CB (9.5% vs. 13.6%, p = 0.002), especially for right inferior PVs (RIPVs). The touch-up rate was significantly lower for PAF than non-PAF (8.8% vs. 17.2%, P < 0.001) and was similar between the two cryoballoons in non-PAF patients. Right PNI occurred in 64(2.5%) patients and 22(0.9%) were symptomatic. It occurred during the right superior PV (RSPV) ablation in 39(1.5%) patients. The incidence was significantly higher for POLARx-CB than AFA-CB (3.8% vs. 1.3%, P < 0.001) as was the incidence of symptomatic PNI (1.7% vs. 0.1%, P < 0.001). The difference was significant during RSPV (2.5% vs. 0.7%, P < 0.001) but not RIPV ablation. The PNI recovered more quickly for the AFA-CB than POLARx-CB. Conclusions 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. |
format |
Article in Journal/Newspaper |
author |
Tachibana, Shinichi Miyazaki, Shinsuke Nitta, Junichi Shirai, Yasuhiro Nagata, Yasutoshi Sagawa, Yuichiro Sekiguchi, Yukio Inamura, Yukihiro Sasaki, Takeshi Yamauchi, Yasuteru Inaba, Osamu Ono, Yuichi Suzuki, Makoto Suzuki, Atsushi Iwai, Shinsuke Okada, Hiroyuki Mizukami, Akira Azegami, Koji Hachiya, Hitoshi Handa, Keita Goto, Kentaro Nishimura, Takuro Hirao, Kenzo Takahashi, Atsushi Sasano, Tetsuo |
spellingShingle |
Tachibana, Shinichi Miyazaki, Shinsuke Nitta, Junichi Shirai, Yasuhiro Nagata, Yasutoshi Sagawa, Yuichiro Sekiguchi, Yukio Inamura, Yukihiro Sasaki, Takeshi Yamauchi, Yasuteru Inaba, Osamu Ono, Yuichi Suzuki, Makoto Suzuki, Atsushi Iwai, Shinsuke Okada, Hiroyuki Mizukami, Akira Azegami, Koji Hachiya, Hitoshi Handa, Keita Goto, Kentaro Nishimura, Takuro Hirao, Kenzo Takahashi, Atsushi Sasano, Tetsuo Incidence of phrenic nerve injury during pulmonary vein isolation using different cryoballoons: data from a large prospective ablation registry |
author_facet |
Tachibana, Shinichi Miyazaki, Shinsuke Nitta, Junichi Shirai, Yasuhiro Nagata, Yasutoshi Sagawa, Yuichiro Sekiguchi, Yukio Inamura, Yukihiro Sasaki, Takeshi Yamauchi, Yasuteru Inaba, Osamu Ono, Yuichi Suzuki, Makoto Suzuki, Atsushi Iwai, Shinsuke Okada, Hiroyuki Mizukami, Akira Azegami, Koji Hachiya, Hitoshi Handa, Keita Goto, Kentaro Nishimura, Takuro Hirao, Kenzo Takahashi, Atsushi Sasano, Tetsuo |
author_sort |
Tachibana, Shinichi |
title |
Incidence of phrenic nerve injury during pulmonary vein isolation using different cryoballoons: data from a large prospective ablation registry |
title_short |
Incidence of phrenic nerve injury during pulmonary vein isolation using different cryoballoons: data from a large prospective ablation registry |
title_full |
Incidence of phrenic nerve injury during pulmonary vein isolation using different cryoballoons: data from a large prospective ablation registry |
title_fullStr |
Incidence of phrenic nerve injury during pulmonary vein isolation using different cryoballoons: data from a large prospective ablation registry |
title_full_unstemmed |
Incidence of phrenic nerve injury during pulmonary vein isolation using different cryoballoons: data from a large prospective ablation registry |
title_sort |
incidence of phrenic nerve injury during pulmonary vein isolation using different cryoballoons: data from a large prospective ablation registry |
publisher |
Oxford University Press (OUP) |
publishDate |
2024 |
url |
http://dx.doi.org/10.1093/europace/euae092 https://academic.oup.com/europace/advance-article-pdf/doi/10.1093/europace/euae092/57184658/euae092.pdf https://academic.oup.com/europace/article-pdf/26/4/euae092/57352477/euae092.pdf |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Europace volume 26, issue 4 ISSN 1099-5129 1532-2092 |
op_rights |
https://creativecommons.org/licenses/by/4.0/ |
op_doi |
https://doi.org/10.1093/europace/euae092 |
container_title |
Europace |
container_volume |
26 |
container_issue |
4 |
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1799475722259005440 |