Procedural performance between two cryoballoon systems for ablation of atrial fibrillation depends on pulmonary vein anatomy
Abstract Background Cryoballoon ablation is a first‐line therapy for atrial fibrillation. We compared the efficacy and safety of two ablation systems and addressed the influence of pulmonary vein (PV) anatomy on performance and outcome. Methods We consecutively enrolled 122 patients who were planned...
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crwiley:10.1002/joa3.12842 2024-06-09T07:44:20+00:00 Procedural performance between two cryoballoon systems for ablation of atrial fibrillation depends on pulmonary vein anatomy Menger, Vincent Frick, Michael Sharif‐Yakan, Ahmad Emrani, Mahdi Zink, Matthias Daniel Napp, Andreas Marx, Nikolaus Gramlich, Michael 2023 http://dx.doi.org/10.1002/joa3.12842 https://onlinelibrary.wiley.com/doi/pdf/10.1002/joa3.12842 https://onlinelibrary.wiley.com/doi/full-xml/10.1002/joa3.12842 en eng Wiley http://creativecommons.org/licenses/by/4.0/ Journal of Arrhythmia volume 39, issue 3, page 341-351 ISSN 1880-4276 1883-2148 journal-article 2023 crwiley https://doi.org/10.1002/joa3.12842 2024-05-16T14:26:34Z Abstract Background Cryoballoon ablation is a first‐line therapy for atrial fibrillation. We compared the efficacy and safety of two ablation systems and addressed the influence of pulmonary vein (PV) anatomy on performance and outcome. Methods We consecutively enrolled 122 patients who were planned for first‐time cryoballoon ablation. Patients were assigned 1:1 for ablation with the POLARx or the Arctic Front Advance Pro (AFAP) system and followed‐up for 12 months. Procedural parameters were recorded during the ablation. Before the procedure, a magnetic resonance angiography (MRA) of the PVs was generated and diameter, area, and shape of each PV ostium were assessed. We applied an evaluated PV anatomical scoring system on our MRA measurement data ranging from 0 (best anatomical combination) to 5. Results Procedures performed with POLARx were associated with shorter time to balloon temperature −30°C ( p < .001), lower balloon nadir temperature ( p < .001), and longer thawing time till 0°C ( p < .001) in all PVs, however, time to isolation was similar. We observed a decreasing performance with each increase in the score for the AFAP, whereas the POLARx performed constant regardless of the score. At 1 year, AF recurred in 14 of 44 patients treated with AFAP (31.8%) and in 10 of 45 patients treated with POLARx (22.2%) (hazard ratio, 0.61; 95% CI 0.28 to 1.37; p = .225). There was no significant correlation between PV anatomy and clinical outcome. Conclusion We found significant differences in cooling kinetics, especially when anatomical conditions are difficult. However, both systems have a comparable outcome and safety profile. Article in Journal/Newspaper Arctic Wiley Online Library Arctic Journal of Arrhythmia 39 3 341 351 |
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Abstract Background Cryoballoon ablation is a first‐line therapy for atrial fibrillation. We compared the efficacy and safety of two ablation systems and addressed the influence of pulmonary vein (PV) anatomy on performance and outcome. Methods We consecutively enrolled 122 patients who were planned for first‐time cryoballoon ablation. Patients were assigned 1:1 for ablation with the POLARx or the Arctic Front Advance Pro (AFAP) system and followed‐up for 12 months. Procedural parameters were recorded during the ablation. Before the procedure, a magnetic resonance angiography (MRA) of the PVs was generated and diameter, area, and shape of each PV ostium were assessed. We applied an evaluated PV anatomical scoring system on our MRA measurement data ranging from 0 (best anatomical combination) to 5. Results Procedures performed with POLARx were associated with shorter time to balloon temperature −30°C ( p < .001), lower balloon nadir temperature ( p < .001), and longer thawing time till 0°C ( p < .001) in all PVs, however, time to isolation was similar. We observed a decreasing performance with each increase in the score for the AFAP, whereas the POLARx performed constant regardless of the score. At 1 year, AF recurred in 14 of 44 patients treated with AFAP (31.8%) and in 10 of 45 patients treated with POLARx (22.2%) (hazard ratio, 0.61; 95% CI 0.28 to 1.37; p = .225). There was no significant correlation between PV anatomy and clinical outcome. Conclusion We found significant differences in cooling kinetics, especially when anatomical conditions are difficult. However, both systems have a comparable outcome and safety profile. |
format |
Article in Journal/Newspaper |
author |
Menger, Vincent Frick, Michael Sharif‐Yakan, Ahmad Emrani, Mahdi Zink, Matthias Daniel Napp, Andreas Marx, Nikolaus Gramlich, Michael |
spellingShingle |
Menger, Vincent Frick, Michael Sharif‐Yakan, Ahmad Emrani, Mahdi Zink, Matthias Daniel Napp, Andreas Marx, Nikolaus Gramlich, Michael Procedural performance between two cryoballoon systems for ablation of atrial fibrillation depends on pulmonary vein anatomy |
author_facet |
Menger, Vincent Frick, Michael Sharif‐Yakan, Ahmad Emrani, Mahdi Zink, Matthias Daniel Napp, Andreas Marx, Nikolaus Gramlich, Michael |
author_sort |
Menger, Vincent |
title |
Procedural performance between two cryoballoon systems for ablation of atrial fibrillation depends on pulmonary vein anatomy |
title_short |
Procedural performance between two cryoballoon systems for ablation of atrial fibrillation depends on pulmonary vein anatomy |
title_full |
Procedural performance between two cryoballoon systems for ablation of atrial fibrillation depends on pulmonary vein anatomy |
title_fullStr |
Procedural performance between two cryoballoon systems for ablation of atrial fibrillation depends on pulmonary vein anatomy |
title_full_unstemmed |
Procedural performance between two cryoballoon systems for ablation of atrial fibrillation depends on pulmonary vein anatomy |
title_sort |
procedural performance between two cryoballoon systems for ablation of atrial fibrillation depends on pulmonary vein anatomy |
publisher |
Wiley |
publishDate |
2023 |
url |
http://dx.doi.org/10.1002/joa3.12842 https://onlinelibrary.wiley.com/doi/pdf/10.1002/joa3.12842 https://onlinelibrary.wiley.com/doi/full-xml/10.1002/joa3.12842 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Journal of Arrhythmia volume 39, issue 3, page 341-351 ISSN 1880-4276 1883-2148 |
op_rights |
http://creativecommons.org/licenses/by/4.0/ |
op_doi |
https://doi.org/10.1002/joa3.12842 |
container_title |
Journal of Arrhythmia |
container_volume |
39 |
container_issue |
3 |
container_start_page |
341 |
op_container_end_page |
351 |
_version_ |
1801373087878348800 |