PolarX Cryoballoon metrics predicting successful pulmonary vein isolation: targets for ablation of atrial fibrillation
AIM: Evaluate the novel PolarX Cryoballoon in atrial fibrillation (AF) catheter ablation through a propensity-matched comparison with the Arctic Front Advance (AFA). The aim was also to identify cryoablation metrics that are predictive of successful pulmonary vein isolation (PVI) with the PolarX Cry...
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OXFORD UNIV PRESS
2022
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Online Access: | https://discovery.ucl.ac.uk/id/eprint/10160229/2/Bebiano%20Da%20Providencia%20E%20Costa_PolarXvs4%20%281%29.pdf https://discovery.ucl.ac.uk/id/eprint/10160229/ |
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ftucl:oai:eprints.ucl.ac.uk.OAI2:10160229 2023-12-24T10:14:37+01:00 PolarX Cryoballoon metrics predicting successful pulmonary vein isolation: targets for ablation of atrial fibrillation Honarbakhsh, Shohreh Earley, Mark J Martin, Claire A Creta, Antonio Sohaib, Afzal Ang, Richard Butcher, Charles Waddingham, Peter H Dhinoja, Mehul Lim, Wei Srinivasan, Neil T Providencia, Rui Kanthasamy, Vijayabharathy Sporton, Simon Chow, Anthony Lambiase, Pier D Schilling, Richard J Finlay, Malcolm C Hunter, Ross J 2022-09 text https://discovery.ucl.ac.uk/id/eprint/10160229/2/Bebiano%20Da%20Providencia%20E%20Costa_PolarXvs4%20%281%29.pdf https://discovery.ucl.ac.uk/id/eprint/10160229/ eng eng OXFORD UNIV PRESS https://discovery.ucl.ac.uk/id/eprint/10160229/2/Bebiano%20Da%20Providencia%20E%20Costa_PolarXvs4%20%281%29.pdf https://discovery.ucl.ac.uk/id/eprint/10160229/ open Europace , 24 (9) pp. 1420-1429. (2022) Atrial fibrillation Cryoablation Novel technology Pulmonary vein isolation Article 2022 ftucl 2023-11-27T13:07:36Z AIM: Evaluate the novel PolarX Cryoballoon in atrial fibrillation (AF) catheter ablation through a propensity-matched comparison with the Arctic Front Advance (AFA). The aim was also to identify cryoablation metrics that are predictive of successful pulmonary vein isolation (PVI) with the PolarX Cryoballoon. METHODS AND RESULTS: This prospective multi-centre study included patients that underwent cryoablation for AF. All patients underwent PVI with reconnection assessed after a 30-min waiting period and adenosine. Safety, efficacy, and cryoablation metrics were compared between PolarX and a propensity-matched AFA cohort. Seventy patients were included with 278 veins treated. In total, 359 cryoablations were performed (1.3 ± 0.6 per vein) to achieve initial PVI with 205 (73.7%) veins isolating with a single cryoablation. Independent predictors for achieving initial PVI included temperature at 30 s [odds ratio (OR) 1.26; P = 0.003] and time to reach -40°C (OR 1.88; P < 0.001) with an optimal cut-off of ≤-38.5°C at 30 s [area under the curve (AUC) 0.79; P < 0.001] and ≤-40°C at ≤32.5 s (AUC 0.77; P < 0.001), respectively. Of the 278 veins, 46 (16.5%) veins showed acute reconnection. Temperature at 30 s (≤-39.5°C, OR 1.24; P = 0.002), nadir temperature (≤-53.5°C, OR 1.35; P = 0.003), and time to isolation (≤38.0 s, OR 1.18; P = 0.009) were independent predictors of sustained PVI. Combining two of these three targets was associated with reconnection in only 2-5% of PVs. Efficacy and safety of the PolarX Cryoballoon were comparable to AFA Cryoballoon, however, cryoablation metrics were significantly different. CONCLUSIONS: The PolarX Cryoballoon has a different cryoablation profile to AFA Cryoballoon. Prospective testing of these proposed targets in large outcomes studies is required. Article in Journal/Newspaper Arctic University College London: UCL Discovery Arctic |
institution |
Open Polar |
collection |
University College London: UCL Discovery |
op_collection_id |
ftucl |
language |
English |
topic |
Atrial fibrillation Cryoablation Novel technology Pulmonary vein isolation |
spellingShingle |
Atrial fibrillation Cryoablation Novel technology Pulmonary vein isolation Honarbakhsh, Shohreh Earley, Mark J Martin, Claire A Creta, Antonio Sohaib, Afzal Ang, Richard Butcher, Charles Waddingham, Peter H Dhinoja, Mehul Lim, Wei Srinivasan, Neil T Providencia, Rui Kanthasamy, Vijayabharathy Sporton, Simon Chow, Anthony Lambiase, Pier D Schilling, Richard J Finlay, Malcolm C Hunter, Ross J PolarX Cryoballoon metrics predicting successful pulmonary vein isolation: targets for ablation of atrial fibrillation |
topic_facet |
Atrial fibrillation Cryoablation Novel technology Pulmonary vein isolation |
description |
AIM: Evaluate the novel PolarX Cryoballoon in atrial fibrillation (AF) catheter ablation through a propensity-matched comparison with the Arctic Front Advance (AFA). The aim was also to identify cryoablation metrics that are predictive of successful pulmonary vein isolation (PVI) with the PolarX Cryoballoon. METHODS AND RESULTS: This prospective multi-centre study included patients that underwent cryoablation for AF. All patients underwent PVI with reconnection assessed after a 30-min waiting period and adenosine. Safety, efficacy, and cryoablation metrics were compared between PolarX and a propensity-matched AFA cohort. Seventy patients were included with 278 veins treated. In total, 359 cryoablations were performed (1.3 ± 0.6 per vein) to achieve initial PVI with 205 (73.7%) veins isolating with a single cryoablation. Independent predictors for achieving initial PVI included temperature at 30 s [odds ratio (OR) 1.26; P = 0.003] and time to reach -40°C (OR 1.88; P < 0.001) with an optimal cut-off of ≤-38.5°C at 30 s [area under the curve (AUC) 0.79; P < 0.001] and ≤-40°C at ≤32.5 s (AUC 0.77; P < 0.001), respectively. Of the 278 veins, 46 (16.5%) veins showed acute reconnection. Temperature at 30 s (≤-39.5°C, OR 1.24; P = 0.002), nadir temperature (≤-53.5°C, OR 1.35; P = 0.003), and time to isolation (≤38.0 s, OR 1.18; P = 0.009) were independent predictors of sustained PVI. Combining two of these three targets was associated with reconnection in only 2-5% of PVs. Efficacy and safety of the PolarX Cryoballoon were comparable to AFA Cryoballoon, however, cryoablation metrics were significantly different. CONCLUSIONS: The PolarX Cryoballoon has a different cryoablation profile to AFA Cryoballoon. Prospective testing of these proposed targets in large outcomes studies is required. |
format |
Article in Journal/Newspaper |
author |
Honarbakhsh, Shohreh Earley, Mark J Martin, Claire A Creta, Antonio Sohaib, Afzal Ang, Richard Butcher, Charles Waddingham, Peter H Dhinoja, Mehul Lim, Wei Srinivasan, Neil T Providencia, Rui Kanthasamy, Vijayabharathy Sporton, Simon Chow, Anthony Lambiase, Pier D Schilling, Richard J Finlay, Malcolm C Hunter, Ross J |
author_facet |
Honarbakhsh, Shohreh Earley, Mark J Martin, Claire A Creta, Antonio Sohaib, Afzal Ang, Richard Butcher, Charles Waddingham, Peter H Dhinoja, Mehul Lim, Wei Srinivasan, Neil T Providencia, Rui Kanthasamy, Vijayabharathy Sporton, Simon Chow, Anthony Lambiase, Pier D Schilling, Richard J Finlay, Malcolm C Hunter, Ross J |
author_sort |
Honarbakhsh, Shohreh |
title |
PolarX Cryoballoon metrics predicting successful pulmonary vein isolation: targets for ablation of atrial fibrillation |
title_short |
PolarX Cryoballoon metrics predicting successful pulmonary vein isolation: targets for ablation of atrial fibrillation |
title_full |
PolarX Cryoballoon metrics predicting successful pulmonary vein isolation: targets for ablation of atrial fibrillation |
title_fullStr |
PolarX Cryoballoon metrics predicting successful pulmonary vein isolation: targets for ablation of atrial fibrillation |
title_full_unstemmed |
PolarX Cryoballoon metrics predicting successful pulmonary vein isolation: targets for ablation of atrial fibrillation |
title_sort |
polarx cryoballoon metrics predicting successful pulmonary vein isolation: targets for ablation of atrial fibrillation |
publisher |
OXFORD UNIV PRESS |
publishDate |
2022 |
url |
https://discovery.ucl.ac.uk/id/eprint/10160229/2/Bebiano%20Da%20Providencia%20E%20Costa_PolarXvs4%20%281%29.pdf https://discovery.ucl.ac.uk/id/eprint/10160229/ |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Europace , 24 (9) pp. 1420-1429. (2022) |
op_relation |
https://discovery.ucl.ac.uk/id/eprint/10160229/2/Bebiano%20Da%20Providencia%20E%20Costa_PolarXvs4%20%281%29.pdf https://discovery.ucl.ac.uk/id/eprint/10160229/ |
op_rights |
open |
_version_ |
1786195868263645184 |