Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience.
AIMS: Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation for atrial fibrillation (AF). There are limited data on the PolarX Cryoballoon. The study aimed to establish the safety, efficacy, and feasibility of same day discharge for Cryoballoon PVI. METHODS AND RESULTS: Multi-centre...
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2023
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ftunivcam:oai:www.repository.cam.ac.uk:1810/361005 2023-12-17T10:25:50+01:00 Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience. Honarbakhsh, Shohreh Martin, Claire A Mesquita, Joao Herlekar, Rahul Till, Richard Srinivasan, Neil T Duncan, Edward Leong, Fong Dulai, Rajdip Veasey, Rick Panikker, Sandeep Paisey, John Ramgopal, Balasubramanian Das, Moloy Ahmed, Wissam Sahu, Jonathan Earley, Mark J Finlay, Malcolm C Schilling, Richard J Hunter, Ross J 2023-11-16T18:45:24Z application/zip application/pdf text/xml https://www.repository.cam.ac.uk/handle/1810/361005 en eng Oxford University Press (OUP) http://dx.doi.org/10.1093/europace/euad286 Europace https://www.repository.cam.ac.uk/handle/1810/361005 Atrial fibrillation Cryoablation Novel technology Pulmonary vein isolation Humans Cryosurgery Treatment Outcome Time Factors Pulmonary Veins Catheter Ablation United Kingdom Recurrence Article 2023 ftunivcam 2023-11-23T23:19:15Z AIMS: Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation for atrial fibrillation (AF). There are limited data on the PolarX Cryoballoon. The study aimed to establish the safety, efficacy, and feasibility of same day discharge for Cryoballoon PVI. METHODS AND RESULTS: Multi-centre study across 12 centres. Procedural metrics, safety profile, and procedural efficacy of the PolarX Cryoballoon with the Arctic Front Advance (AFA) Cryoballoon were compared in a cohort large enough to provide definitive comparative data. A total of 1688 patients underwent PVI with cryoablation (50% PolarX and 50% AFA). Successful PVI was achieved with 1677 (99.3%) patients with 97.2% (n = 1641) performed as day case procedures with a complication rate of <1%. Safety, procedural metrics, and efficacy of the PolarX Cryoballoon were comparable with the AFA cohort. The PolarX Cryoballoon demonstrated a nadir temperature of -54.6 ± 7.6°C, temperature at 30 s of -38.6 ± 7.2°C, time to -40°C of 34.1 ± 13.7 s, and time to isolation of 49.8 ± 33.2 s. Independent predictors for achieving PVI included time to reach -40°C [odds ratio (OR) 1.34; P < 0.001] and nadir temperature (OR 1.24; P < 0.001) with an optimal cut-off of ≤34 s [area under the curve (AUC) 0.73; P < 0.001] and nadir temperature of ≤-54.0°C (AUC 0.71; P < 0.001), respectively. CONCLUSIONS: This large-scale UK multi-centre study has shown that Cryoballoon PVI is a safe, effective day case procedure. PVI using the PolarX Cryoballoon was similarly safe and effective as the AFA Cryoballoon. The cryoablation metrics achieved with the PolarX Cryoballoon were different to that reported with the AFA Cryoballoon. Modified cryoablation targets are required when utilizing the PolarX Cryoballoon. Article in Journal/Newspaper Arctic Apollo - University of Cambridge Repository Arctic |
institution |
Open Polar |
collection |
Apollo - University of Cambridge Repository |
op_collection_id |
ftunivcam |
language |
English |
topic |
Atrial fibrillation Cryoablation Novel technology Pulmonary vein isolation Humans Cryosurgery Treatment Outcome Time Factors Pulmonary Veins Catheter Ablation United Kingdom Recurrence |
spellingShingle |
Atrial fibrillation Cryoablation Novel technology Pulmonary vein isolation Humans Cryosurgery Treatment Outcome Time Factors Pulmonary Veins Catheter Ablation United Kingdom Recurrence Honarbakhsh, Shohreh Martin, Claire A Mesquita, Joao Herlekar, Rahul Till, Richard Srinivasan, Neil T Duncan, Edward Leong, Fong Dulai, Rajdip Veasey, Rick Panikker, Sandeep Paisey, John Ramgopal, Balasubramanian Das, Moloy Ahmed, Wissam Sahu, Jonathan Earley, Mark J Finlay, Malcolm C Schilling, Richard J Hunter, Ross J Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience. |
topic_facet |
Atrial fibrillation Cryoablation Novel technology Pulmonary vein isolation Humans Cryosurgery Treatment Outcome Time Factors Pulmonary Veins Catheter Ablation United Kingdom Recurrence |
description |
AIMS: Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation for atrial fibrillation (AF). There are limited data on the PolarX Cryoballoon. The study aimed to establish the safety, efficacy, and feasibility of same day discharge for Cryoballoon PVI. METHODS AND RESULTS: Multi-centre study across 12 centres. Procedural metrics, safety profile, and procedural efficacy of the PolarX Cryoballoon with the Arctic Front Advance (AFA) Cryoballoon were compared in a cohort large enough to provide definitive comparative data. A total of 1688 patients underwent PVI with cryoablation (50% PolarX and 50% AFA). Successful PVI was achieved with 1677 (99.3%) patients with 97.2% (n = 1641) performed as day case procedures with a complication rate of <1%. Safety, procedural metrics, and efficacy of the PolarX Cryoballoon were comparable with the AFA cohort. The PolarX Cryoballoon demonstrated a nadir temperature of -54.6 ± 7.6°C, temperature at 30 s of -38.6 ± 7.2°C, time to -40°C of 34.1 ± 13.7 s, and time to isolation of 49.8 ± 33.2 s. Independent predictors for achieving PVI included time to reach -40°C [odds ratio (OR) 1.34; P < 0.001] and nadir temperature (OR 1.24; P < 0.001) with an optimal cut-off of ≤34 s [area under the curve (AUC) 0.73; P < 0.001] and nadir temperature of ≤-54.0°C (AUC 0.71; P < 0.001), respectively. CONCLUSIONS: This large-scale UK multi-centre study has shown that Cryoballoon PVI is a safe, effective day case procedure. PVI using the PolarX Cryoballoon was similarly safe and effective as the AFA Cryoballoon. The cryoablation metrics achieved with the PolarX Cryoballoon were different to that reported with the AFA Cryoballoon. Modified cryoablation targets are required when utilizing the PolarX Cryoballoon. |
format |
Article in Journal/Newspaper |
author |
Honarbakhsh, Shohreh Martin, Claire A Mesquita, Joao Herlekar, Rahul Till, Richard Srinivasan, Neil T Duncan, Edward Leong, Fong Dulai, Rajdip Veasey, Rick Panikker, Sandeep Paisey, John Ramgopal, Balasubramanian Das, Moloy Ahmed, Wissam Sahu, Jonathan Earley, Mark J Finlay, Malcolm C Schilling, Richard J Hunter, Ross J |
author_facet |
Honarbakhsh, Shohreh Martin, Claire A Mesquita, Joao Herlekar, Rahul Till, Richard Srinivasan, Neil T Duncan, Edward Leong, Fong Dulai, Rajdip Veasey, Rick Panikker, Sandeep Paisey, John Ramgopal, Balasubramanian Das, Moloy Ahmed, Wissam Sahu, Jonathan Earley, Mark J Finlay, Malcolm C Schilling, Richard J Hunter, Ross J |
author_sort |
Honarbakhsh, Shohreh |
title |
Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience. |
title_short |
Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience. |
title_full |
Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience. |
title_fullStr |
Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience. |
title_full_unstemmed |
Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience. |
title_sort |
atrial fibrillation cryoablation is an effective day case treatment: the uk polarx vs. arctic front advance experience. |
publisher |
Oxford University Press (OUP) |
publishDate |
2023 |
url |
https://www.repository.cam.ac.uk/handle/1810/361005 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_relation |
https://www.repository.cam.ac.uk/handle/1810/361005 |
_version_ |
1785577510259392512 |