The following is a summary of “Comparison of Arctic Front Advance Pro and POLARx cryoballoons for ablation therapy of atrial fibrillation: an intraprocedural analysis,” published in the February 2024 issue of Cardiology by Knappe et al.
The cryoballoon (CB) ablation technique has gained popularity as a means of achieving pulmonary vein isolation (PVI) during the treatment of atrial fibrillation (AF).
Researchers conducted a retrospective study to evaluate and compare the intraprocedural ablation characteristics of two CBs, the Arctic Front Advance Pro™ (AFA-Pro, Medtronic) and POLARx™ (Boston Scientific).
They conducted a retrospective single-center study involving 230 symptomatic patients with paroxysmal or persistent AF who underwent CB ablation using either AFA-Pro or POLARx. Through propensity-score matching, two cohorts of 114 patients each were established, with comparable baseline and procedural characteristics for both CBs. POLARx exhibited lower minimal temperatures (e.g., left superior pulmonary vein, LSPV: AFA-Pro − 49.0°C vs POLARx − 59.5 °C), and lower temperatures at time-to-isolation (TTI). POLARx reached lower temperatures more rapidly, demonstrated by decreased temperatures after 40 and 60 s, along with a greater mean temperature change between 20 and 40 s. POLARx also displayed a larger area under the curve below 0°C and a prolonged thawing phase. Despite these differences, both CBs achieved similarly high rates of final PV-isolation.
The results showed that TTI, minimal esophagus temperature, and first-pass isolation rates were comparable between the two groups. Periprocedural complications, including phrenic nerve injuries, were similar as well. Elevated troponin levels in the left atrium were observed with both CB systems. While troponin values and changes tended to be higher in the POLARx group (delta troponin: AFA-Pro 36.3 (26.4, 125.4) ng/L vs. POLARx 104.9 (49.5, 122.2) ng/L), the difference did not reach statistical significance (P=0.077).
Investigators concluded that Despite differences in freezing characteristics and myocardial injury markers, AFA-Pro and POLARx exhibit comparable performance, procedural efficiency, and safety profiles for PVI in AF ablation therapy.
Source: link.springer.com/article/10.1007/s00392-024-02398-2