Comparison of procedural efficacy, balloon nadir temperature, and incidence of phrenic nerve palsy between two cryoballoon technologies for pulmonary vein isolation: A systematic review and meta-analysis

Amira Assaf, Rohit Bhagwandien, Tamas Szili-Torok, Sing Chien Yap*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Scopus)
55 Downloads (Pure)

Abstract

Introduction: In May 2020, a novel cryoballoon system (POLARx; Boston Scientific) became available for catheter ablation of atrial fibrillation (AF). The design of the cryoballoon is comparable to the Arctic Front Advance Pro (AFA-Pro; Medtronic), but it is more compliant during freezing. We compared the procedural efficacy, biophysical parameters, and risk of phrenic nerve palsy (PNP) between the two cryoballoons. Methods: Embase, MEDLINE, Web of Science, Cochrane, and Google Scholar databases were searched until June 1, 2021 for relevant studies comparing POLARx versus AFA-Pro in patients undergoing pulmonary vein isolation (PVI) for AF. Results: A total of four studies, involving 310 patients were included. There was no difference between the two groups for outcomes regarding procedural efficacy: acute PVI (odds ratio [OR]: 0.43; 95% confidence interval [CI]: 0.06 to 3.03; p =.40), procedure time (mean difference [MD]: 8.15 min; 95% CI: −8.09 to 24.39; p =.33), fluoroscopy time (MD: 1.32 min; 95% CI: −1.61 to 4.25; p =.38) and ablation time (MD: 1.00 min; 95% CI: −0.20 to 2.20; p =.10). The balloon nadir temperature was lower for all individual pulmonary veins (PV) in POLARx compared with AFA-Pro (MD: −9.74°C, −9.98°C, −6.72°C, −7.76°C, for left superior PV, left inferior PV, right superior PV, and right inferior PV, respectively; all p <.001). The incidence of PNP was similar between groups (OR: 0.79; 95% CI: 0.22 to 2.85; p =.72). Conclusion: In AF patients undergoing PVI, POLARx and AFA-Pro had a similar procedural efficacy. Balloon nadir temperatures were lower with POLARx, however, the incidence of PNP was similar.

Original languageEnglish
Pages (from-to)2424-2431
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume32
Issue number9
Early online date21 Jul 2021
DOIs
Publication statusPublished - Sep 2021

Bibliographical note

Funding Information:
Sing‐Chien Yap is a consultant for Boston Scientific and has received a research grant from Medtronic. Other authors: No disclosures. Disclosures:

ACKNOWLEDGMENTS:
The authors wish to thank Maarten F. M. Engel, PhD, from the Erasmus MC Medical Library for developing and updating the search strategies.

Publisher Copyright:
© 2021 The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals LLC.

Fingerprint

Dive into the research topics of 'Comparison of procedural efficacy, balloon nadir temperature, and incidence of phrenic nerve palsy between two cryoballoon technologies for pulmonary vein isolation: A systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this