Comparative Study of Arctic Front Advance Pro and POLARx Cryoballoons for Linear Ablation of the Left Atrial Roof.

IF 1.7 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Pace-Pacing and Clinical Electrophysiology Pub Date : 2024-11-27 DOI:10.1111/pace.15112

Takatoshi Shigeta, Yuichiro Sagawa, Hirofumi Arai, Atsuhito Oda, Koji Sudo, Kazuya Murata, Kaoru Okishige, Manabu Kurabayashi, Masahiko Goya, Tetsuo Sasano, Yasuteru Yamauchi

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Abstract

Background: The effectiveness of cryoballoon ablation (CBA) of the left atrial (LA) roof in addition to pulmonary vein isolation (PVI) using a novel cryoballoon catheter, POLARx, remains unclear.

Methods: This study compared the efficacy of LA roof line ablation and PVI using POLARx (Boston Scientific) or AFA-Pro (Medtronic) in 100 patients with persistent atrial fibrillation. The right superior pulmonary vein (PV) anchoring and raise-up techniques were consistently used for LA roof line ablation, and rapid right ventricular pacing was applied if the cryoballoon temperature did not reach -40°C.

Results: Complete conduction block at the LA roof could be obtained in all patients with POLARx and in 98.0% of patients with AFA-Pro. Rapid right ventricular pacing was needed in 64.0% of patients with AFA-Pro and in no patients with POLARx. During LA roof line ablation, the nadir cryoballoon temperature was significantly lower with POLARx than with AFA-Pro (right: -54.2°C ± 4.4°C vs. -46.0°C ± 5.4°C; central: -56.8°C ± 4.4°C vs. -45.7°C ± 4.8°C; left: -56.1°C ± 4.3°C vs. -46.1°C ± 5.7°C), and the cryoballoon temperature reached -40°C earlier with POLARx than with AFA-Pro (right: 30.8 ± 7.4 s vs. 74.1 ± 37.7 s; central: 28.2 ± 5.2 s vs. 62.9 ± 30.9 s; left: 29.8 ± 5.8 s vs. 69.6 ± 40.7 s).

Conclusion: The nadir cryoballoon temperature with POLARx was approximately 10°C lower than with AFA-Pro, consistently dropping below -40°C during LA roof line CBA. Thus, a complete conduction block of the LA roof line can be easily accomplished using right superior PV anchoring and the raise-up techniques without the need for rapid right ventricular pacing with POLARx.

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Arctic Front Advance Pro 和 POLARx 低温球囊用于左心房顶部线性消融的比较研究

背景：在使用新型冷冻气球导管 POLARx 进行肺静脉隔离术（PVI）的同时进行左心房（LA）房顶冷冻气球消融术（CBA）的有效性仍不明确：本研究比较了在 100 名持续性心房颤动患者中使用 POLARx（波士顿科学公司）或 AFA-Pro（美敦力公司）进行 LA 房顶线消融和 PVI 的疗效。LA 屋顶线消融始终使用右上肺静脉 (PV) 固定和提升技术，如果冷冻球囊温度未达到 -40°C，则使用快速右心室起搏：所有使用 POLARx 的患者和 98.0% 使用 AFA-Pro 的患者都能获得 LA 室顶完全传导阻滞。64.0%的 AFA-Pro 患者需要快速右心室起搏，没有 POLARx 患者需要快速右心室起搏。在 LA 顶线消融过程中，POLARx 的低温球囊最低温度明显低于 AFA-Pro（右侧：-54.2°C ± 4.4°C vs. -46.0°C ± 5.4°C；中央：-56.8°C ± 4.4°C vs. -45.7°C ± 4.8°C；左侧：-56.1°C ± 4.3°C vs. -46.1°C ± 5.4°C）。-与 AFA-Pro 相比，POLARx 的低温球囊温度更早达到 -40°C（右侧：30.8 ± 7.4 秒 vs. 74.1 ± 37.7 秒；中部：28.2 ± 5.2 秒 vs. 62.9 ± 30.9 秒；左侧：29.8 ± 5.8 秒 vs. 69.6 ± 40.7 秒）：结论：使用 POLARx 时的低温球囊最低温度比使用 AFA-Pro 时低约 10°C，在 LA 屋顶线 CBA 期间持续低于 -40°C。因此，使用 POLARx，无需快速右心室起搏，即可通过右上 PV 锚定和升高技术轻松实现 LA 顶线的完全传导阻滞。

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来源期刊

Pace-Pacing and Clinical Electrophysiology 医学-工程：生物医学

CiteScore

2.70

自引率

5.60%

发文量

209

审稿时长

2-4 weeks

期刊介绍： Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.