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Comparative efficacy and safety of POLARx versus Arctic front advance pro cryoballoon systems for pulmonary vein isolation in atrial fibrillation: an updated systematic review and meta-analysis.

作者信息

Tahir Muhammad Fawad, Shuja Muhammad Hamza, Hannat Ramish, Shaheen Fabeeha, Sayeed Amna, Shaukat Ayesha, Rajput Faiza, Zahoor Muhammad Ahmed, Hamid Kinza, Khan Areeba, Ahmed Aymen Azan, Wasiq Syeda Asfiha, Naeem Huda, Shaikh Bakhtawar, Larik Muhammad Omar, Ahmed Raheel, Shehzad Mustafa, Changez Mah I Kan, Haider Muhammad Usman, Ayyalu Tanesh

机构信息

Department of Medicine, H.B.S Medical and Dental College, Islamabad, Pakistan.

Department of Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan.

出版信息

Front Cardiovasc Med. 2025 Aug 18;12:1625399. doi: 10.3389/fcvm.2025.1625399. eCollection 2025.


DOI:10.3389/fcvm.2025.1625399
PMID:40901360
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12400518/
Abstract

BACKGROUND: Cryoballoon (CB) ablation is a well-established treatment for atrial fibrillation (AF). The Arctic Front Advance Pro™ (AFA-Pro) system, in use for over a decade, has demonstrated consistent efficacy and safety. Recently, the POLARx™, a novel CB system, has gained attention due to its advanced design and comparable clinical outcomes. METHODS: We conducted a systematic review and meta-analysis of studies comparing AFA-Pro and POLARx in patients undergoing CB ablation for AF. Outcomes included procedural parameters (procedure time, ablation time, fluoroscopy time, balloon nadir temperature) and safety endpoints such as phrenic nerve palsy (PNP) and Stroke rates. RESULTS: There were no significant differences between POLARx and AFA in acute PVI success (OR = 0.49, P = 0.24), procedure time (MD = 4.40, P = 0.14), ablation time (SMD = 0.12, P = 0.10), fluoroscopy time (MD = 0.34, P = 0.67), freezing time and stroke rates. POLARx showed a significant advantage in balloon nadir temperature (P < 0.00001) and demonstrated longer time to isolation (TTI) in the RSPV (MD = 5.49, P = 0.05) and RIPV (MD = 4.54, P = 0.04), while TTI was similar for the LSPV and LIPV. However, POLARx was associated with a higher risk of PNP (OR = 1.87, P = 0.007). CONCLUSION: POLARx demonstrates lower balloon nadir temperature but is associated with a higher risk of phrenic nerve palsy compared to AFA-Pro. These findings provide important insights into the procedural efficiency and safety profiles of these cryoablation systems. SYSTEMATIC REVIEW REGISTRATION: identifier CRD42024588371.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b9e/12400518/0f3d8f622d3b/fcvm-12-1625399-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b9e/12400518/bf748f222e77/fcvm-12-1625399-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b9e/12400518/143c34a23fad/fcvm-12-1625399-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b9e/12400518/148237060010/fcvm-12-1625399-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b9e/12400518/8a6bd7eec126/fcvm-12-1625399-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b9e/12400518/965024f515da/fcvm-12-1625399-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b9e/12400518/b07e2128fc8a/fcvm-12-1625399-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b9e/12400518/0f3d8f622d3b/fcvm-12-1625399-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b9e/12400518/bf748f222e77/fcvm-12-1625399-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b9e/12400518/143c34a23fad/fcvm-12-1625399-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b9e/12400518/148237060010/fcvm-12-1625399-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b9e/12400518/8a6bd7eec126/fcvm-12-1625399-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b9e/12400518/965024f515da/fcvm-12-1625399-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b9e/12400518/b07e2128fc8a/fcvm-12-1625399-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b9e/12400518/0f3d8f622d3b/fcvm-12-1625399-g007.jpg

相似文献

[1]
Comparative efficacy and safety of POLARx versus Arctic front advance pro cryoballoon systems for pulmonary vein isolation in atrial fibrillation: an updated systematic review and meta-analysis.

Front Cardiovasc Med. 2025-8-18

[2]
Non-Occlusive Separate Freezing for Cryoballoon Pulmonary Vein Isolation to the Large Pulmonary Vein.

Pacing Clin Electrophysiol. 2025-8-2

[3]
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.

J Cardiovasc Electrophysiol. 2021-9

[4]
Comparison of the acute outcome of two cryoballoon technologies for pulmonary vein isolation: An updated systematic review and meta-analysis.

Int J Cardiol Heart Vasc. 2022-9-5

[5]
Comparison of procedural efficacy and biophysical parameters between two competing cryoballoon technologies for pulmonary vein isolation: Insights from an initial multicenter experience.

J Cardiovasc Electrophysiol. 2021-3

[6]
Comparison of Arctic Front Advance Pro and POLARx cryoballoons for ablation therapy of atrial fibrillation: an intraprocedural analysis.

Clin Res Cardiol. 2025-1

[7]
Outcomes after cryoballoon ablation of paroxysmal atrial fibrillation with the PolarX or the Arctic Front Advance Pro: a prospective multicentre experience.

Europace. 2023-3-30

[8]
The established and the challenger: A direct comparison of current cryoballoon technologies for pulmonary vein isolation.

J Cardiovasc Electrophysiol. 2022-1

[9]
Key characteristics for effective acute pulmonary vein isolation when using a novel cryoballoon technology: insights from the CHARISMA registry.

J Interv Card Electrophysiol. 2022-9

[10]
Cryoballoon Ablation With the POLARx FIT or the Arctic Front Advance Pro for Paroxysmal Atrial Fibrillation: A Health Economic Analysis.

J Health Econ Outcomes Res. 2025-4-21

本文引用的文献

[1]
Meta-analysis accelerator: a comprehensive tool for statistical data conversion in systematic reviews with meta-analysis.

BMC Med Res Methodol. 2024-10-18

[2]
PolarX vs Arctic Front for Cryoballoon Ablation of Paroxysmal AF: The Randomized COMPARE CRYO Study.

JACC Clin Electrophysiol. 2024-7

[3]
Incidence of phrenic nerve injury during pulmonary vein isolation using different cryoballoons: data from a large prospective ablation registry.

Europace. 2024-3-30

[4]
Comparison of Arctic Front Advance Pro and POLARx cryoballoons for ablation therapy of atrial fibrillation: an intraprocedural analysis.

Clin Res Cardiol. 2025-1

[5]
Atrial fibrillation cryoablation is an effective day case treatment: the UK PolarX vs. Arctic Front Advance experience.

Europace. 2023-11-2

[6]
Novel or established cryoballoon ablation system for pulmonary vein isolation: the prospective ICE-AGE-1 study.

Europace. 2023-8-2

[7]
Procedural performance between two cryoballoon systems for ablation of atrial fibrillation depends on pulmonary vein anatomy.

J Arrhythm. 2023-3-17

[8]
Acute procedural efficacy and safety of a novel cryoballoon for the treatment of paroxysmal atrial fibrillation: Results from the POLAR ICE study.

J Cardiovasc Electrophysiol. 2023-4

[9]
Outcomes after cryoballoon ablation of paroxysmal atrial fibrillation with the PolarX or the Arctic Front Advance Pro: a prospective multicentre experience.

Europace. 2023-3-30

[10]
Comparison of the acute outcome of two cryoballoon technologies for pulmonary vein isolation: An updated systematic review and meta-analysis.

Int J Cardiol Heart Vasc. 2022-9-5

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