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
Department of Medicine, H.B.S Medical and Dental College, Islamabad, Pakistan.
Department of Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan.
Front Cardiovasc Med. 2025 Aug 18;12:1625399. doi: 10.3389/fcvm.2025.1625399. eCollection 2025.
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.
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.
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).
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.
identifier CRD42024588371.
冷冻球囊（CB）消融是一种成熟的心房颤动（AF）治疗方法。已使用十多年的北极锋推进Pro™（AFA-Pro）系统已证明具有一致的疗效和安全性。最近，新型CB系统POLARx™因其先进的设计和可比的临床结果而受到关注。
我们对比较AFA-Pro和POLARx用于AF患者CB消融的研究进行了系统评价和荟萃分析。结果包括手术参数（手术时间、消融时间、透视时间、球囊最低点温度）和安全终点，如膈神经麻痹（PNP）和卒中发生率。
POLARx和AFA在急性肺静脉隔离成功率（OR = 0.49，P = 0.24）、手术时间（MD = 4.40，P = 0.14）、消融时间（SMD = 0.12，P = 0.10）、透视时间（MD = 0.34，P = 0.67）、冷冻时间和卒中发生率方面无显著差异。POLARx在球囊最低点温度方面显示出显著优势（P < 0.00001），并且在右上肺静脉（RSPV）（MD = 5.49，P = 0.05）和右下肺静脉（RIPV）（MD = 4.54，P = 0.04）中显示出更长的隔离时间（TTI），而左上肺静脉（LSPV）和左下肺静脉（LIPV）的TTI相似。然而，POLARx与更高的PNP风险相关（OR = 1.87，P = 0.007）。
与AFA-Pro相比，POLARx显示出较低的球囊最低点温度，但与更高的膈神经麻痹风险相关。这些发现为这些冷冻消融系统的手术效率和安全性概况提供了重要见解。
标识符CRD42024588371。
