Incidence of pulmonary vein stenosis in two types of cryoballoon systems

IF 2.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Arrhythmia Pub Date : 2024-06-14 DOI:10.1002/joa3.13087

Satoko Shiomi MD, Michifumi Tokuda MD, PhD, Ryutaro Sakurai MD, Yoshito Yamazaki MD, Takuya Matsumoto MD, Hidenori Sato MD, PhD, Hirotsuna Oseto MD, Masaaki Yokoyama MD, PhD, Kenichi Tokutake MD, PhD, Mika Kato MD, PhD, Seigo Yamashita MD, PhD, Teiichi Yamane MD, PhD, FHRS, Michihiro Yoshimura MD, PhD

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引用次数: 0

Abstract

Background

Currently, two types of cryoballoon (CB) systems are available for catheter ablation of atrial fibrillation (AF). Since the POLARx (Boston Scientific) is softer during freezing than the Arctic Front Advance Pro (AFA-Pro; Medtronic), it tends to go more deeply into the pulmonary vein (PV), risking PV stenosis.

Methods

Ninety-one patients underwent initial CB ablation for paroxysmal AF (AFA-Pro 56; POLARx 35). Twenty-six from each group were extracted using propensity score matching. The PV cross-sectional area (PVA) was measured by tracing the area within the PV plane at 5-mm intervals from the PV ostium in a distal direction for 20 mm or to the bifurcation in each PV. The PVA was compared before and 3 months after ablation.

Results

Time to balloon temperatures of −30 and − 40°C was significantly shorter and the nadir temperature was significantly lower with POLARx than with AFA-Pro. In the left inferior (LI) PV and right superior (RS) PV, the freezing balloon position was significantly deeper in POLARx than in AFA-pro. The freezing position in RSPV with mild to moderate narrowing was deeper than those without (10.2 ± 3.3 mm vs. 8.2 ± 1.8 mm, p = .01). In RSPV, the reduction of PVA tended to be greater with the POLARx than with the AFA-Pro (26.1% ± 14.1% vs. 19.9% ± 10.3%, p = .07).

Conclusion

There was no significant difference in the incidence of PV stenosis between POLARx and AFA-Pro. However, if POLARx goes deep into the PVs, we will still have to be careful.

Abstract Image

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两种低温球囊系统中肺静脉狭窄的发生率

目前，有两种冷冻球囊（CB）系统可用于心房颤动（房颤）的导管消融。由于 POLARx（波士顿科学公司）在冷冻过程中比 Arctic Front Advance Pro（美敦力公司，AFA-Pro）更柔软，它往往会更深地进入肺静脉（PV），从而导致 PV 狭窄的风险。91 名患者因阵发性房颤接受了首次 CB 消融术（AFA-Pro 56 例；POLARx 35 例）。采用倾向得分匹配法从每组患者中抽取 26 人。测量 PV 横截面面积（PVA）的方法是在 PV 平面内，以 5 mm 为间隔，从 PV 骨膜向远端方向追踪 20 mm，或追踪到每个 PV 的分叉处。与 AFA-Pro 相比，POLARx 的球囊温度达到 -30°C 和 -40°C 的时间明显更短，最低温度明显更低。在左下（LI）PV 和右上（RS）PV，POLARx 的球囊冷冻位置明显比 AFA-pro 深。在有轻度至中度狭窄的 RSPV 中，冷冻球囊位置比没有轻度至中度狭窄的更深（10.2 ± 3.3 mm vs. 8.2 ± 1.8 mm，p = .01）。在 RSPV 中，POLARx 与 AFA-Pro 相比，PVA 的缩小幅度更大（26.1% ± 14.1% vs. 19.9% ± 10.3%，p = .07）。不过，如果 POLARx 深入 PV，我们仍需谨慎。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Arrhythmia CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.90

自引率

10.00%

发文量

127

审稿时长

45 weeks