Myocardial Injury and Incidence of Early Recurrence of Atrial Fibrillation after Catheter Ablation between Two Types of Cryoballoon Systems.

Abstract

Two types of cryoballoon (CB) systems are currently available for catheter ablation of atrial fibrillation (AF). It is not clear how the difference between POLARx (Boston Scientific) and AFA-Pro (Medtronic) relates to myocardial injury and the incidence of early recurrence of fibrillation (ERAF).Patients (n = 137) who underwent catheter ablation for paroxysmal AF by 2 CB devices were included (AFA-Pro in 87; POLARx in 50). We assessed creatine kinase (CK)-MB pre and post-procedure, ERAF, and the number of atrial premature contractions (APCs) at Holter monitoring 1 month and 3 months after the procedure. The change ratio was defined by the following formula: (post-procedure/pre-procedure). ERAF is defined as the recurrence of AF within 90 days after the procedure.The 2 groups did not differ significantly in the number of CB applications or the percentage of touch-up applications by radiofrequency catheter. The CK-MB change ratio was considerably higher in the POLARx group than the AFA-Pro group (19.3 ± 21.6 versus 27.4 ± 21.3; P = 0.036). The incidence of ERAF was similar between the 2 groups (15% versus 24%; P = 0.23). Additionally, there were no significant differences in the number of APCs (120 [39-784] versus 147 [43-1039]; P = 0.70) or AF recurrence (3% versus 12%; P = 0.10).POLARx causes stronger myocardial injury than AFA-Pro but does not increase ERAF and APC numbers.