Evidence map›Paper›PMID 37738643›Full record

ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2023

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

Shohreh Honarbakhsh, Claire A Martin, Joao Mesquita, Rahul Herlekar, Richard Till, Neil T Srinivasan, Edward Duncan, Fong Leong, Rajdip Dulai, Rick Veasey and 10 more

Abstract readMulticenter Study
In one paragraph

Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Procedural characteristics and clinical outcomes from same-day discharge after pulsed field ablation treatment for atrial fibrillation: an admIRE trial sub-analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Trial
  3. A day off to admIRE: same-day discharge after pulsed field ablation with a Variable-loop circular catheter.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
  9. Same-day discharge after atrial fibrillation ablation under a nurse-coordinated standardized protocol.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Article
  10. Pulsed electric field, cryoballoon, and radiofrequency for paroxysmal atrial fibrillation ablation: a propensity score-matched comparison.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Shohreh HonarbakhshThe Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS trust, W Smithfield, EC1A 7BE London, UK.ORCID 0000-0003-0081-5739
Claire A MartinDepartment of Electrophysiology, Royal Papworth Hospital, Cambridge, UK.
Joao MesquitaDepartment of Electrophysiology, Royal Papworth Hospital, Cambridge, UK.ORCID 0000-0001-6965-4457
Rahul HerlekarDepartment of Electrophysiology, Royal Papworth Hospital, Cambridge, UK.ORCID 0000-0002-7795-0771
Richard TillDepartment of Electrophysiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.ORCID 0000-0001-8536-6834
Neil T SrinivasanDepartment of Electrophysiology, Basildon and Thurrock University Hospital NHS Foundation Trust, Essex, UK.ORCID 0000-0002-4423-6547
Edward DuncanDepartment of Electrophysiology, The University Hospitals Bristol and Weston NHS Foundation trust, Bristol, UK.
Fong LeongDepartment of Electrophysiology, Cardiff and Vale University Health Board, Cardiff, UK.ORCID 0000-0002-8161-6928
Rajdip DulaiDepartment of Electrophysiology, Eastbourne District General Hospital, East Sussex Healthcare NHS trust, Eastbourne, UK.ORCID 0000-0003-1583-2494
Rick VeaseyDepartment of Electrophysiology, Eastbourne District General Hospital, East Sussex Healthcare NHS trust, Eastbourne, UK.
Sandeep PanikkerDepartment of Electrophysiology, University Hospital Coventry and Warwickshire, Coventry, UK.ORCID 0009-0009-3566-6252
John PaiseyDepartment of Electrophysiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.ORCID 0000-0002-0220-0343
Balasubramanian RamgopalDepartment of Electrophysiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.ORCID 0000-0003-0694-0573
Moloy DasDepartment of Electrophysiology, Freeman Hospital, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.ORCID 0000-0002-4237-1630
Wissam AhmedDepartment of Electrophysiology, Freeman Hospital, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.
Jonathan SahuDepartment of Electrophysiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.ORCID 0009-0002-1180-5253
Mark J EarleyThe Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS trust, W Smithfield, EC1A 7BE London, UK.ORCID 0000-0003-0144-7405
Malcolm C FinlayThe Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS trust, W Smithfield, EC1A 7BE London, UK.ORCID 0000-0001-6403-9340
Richard J SchillingThe Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS trust, W Smithfield, EC1A 7BE London, UK.ORCID 0000-0002-0621-8241
Ross J HunterThe Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS trust, W Smithfield, EC1A 7BE London, UK.ORCID 0000-0002-4641-3279

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsPulmonary vein isolation (PVI) is the cornerstone of catheter ablation for atrial fibrillation (AF). There are limited data on the PolarX Cryoballoon. The study aimed to establish the safety, efficacy, and feasibility of same day discharge for Cryoballoon PVI. METHODS AND

resultsMulti-centre study across 12 centres. Procedural metrics, safety profile, and procedural efficacy of the PolarX Cryoballoon with the Arctic Front Advance (AFA) Cryoballoon were compared in a cohort large enough to provide definitive comparative data. A total of 1688 patients underwent PVI with cryoablation (50% PolarX and 50% AFA). Successful PVI was achieved with 1677 (99.3%) patients with 97.2% (n = 1641) performed as day case procedures with a complication rate of <1%. Safety, procedural metrics, and efficacy of the PolarX Cryoballoon were comparable with the AFA cohort. The PolarX Cryoballoon demonstrated a nadir temperature of -54.6 ± 7.6°C, temperature at 30 s of -38.6 ± 7.2°C, time to -40°C of 34.1 ± 13.7 s, and time to isolation of 49.8 ± 33.2 s. Independent predictors for achieving PVI included time to reach -40°C [odds ratio (OR) 1.34; P < 0.001] and nadir temperature (OR 1.24; P < 0.001) with an optimal cut-off of ≤34 s [area under the curve (AUC) 0.73; P < 0.001] and nadir temperature of ≤-54.0°C (AUC 0.71; P < 0.001), respectively.

conclusionsThis large-scale UK multi-centre study has shown that Cryoballoon PVI is a safe, effective day case procedure. PVI using the PolarX Cryoballoon was similarly safe and effective as the AFA Cryoballoon. The cryoablation metrics achieved with the PolarX Cryoballoon were different to that reported with the AFA Cryoballoon. Modified cryoablation targets are required when utilizing the PolarX Cryoballoon.

Indexed as

Atrial FibrillationCatheter AblationCryosurgeryPulmonary VeinsHumansRecurrenceTime FactorsTreatment OutcomeUnited KingdomAtrial fibrillationCryoablationNovel technologyPulmonary vein isolation

Identifiers

PMID37738643
PMCPMC10629714

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.