ReviewPacing and clinical electrophysiology : PACE2026
Impact of Expandable Cryoballoon on Pulmonary Vein Morphology and Treatment Selection in Atrial Fibrillation Ablation.
Review in Pacing and clinical electrophysiology : PACE, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCryoballoon (CB) ablation is widely used for pulmonary vein isolation (PVI). A novel CB (POLARx-FIT) that can be expanded from 28 to 31 mm has recently been introduced. However, its impact on pulmonary vein (PV) morphology, acute lesion characteristics, and treatment selection remains unclear.
methodsAmong 416 consecutive patients undergoing PVI for atrial fibrillation, after excluding radiofrequency catheter ablation (RFCA) cases and CB ablation with Arctic Front Advance, 190 patients were included: a 28 mm CB group (POLARx, N = 122) and a 31 mm CB group (POLARx-FIT, N = 68). PV morphology was assessed on preoperative computed tomography. Lesion size of the CB was evaluated using post-ablation voltage mapping.
resultsAfter introduction of 31 mm CB, the proportion of patients selecting RFCA due to large PV size decreased from 30.7% to 8.3% (p < 0.01). Left and right superior PV were significantly larger and both left and right PV distance were significantly longer in the 31 mm CB group. The actual PVI lesion area was significantly larger in the 31 mm CB group (28 mm CB: 14.1 ± 3.4 cm
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