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ORIGINAL ARTICLE
Year : 2017  |  Volume : 2  |  Issue : 2  |  Page : 73-80

The real-time assessment of pulmonary vein isolation and safety of cryoballoon 3 versus cryoballoon 2 for atrial fibrillation: A systemic review and meta-analysis


1 Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
2 Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA, USA
3 Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China

Correspondence Address:
Prof. Tong Liu
Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin
China
Prof. Yunlong Xia
Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJHR.IJHR_6_17

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Objectives: Cryoballoon ablation (CBA) has become a routine treatment option for paroxysmal atrial fibrillation (PAF). The third-generation CB (CB3) also known as “Arctic Front Advance ST” (CB-ST) was designed with a shorter distal tip. There have been several publications describing the characteristics of the CB3 system. We, therefore, undertook this systemic review and meta-analysis to compare the efficacy and safety of CB3 versus the second-generation CB (CB2) also known as “Arctic Front Advance.” Methods and Results: We performed a search on PubMed, Embase, and Web of Science database for studies published by August 2016 using the keywords “CB3,” “short-tip cryoballoon,” “Arctic Front Advance ST,” “CB3,” “cryoablation,” and “CBA.” Six studies with a total of 1625 patients were identified. There were 351 patients underwent CBA with CB3, and 1274 underwent CBA with CB2. Overall analyses indicated that there was a significant improvement in the real-time pulmonary vein isolation (RT-PVI) recording rate with CB3 compared to CB2 (odds ratio of 3.08, P < 0.00001). The procedure time (PT) was shorter for CB3 (weighted mean difference [WMD], 95% confidence interval CI: −10.27, [ − 19.2, −1.35], P = 0.02), while fluoroscopic time (WMD, 95% CI: 0.71, [ − 1.27, 2.68], P = 0.48) was not statistically different between the two groups. Conclusions: In this meta-analysis involving 1625 patients, the CB3 system decreased PT, enhanced RT-PVI recording rate while maintaining a similar safety profile.


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