2-012 A systematic review and meta-analysis of a novel cryoablation system for pulmonary vein isolation in patients with paroxysmal atrial fibrillation
Bibliographic record
Abstract
Introduction Cryoablation technologies have transformed the treatment of paroxysmal atrial fibrillation, with pulmonary vein isolation (PVI) being a key treatment. Technical advancements, including cryoballoon compliance, stable pressure and size during ablation and improved cooling dynamics, have sparked interest in the recently introduced POLARx cryoablation system. These technological advancements could improve procedural efficacy and outcomes, potentially surpassing those achieved with the widely adopted Arctic Front Advance Pro (AFA-Pro) system. Comparative data between these two systems are still scarce. Therefore, we used a meta-analytic method to compare these two cryoablation systems in patients undergoing PVI for paroxysmal atrial fibrillation. Methods On December 6, 2024, a thorough literature search was carried out using PRISMA principles across Embase, Web of Science, Scopus, Cochrane Library, and PubMed. ‘POLARx’, ‘Arctic Front Advance Pro’, and ‘cryoablation’ were among the search terms used. We extracted information on procedure time, fluoroscopy time and nadir temperatures. For continuous data, pooled mean differences (MD) and 95% confidence intervals (CI) were computed. To account for the anticipated heterogeneity, we employed a random-effects model. The Comprehensive Meta-Analysis version 3 software was used for all statistical analyses, and the Newcastle-Ottawa scale was used to evaluate the quality of the studies. Results We included three observational studies (n=379, mean age: 61.79 years; 36.9% female) from 792 screened records. All studies had some risk of bias. The POLARx system demonstrated statistically significant reductions in procedure time (n=379, MD: -10.95 minutes, 95% CI: -20.7 to -1.15, p=0.02) and fluoroscopy time (n=327, MD: -2.7 minutes, 95% CI: -5.25 to -0.14, p=0.03) compared to AFA-Pro. POLARx also achieved a markedly lower total nadir temperature (n=379, MD: -8.66°C, 95% CI: -10.94 to -6.39, p=0.000). Conclusions The POLARx system shows potential superiority to the AFA-Pro system in terms of procedure and fluoroscopy times as well as total nadir temperature. However, we recommend conducting further research to validate these findings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.020 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.031 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.012 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".