Cryoballoon Ablation With the POLARx FIT or the Arctic Front Advance Pro for Paroxysmal Atrial Fibrillation: A Health Economic Analysis.

Background

Pulmonary vein isolation (PVI) is the main ablation strategy for the treatment of paroxysmal atrial fibrillation. Different technologies are available for PVI, including various cryoballoon catheters (CB-A). Compared with the Arctic Front Advance Pro™, the novel POLARx FIT™ CB-A might reduce costs for atrial fibrillation ablation.

Objective

The aim of this study is to perform a health economic evaluation of two cryoballoon systems for PVI procedures.

Methods

All patients undergoing their first PVI procedure with POLARx FIT™ CB-A or the Arctic Front Advance Pro™ CB-A were prospectively enrolled. The health economic analysis was performed on the index hospitalization and procedure. The primary safety endpoint included procedure-related adverse events within the index hospitalization. A decision tree model was built to estimate downstream costs.

Results

A total of 80 patients with paroxysmal atrial fibrillation undergoing PVI were analyzed, with 40 patients in each arm. Compared with the Arctic Front Advance Pro™ CB-A, POLARx FIT™ CB-A showed a lower procedure time, left-atrium dwell time, and fluoroscopy time. The complication rate was low (6.3%) and included 3 reversible phrenic nerve palsies in the POLARx FIT™ CB-A group vs 2 in the Arctic Front Advance Pro™ CB-A group. Compared with the Arctic Front Advance Pro, the POLARx FIT™ CB-A was associated with lower procedural costs (€2069.7 ± €165.2 vs €2239.5 ±  €366.0; P =.009).

Conclusion

The POLARx FIT™ CB-A was associated with a shorter procedure time, translating into lower procedural costs, compared with the Arctic Front Advance Pro. Complications were rare and comparable between the two technologies.