Comparison Between Cryoballoon ablation and Radiofrequency Catheter
Ablation for Atrial Fibrillation in Patients on Hemodialysis
Abstract
Aims: Difficulties are often encountered while controlling atrial
fibrillation (AF), especially in hemodialysis (HD) patients. Previous
data revealed that cryoballoon ablation (CBA) for treating paroxysmal
atrial fibrillation (PAF) was not inferior to radiofrequency ablation
(RFA); however, HD patients were excluded in this prior trial. Thus, the
efficacy of CBA for HD patients is still unknown. Methods: This
retrospective study analyzed HD patients who underwent catheter ablation
(CA) for AF from August 2011 to June 2019. Patients who received CBA
(CBA group) and those who received RFA (RFA group) were compared. The
primary endpoint was defined as freedom from a composite outcome (a
documented recurrence of any atrial tachyarrhythmia or a prescription of
antiarrhythmic drugs) at one year after CA. The secondary endpoint was
freedom from a documented recurrence of any atrial tachyarrhythmia at
one year after CA. Results: The RFA and CBA groups were composed of 21
and 23 patients, respectively. Freedom from a composite outcome was
58.4% in the RFA group and 68.2 % in the CBA group (Log-rank:
p=0.571). Freedom from any atrial tachyarrhythmia was 63.5% in the RFA
group and 90.9% in the CBA group (Log-rank: p=0.042). Conclusion: Our
results suggest that patients on HD with AF who were treated with CBA
tended to have better outcomes than patients treated with RFA.
Therefore, CBA could be a suitable ablation method for HD patients.