Comparison between cryoballoon ablation and radiofrequency catheter ablation for atrial fibrillation in patients on hemodialysis

Takahiro Hayashi; Masato Murakami; Shohei Yokota; Takashi Yamada; Yuka Mashimo; Hirokazu Miyashita; Hiroaki Yokoyama; Tomoki Ochiai; Takashi Nishimoto; Masashi Yamaguchi; Noriaki Moriyama; Tamiharu Yamagishi; Kazuki Tobita; Koki Shishido; Shingo Mizuno; Futoshi Yamanaka; Yutaka Tanaka; Saeko Takahashi; Shigeru Saito

doi:10.1016/j.ipej.2021.02.002

Comparison between cryoballoon ablation and radiofrequency catheter ablation for atrial fibrillation in patients on hemodialysis

Indian Pacing Electrophysiol J. 2021 Mar-Apr;21(2):67-72. doi: 10.1016/j.ipej.2021.02.002. Epub 2021 Feb 6.

Authors

Takahiro Hayashi¹, Masato Murakami², Shohei Yokota¹, Takashi Yamada¹, Yuka Mashimo¹, Hirokazu Miyashita¹, Hiroaki Yokoyama¹, Tomoki Ochiai¹, Takashi Nishimoto¹, Masashi Yamaguchi¹, Noriaki Moriyama¹, Tamiharu Yamagishi¹, Kazuki Tobita¹, Koki Shishido¹, Shingo Mizuno¹, Futoshi Yamanaka¹, Yutaka Tanaka¹, Saeko Takahashi¹, Shigeru Saito¹

Affiliations

¹ Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan.
² Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan. Electronic address: murakami20040408@yahoo.co.jp.

Abstract

Background: 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.

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).

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.

Keywords: Atrial fibrillation; Catheter ablation; Cryoballoon ablation; Hemodialysis; Radiofrequency ablation.