Key result
Cryoballoon ablation yielded 68.2% freedom from recurrent atrial tachyarrhythmia or antiarrhythmic drug use at one year, compared to 58.4% with radiofrequency ablation (p=0.571).
Why the study?
Prior trials establishing that cryoballoon ablation was not inferior to radiofrequency ablation for paroxysmal AF excluded hemodialysis patients, leaving the efficacy of cryoballoon ablation in this population unknown.
Does cryoballoon ablation improve freedom from a composite outcome of atrial tachyarrhythmia recurrence or antiarrhythmic drug prescription compared to radiofrequency catheter ablation in hemodialysis patients with atrial fibrillation?
Cohort (n=44)
Does cryoballoon ablation improve freedom from a composite outcome of atrial tachyarrhythmia recurrence or antiarrhythmic drug prescription compared to radiofrequency catheter ablation in hemodialysis patients with atrial fibrillation?
Cryoballoon ablation appears to be a feasible alternative to radiofrequency ablation for atrial fibrillation in hemodialysis patients, with comparable efficacy at one year.
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.
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Hayashi et al. (2021) conducted a cohort in Atrial fibrillation in hemodialysis patients (n=44). Cryoballoon ablation vs. Radiofrequency catheter ablation was evaluated on freedom from a composite outcome (a documented recurrence of any atrial tachyarrhythmia or a prescription of antiarrhythmic drugs) at one year after CA (p=0.571). Cryoballoon ablation yielded 68.2% freedom from recurrent atrial tachyarrhythmia or antiarrhythmic drug use at one year, compared to 58.4% with radiofrequency ablation (p=0.571).
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