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Comparison Between Cryoballoon ablation and Radiofrequency Catheter Ablation for Atrial Fibrillation in Patients on Hemodialysis
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  • Takahiro Hayashi,
  • Masato Murakami,
  • Yuka Mashimo,
  • Takashi Yamada,
  • Takashi Nishimoto,
  • Tomoki Ochiai,
  • Koki Shishido,
  • Shingo Mizuno,
  • Saeko Takahashi,
  • Shigeru Saito
Takahiro Hayashi
Shonan Kamakura General Hospital
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Masato Murakami
Shonan Kamakura General Hospital
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Yuka Mashimo
Shonan Kamakura General Hospital
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Takashi Yamada
Shonan Kamakura General Hospital
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Takashi Nishimoto
Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences
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Tomoki Ochiai
Shonan Kamakura General Hospital
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Koki Shishido
Shonan Kamakura General Hospital
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Shingo Mizuno
Shonan Kamakura General Hospital
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Saeko Takahashi
Shonan Kamakura General Hospital
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Shigeru Saito
Shonan Kamakura General Hospital
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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.