Introduction:
Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice leading to significant morbidity and mortality. Pulmonary vein isolation (PVI) via catheter ablation (CA) has become an effective procedure for AF management, and given the association of AF with increasing age, a rising proportion of patients of advanced age are receiving this procedure. There have been significant advancements in ablation techniques over the last decade. Cryoballoon (CB) ablation has recently emerged as an effective strategy for the treatment of symptomatic paroxysmal AF (PAF)1. CB ablation has been reported to be associated with shorter procedure time and comparable safety and efficacy as compared to radiofrequency (RF) ablation in randomized controlled trials (RCTs)2,3. Interestingly, these RCTs were conspicuous for the exclusion of patients with advanced age. While several studies have reported data regarding the safety and efficacy of CB vs. RF ablation of AF in elderly patients from Asia4,5, there is a paucity of such data from the United States (US). Accordingly, the objective of our study was to compare the safety and efficacy of CB vs. RF ablation in elderly patients and to determine the predictor of arrhythmia recurrence in a contemporary cohort of patients at our center.