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Tytuł:
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Cryoballoon versus radiofrequency ablation for paroxysmal atrial fibrillation in hemodialysis patients.
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Autorzy:
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Takamiya T; Department of Cardiology, Japanese Red Cross Saitama Hospital, 1-5 Shintosin, Chuo-ku, Saitama, 330-8553, Japan. .
Nitta J; Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
Inaba O; Department of Cardiology, Japanese Red Cross Saitama Hospital, 1-5 Shintosin, Chuo-ku, Saitama, 330-8553, Japan.
Sato A; Department of Cardiology, Japanese Red Cross Saitama Hospital, 1-5 Shintosin, Chuo-ku, Saitama, 330-8553, Japan.
Inamura Y; Department of Cardiology, Japanese Red Cross Saitama Hospital, 1-5 Shintosin, Chuo-ku, Saitama, 330-8553, Japan.
Kato N; Department of Cardiology, Hiratsuka Kyosai Hospital, Kanagawa, Japan.
Murata K; Department of Cardiology, Japanese Red Cross Saitama Hospital, 1-5 Shintosin, Chuo-ku, Saitama, 330-8553, Japan.
Ikenouchi T; Department of Cardiology, Japanese Red Cross Saitama Hospital, 1-5 Shintosin, Chuo-ku, Saitama, 330-8553, Japan.
Kono T; Department of Cardiology, Japanese Red Cross Saitama Hospital, 1-5 Shintosin, Chuo-ku, Saitama, 330-8553, Japan.
Nitta G; Department of Cardiology, Japanese Red Cross Saitama Hospital, 1-5 Shintosin, Chuo-ku, Saitama, 330-8553, Japan.
Matsumura Y; Department of Cardiology, Japanese Red Cross Saitama Hospital, 1-5 Shintosin, Chuo-ku, Saitama, 330-8553, Japan.
Takahashi Y; Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Goya M; Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Sasano T; Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
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Źródło:
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Heart and vessels [Heart Vessels] 2020 Dec; Vol. 35 (12), pp. 1709-1716. Date of Electronic Publication: 2020 Jun 10.
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Typ publikacji:
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Comparative Study; Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Tokyo : Springer Verlag
Original Publication: Tokyo ; Secaucus, NY : Springer International, c1985-
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MeSH Terms:
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Catheter Ablation*/adverse effects
Cryosurgery*/adverse effects
Renal Dialysis*/adverse effects
Atrial Fibrillation/*surgery
Kidney Diseases/*therapy
Pulmonary Veins/*surgery
Aged ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/physiopathology ; Female ; Humans ; Kidney Diseases/diagnosis ; Kidney Diseases/physiopathology ; Male ; Middle Aged ; Operative Time ; Pulmonary Veins/physiopathology ; Recurrence ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome
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Contributed Indexing:
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Keywords: Atrial fibrillation; Catheter ablation; Cryoballoon; Hemodialysis; Pulmonary vein isolation
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Entry Date(s):
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Date Created: 20200612 Date Completed: 20201207 Latest Revision: 20201214
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Update Code:
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20240104
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DOI:
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10.1007/s00380-020-01646-5
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PMID:
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32524235
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Introduction: Little evidence exists regarding cryoballoon ablation (CBA) of paroxysmal atrial fibrillation (PAF) in hemodialysis (HD) patients. We compared CBA and radiofrequency ablation (RFA) of PAF in HD patients, referring to CBA of PAF in non-HD patients.
Methods and Results: This historical cohort study examined 88 patients who underwent catheter ablation of PAF, including 21 HD patients with a second-generation 28-mm cryoballoon (CB-HD group), 17 HD patients with a non-force-sensing radiofrequency catheter (RF-HD group), and 50 non-HD patients with a cryoballoon (CB-non-HD group). Pulmonary vein (PV) isolation alone aside from cavotricuspid isthmus ablation was performed in 14 (67%) in the CB-HD group, 12 (71%) in the RF-HD group, and 36 (72%) in the CB-non-HD group (P = 0.95), without isoproterenol-induced non-PV triggers. Non-PV trigger ablation was added to the other patients. The Kaplan-Meier estimated 1-year freedom from atrial tachyarrhythmia recurrence without antiarrhythmic drugs after a single procedure was 76%, 59%, and, 92% in the CB-HD, RF-HD, and CB-non-HD groups, respectively (P = 0.002). The mean procedure time was shorter in the CB-HD group than in the RF-HD group (127 vs. 199 min; P < 0.001). In the second procedure, the median number of reconnected pulmonary veins was 0.5 in the CB-HD group versus 2.0 in the RF-HD group (P = 0.17).
Conclusion: For PAF in HD patients, CBA showed a comparable single-procedure efficacy to that of RFA with a short procedure time. CBA may be a reasonable initial procedure for HD patients suffering from symptomatic PAF.
