TY - JOUR
T1 - Safety and efficacy of cryoballoon versus radiofrequency ablation for atrial fibrillation in elderly patients
T2 - A real-world evidence: RF vs CB AF ablation in elderly patients
AU - Akhtar, Tauseef
AU - Wallace, Ryan
AU - Daimee, Usama A.
AU - Sivasambu, Bhradeev
AU - Hart, Erica
AU - Yang, Eunice
AU - Marine, Joseph E.
AU - Berger, Ronald
AU - Calkins, Hugh
AU - Spragg, David
N1 - Funding Information:
Funding for this research was provided in part by the Edward St. John Fund for AF Research, the Roz and Marvin H. Weiner and Family Foundation, the Dr. Francis P. Chiaramonte Foundation, the Marilyn and Christian Poindexter Arrhythmia Research Fund, Norbert and Louise Grunwald Cardiac Arrhythmia Research Fund, and the Mr. & Mrs. Larry Small AF Research Fund. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Publisher Copyright:
© 2021 Indian Heart Rhythm Society
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Background: There are limited data describing the experience of radiofrequency (RF) vs. cryoballoon (CB) ablation for atrial fibrillation (AF) among elderly patients in the United States. Methods: We conducted a retrospective analysis of patients ≥75 years of age undergoing index RF vs. CB ablation between January 2014 and May 2020 at our center. The choice of ablation technique was left to the operator's discretion. Major complications and efficacy, defined as freedom from any atrial tachyarrhythmia (ATA) lasting ≥30 s after one year of follow-up, were assessed in patients with index RF vs. CB ablation. Results: In our cohort of 186 patients, the median age was 78 (76–81) years, 54.8% were men, and 39.2% had persistent AF. The median CHA2DS2-VASc score was 4 (3–4), while the median duration of AF was 3 (1–7) years. The majority (n = 112, 60.2%) underwent RF ablation. The median procedure time was significantly lower in CB group (197 vs 226.5 min, p=<0.01). The incidence of complications was similar in the two sub-groups (RF: 1.8% vs. CB: 2.7%, p = 0.67). Similarly, arrhythmia-free survival rate on antiarrhythmic drugs at 1-year follow-up remained statistically comparable (63.4% vs. 68.9%, p = 0.33) between patients receiving RF vs. CB ablation. Conclusion: The safety and efficacy of RF vs. CB ablation for AF remained comparable in our cohort of patients older than 75 years. CB ablation was associated with a shorter procedure time.
AB - Background: There are limited data describing the experience of radiofrequency (RF) vs. cryoballoon (CB) ablation for atrial fibrillation (AF) among elderly patients in the United States. Methods: We conducted a retrospective analysis of patients ≥75 years of age undergoing index RF vs. CB ablation between January 2014 and May 2020 at our center. The choice of ablation technique was left to the operator's discretion. Major complications and efficacy, defined as freedom from any atrial tachyarrhythmia (ATA) lasting ≥30 s after one year of follow-up, were assessed in patients with index RF vs. CB ablation. Results: In our cohort of 186 patients, the median age was 78 (76–81) years, 54.8% were men, and 39.2% had persistent AF. The median CHA2DS2-VASc score was 4 (3–4), while the median duration of AF was 3 (1–7) years. The majority (n = 112, 60.2%) underwent RF ablation. The median procedure time was significantly lower in CB group (197 vs 226.5 min, p=<0.01). The incidence of complications was similar in the two sub-groups (RF: 1.8% vs. CB: 2.7%, p = 0.67). Similarly, arrhythmia-free survival rate on antiarrhythmic drugs at 1-year follow-up remained statistically comparable (63.4% vs. 68.9%, p = 0.33) between patients receiving RF vs. CB ablation. Conclusion: The safety and efficacy of RF vs. CB ablation for AF remained comparable in our cohort of patients older than 75 years. CB ablation was associated with a shorter procedure time.
KW - Arrhythmia recurrence
KW - Atrial fibrillation
KW - Cryoballoon ablation
KW - Elderly patients
KW - Radiofrequency ablation
KW - Transient phrenic nerve palsy
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U2 - 10.1016/j.ipej.2021.11.006
DO - 10.1016/j.ipej.2021.11.006
M3 - Article
C2 - 34838748
AN - SCOPUS:85120697848
SN - 0972-6292
VL - 22
SP - 24
EP - 29
JO - Indian Pacing and Electrophysiology Journal
JF - Indian Pacing and Electrophysiology Journal
IS - 1
ER -