In elderly patients with atrial fibrillation, cryoballoon and radiofrequency ablation were associated with similar outcomes, although procedures were shorter with the cryoballoon technology, researchers reported.
The researchers conducted a single-center, retrospective study of 305 patients older than 75 years with paroxysmal or persistent AF who underwent pulmonary vein isolation with cryoballoon or radiofrequency ablation.
The researchers matched 198 patients (mean age, 78 years; 83% with paroxysmal AF) based on propensity scores; each of the 99 pairs had one patient treated with cryoballoon ablation and one treated with radiofrequency ablation.
cryoballoon group than the radiofrequency group (134 minutes vs. 190 minutes; P < .001), Takashi Ikenouchi, MD, from the department of cardiology at Japanese Red Cross Saitama Hospital in Saitama City, Japan, and colleagues wrote.
At 12 months, the groups were similar in terms of success rate (cryoballoon, 80.5%; radiofrequency, 79.4%; P = .72) and complication rate (cryoballoon, 12%; radiofrequency, 16%; P = .8), the researchers wrote.
Subgroup analyses indicated that success rates were similar between the groups regardless of type of AF or whether patients had nonpulmonary vein foci.
In a multivariate analysis, the two predictors of recurrent AF/atrial tachycardia were female sex (HR = 1.9; 95% CI, 1.1-3.6) and procedure time (HR = 1.01; 95% CI, 1-1.01).
“The current study showed that with careful selection of patient characteristics, [pulmonary vein isolation] with [cryoballoon] or [radiofrequency] ablation and additional ablation at non-[pulmonary vein] foci can be safe and effective in elderly patients,” Ikenouchi and colleagues wrote. “We demonstrated that the procedure time was significantly associated with AF recurrence. As [cryoballoon] ablation could significantly shorten the procedure time, it might be a potentially favorable strategy in the elderly population.” – by Erik Swain
Disclosures: The authors report no relevant financial disclosures.