Introduction
Atrial fibrillation (AF) is observed in 12% of patients who start hemodialysis (HD), and 12% of patients with a normal sinus rhythm develop AF within 2 years.1 HD patients with AF exhibit an much higher mortality rate than those without AF.1 Further, over 30% of HD patients aged >70 years have AF.2 In addition, antiarrhythmic drugs (AAD) are strictly limited to HD patients, which might lead to the difficulty in controlling AF occurrence. We sometimes encounter the necessity of maintaining sinus rhythm because of symptoms, such as palpitation, despite sufficient heart rate control.
Literature about catheter ablation (CA) for AF in HD patients are limited. A previous study reported on radiofrequency catheter ablation (RFA) for paroxysmal atrial fibrillation (PAF), but found that the outcome was worse in comparison to non-HD patients.3The FIRE and ICE trial revealed the efficacy of cryoballoon ablation (CBA),4 but HD patients were excluded from this trial. Thus, the efficacy of CBA for HD patients is still unknown. In the present study, we aimed to compare the efficacy of CBA for AF with RFA.