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Long-term clinical efficacy and risk of catheter ablation for atrial fibrillation in the elderly.
- Source :
-
Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2008 Jun; Vol. 19 (6), pp. 621-6. Date of Electronic Publication: 2008 May 05. - Publication Year :
- 2008
-
Abstract
- Introduction: The number of elderly patients with atrial fibrillation (AF) is increasing rapidly, and the safety and efficacy of catheter ablation in this demographic group has not been established.<br />Methods: Over a 7-year period we studied 1,165 consecutive patients undergoing 1,506 AF ablation procedures using a consistent ablation protocol that included proximal ostial pulmonary vein (PV) isolation and focal ablation of non-PV AF triggers. Outcome was analyzed for three distinct age groups: <65 years (group 1; n = 948 patients), 65-74 years (group 2; n = 185 patients), and > or =75 years (group 3; n = 32 patients) based on the age at the initial procedure.<br />Results: There was no significant difference in AF control (89% in group 1, 84% in group 2, and 86% in group 3, P = NS) during a mean follow-up of 27 months. Major complication rates were also comparable (1.6% in group 1, 1.7% in group 2, 2.9% in group 3, P = NS) between the three groups. There was no difference in the left atrial size, percentage with left ventricular ejection fraction <50%, or percentage with paroxysmal versus more persistent forms of atrial fibrillation. However, older patients were more likely to be women (20% in group 1, 34% in group 2, and 56% in group 3, P < 0.001) and have hypertension and/or structural heart disease (56% in group 1 vs 68% in group 2 vs 88% in group 3; P < 0.001). There was a strong trend demonstrating that older patients were less likely to undergo repeat ablation (26% vs 27% vs 9%) to achieve AF control and more likely to remain on antiarrhythmic drugs (20% vs 29% vs 37%; P < 0.05).<br />Conclusions: Elderly patients with AF undergoing catheter ablation therapy are represented by a higher proportion of women and have a higher incidence of hypertension/structural heart disease. To achieve a similar level of AF control, there appears to be no increased risk from the ablation procedure, but elderly patients are more likely to remain on antiarrhythmic drugs.
- Subjects :
- Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Atrial Fibrillation diagnosis
Atrial Fibrillation physiopathology
Echocardiography
Electrocardiography
Female
Follow-Up Studies
Heart Rate physiology
Humans
Incidence
Male
Middle Aged
Postoperative Complications epidemiology
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Atrial Fibrillation surgery
Catheter Ablation methods
Subjects
Details
- Language :
- English
- ISSN :
- 1540-8167
- Volume :
- 19
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of cardiovascular electrophysiology
- Publication Type :
- Academic Journal
- Accession number :
- 18462325
- Full Text :
- https://doi.org/10.1111/j.1540-8167.2008.01183.x