Catheter ablation in patients aged ≥80 years achieved a 2-year recurrence-free survival of 85.8% in paroxysmal AF compared to 63.6% in persistent AF (p=0.024), with a 12.0% complication rate.
Cohort (n=150)
Yes
Is catheter ablation effective and safe in very elderly patients (age ≥ 80 years) with atrial fibrillation?
Catheter ablation for atrial fibrillation in patients aged 80 and older shows reasonable efficacy and safety, with higher recurrence-free survival in paroxysmal versus persistent AF.
Absolute Event Rate: 85.8% vs 63.6%
p-value: p=0.024
ABSTRACT Background Catheter ablation has become a cornerstone of atrial fibrillation (AF) treatment. The prevalence of AF increases with age. However, research on catheter ablation in very elderly patients (age ≥ 80 years) is limited. This study aimed to assess the efficacy and safety of catheter ablation in very elderly patients with AF. Methods We enrolled 150 very elderly patients (mean age, 82.2 ± 2.2 years, 84 men) who underwent catheter ablation for AF in 2018–2023. We assessed AF recurrence, periprocedural complications, and all‐cause mortality. Results One hundred (67%) patients had paroxysmal AF, and 136 (90.6%) underwent their first ablation for AF. At 2 years, the recurrence‐free survival rate was 85.8% (95% confidence interval CI, 78.2%–94.2%) in paroxysmal AF and 63.6% (95% CI, 48.9%–82.6%) in persistent AF ( p = 0.024). Periprocedural complications occurred in 18 (12.0%) patients. The most common were bleeding events ( n = 9; 6.0%), followed by post‐ablation heart failure ( n = 7; 4.7%). In‐hospital death, embolism, gastroesophageal complications, and phrenic nerve paralysis did not occur in any cases. During the median follow‐up period of 527 days (interquartile range: 364–913 days), 11 patients (7.3%) died from causes unrelated to the catheter ablation procedures. Periprocedural complications were not associated with an increased risk of all‐cause mortality ( p = 0.475). Conclusions Catheter ablation demonstrates reasonable efficacy and safety in very elderly patients with AF.
Tamura et al. (Thu,) conducted a cohort in Atrial Fibrillation (n=150). Catheter ablation (Paroxysmal AF) vs. Catheter ablation (Persistent AF) was evaluated on 2-year recurrence-free survival (p=0.024). Catheter ablation in patients aged ≥80 years achieved a 2-year recurrence-free survival of 85.8% in paroxysmal AF compared to 63.6% in persistent AF (p=0.024), with a 12.0% complication rate.