Acute safety outcomes in younger and older patients with atrial fibrillation treated with catheter ablation.

Purpose: Catheter ablation for atrial fibrillation (AF) has been demonstrated to be safe and effective in subsets of patients with AF, but primarily in patients age <65. This study compared acute safety in patients age ≥65 vs. those <65 who have undergone catheter ablation for AF.

Methods: A retrospective analysis of data from two Thomson Reuters MarketScan® research databases was performed on 5,947 patients who underwent catheter ablation for treatment of AF. Acute safety was measured as a composite endpoint of procedure-related adverse events coded ≤7 days post-procedure. A logistic regression model was fitted to this endpoint, using age (<65, ≥65) and relevant covariates. Peri-procedural mortality rates were examined among patients with inpatient ablation procedures, where death rates could be determined by discharge status.

Results: The acute safety event rate was nearly identical between both groups. This finding persisted after adjusting for covariates in the logistic regression model (p = 0.6648). There were no peri-procedural mortalities among the 3,575 index ablation procedures performed in an inpatient setting.

Conclusion: Acute safety of catheter ablation for AF in patients ≥65 was consistent with that of younger patients. A prior history of hypertension and stroke was associated with a high risk for complications with AF ablation. These findings in a large, real world population may have implications for Medicare patients with AF.