Background: Atrial fibrillation (AF) risk increases with age. We aim to assess the efficacy and safety of catheter ablation in the older population.
Methods: All patients undergoing AF ablation (2013-2021) at our institution were enrolled in a prospectively maintained registry. The primary endpoint was AF recurrence. Patients were divided into 3 groups: non-elderly (< 65 years), elderly (65-75 years), and very elderly (> 75 years). Patient surveys at baseline and during follow-up were used to calculate quality of life (QoL) metrics: the AF severity score as well as the AF burden.
Results: A total of 7020 patients were included (42% non-elderly, 42% elderly, and 16% very elderly). Periprocedural major complications were low (< 1.5%) and similar in all groups besides pericardial effusion which was more frequent with older age and similar between the elderly and very elderly. At 3 years, AF recurrence for persistent AF (PersAF) was highest in the very elderly group (48%), followed by the elderly group (42%), and was the lowest in the non-elderly group (36%). In paroxysmal AF (PAF), there was no difference in AF recurrence between the elderly and non-elderly, while the very elderly remained associated with a significantly increased risk. Multivariable Cox analysis confirmed these findings (PersAF; elderly: HR = 1.23, P = 0.003; very elderly: HR = 1.44, P < 0.001) (PAF; elderly: HR = 1.04, P = 0.62; very elderly: HR = 1.30, P = 0.01). Catheter ablation resulted in a significant improvement in quality of life, irrespective of age group.
Conclusion: Catheter ablation in elderly and very elderly patients is safe, efficacious, and associated with QoL benefits. Overall, major complications were minimal and did not differ significantly between age groups, with the exception of pericardial effusions which were higher in the elderly and very elderly compared to non-elderly adults. Very elderly patients had a higher rate of AF recurrence when compared with elderly or non-elderly patients. Nevertheless, ablation resulted in a remarkable improvement in QoL and a reduction of AF burden and AF symptoms with a similar magnitude, irrespective of age.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s10840-023-01659-w | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Catheter ablation for supraventricular arrhythmias in adults with congenital heart disease: Recurrence rates and predictors of acute procedural success.
Int J Cardiol Congenit Heart Dis
June 2023
Bristol Heart Institute, Terrell Street, Bristol, BS2 8ED, UK.
Aims: To define the cohort of adult congenital heart disease (ACHD) patients undergoing catheter ablation for supraventricular arrhythmia in a large tertiary centre, characterise outcomes, and determine factors associated with arrhythmia recurrence.
Methods: Single centre retrospective study of all catheter ablations for atrial arrhythmias in ACHD patients between September 2014 and October 2021. Patients were identified using a field search through a centralised database.
Catheter Ablation of Paroxysmal Atrial Fibrillation and Disease Progression: Magnitude of the anti-progression effect and role of intervention timing.
Heart Rhythm
December 2024
Montreal Heart Institute, Université de Montréal, Montréal, Canada; University of British Columbia, Vancouver, Canada; Centre for Cardiovascular Innovation, Vancouver, Canada.
Background: Recent randomized controlled trials(RCT) have shown that catheter ablation of paroxysmal atrial fibrillation(AF) is associated with a lower incidence of progression to persistent AF compared to the use of antiarrhythmic drug(AAD) therapy.
Objective: This meta-analysis aimed to investigate the magnitude of the anti-progression effect of catheter ablation, as well as the effect of intervention timing.
Methods: MEDLINE/EMBASE databases were searched until April 1 2024 for RCTs comparing catheter ablation and AAD therapy for the treatment of paroxysmal AF and reporting the rate of progression to persistent AF at 3 years (PROSPERO CRD42024534288).
Vagal response during radiofrequency catheter ablation initiated from right superior pulmonary vein: Incidence, risk factors, and clinical outcomes.
Int J Cardiol
December 2024
Central China Fuwai Hospital, Heart Center of Henan Provincial People's Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China. Electronic address:
Background: The vagal response (VR) is unavoidable during pulmonary vein isolation (PVI) for atrial fibrillation (AF). In this study, we aimed to investigate the incidence, risk factors, and clinical outcomes of VR during PVI initiated from the right superior pulmonary vein (RSPV).
Methods: Patients with AF were consecutively enrolled.
Image quality assessment and automation in late gadolinium-enhanced MRI of the left atrium in atrial fibrillation patients.
J Interv Card Electrophysiol
December 2024
Department of Biomedical Engineering, University of Utah, SLC, UT, USA.
Background: Late gadolinium-enhanced (LGE) MRI has become a widely used technique to non-invasively image the left atrium prior to catheter ablation. However, LGE-MRI images are prone to variable image quality, with quality metrics that do not necessarily correlate to the image's diagnostic quality. In this study, we aimed to define consistent clinically relevant metrics for image and diagnostic quality in 3D LGE-MRI images of the left atrium, have multiple observers assess LGE-MRI image quality to identify key features that measure quality and intra/inter-observer variabilities, and train and test a CNN to assess image quality automatically.
View Article and Find Full Text PDFAtrial Tachyarrhythmias With Ultra-Rapid Ventricular Response and Sudden Death in Patients Without Structural Heart Disease.
JACC Clin Electrophysiol
November 2024
Department of Cardiology, AZ Sin Jan Bruges, Bruges, Belgium. Electronic address:
Background: Sudden cardiac death (SCD) is generally associated with life-threatening ventricular arrhythmias. Supraventricular arrhythmias are an accepted cause of SCD in Wolff-Parkinson-White syndrome and complex congenital heart disease. However, the role of atrial tachyarrhythmias (ATAs) in SCD in patients with structurally normal hearts is unclear.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!