Clinical efficacy and safety of radiofrequency catheter ablation for atrial fibrillation in patients aged ≥80 years

Abstract

Aim: To evaluate the clinical safety and efficacy of radiofrequency catheter ablation for atrial fibrillation (AF) in patients aged ≥80 years. Methods: A total of 333 AF patients aged ≥60 years were enrolled, who underwent contact forceguided radiofrequency catheter ablation with uninterrupted anticoagulation. All patients were followed-up for at least 12 months. Success was defined by the absence of episodes of AF/atrial tachycardia lasting more than 30 seconds after a 3-month blanking period, without antiarrhythmic drugs. Results: Compared to patients aged 60-79 years (Group 2, n = 244), patients aged ≥80 years (Group 1, n = 89) were presented with higher rate of diabetes (36.0% vs 22.1%, P = .011), lower body mass index (23.4 ± 3.1 vs 24.9 ± 3.4 kg/m 2 , P = .001), lower creatinine clearance (56.9 ± 16.5 vs 83.3 ± 24.5 mL/min, P < .001), higher CHA 2 DS 2-VASc score (4.3 ± 1.3 vs 3.3 ± 1.4, P < .001), and HAS-BLED score (2.2 ± 0.8 vs 1.8 ± 0.8, P < .001). Wide antral pulmonary vein isolation was achieved in all patients, and there was no significant difference in procedure time, ablation time, fluoroscopy time, and complications rate between two age groups (P > .05). After a mean followup of 24.4 ± 9.6 months, the overall success rate was 78.2% in Group 1 and 78.9% in Group 2 (P = .622). Conclusions: Radiofrequency ablation with contact force sensing catheters for AF is safe and effective in selected patients aged ≥80 years.

Catheter ablation for atrial fibrillation in elderly patients: Systematic review and a meta‐analysis

“…We analyzed the procedure time between the elderly patients versus nonelderly patients to investigate whether longer procedure time was related to higher incidence of procedure-related complications, however among available 13 studies, there was no significant difference in procedure time between the groups. Although our meta-regression analysis showed there was no significant interaction between several confounding factors and our major outcomes, we could not conduct meta-regression analysis regarding to anticoagulation, AADs and ablation strategies, since there were only four, 8,19,20,22 three, 10,19,20 and four 8,10,21,32 studies had detailed number of patients, respectively.…”

“…Under such circumstance, evidence of CA for the elderly patients with AF is needed. During the past decade, there have been a number of studies which have specifically focused on reporting the outcomes of CA for AF in elderly individuals both using with radiofrequency [8][9][10][11][12][13][14][15][16][17] and cryoballoon CA. [18][19][20][21][22][23] However, outcome of CA for elderly patients with AF remains conflicting due to relatively small-sample sizes of available studies, disparate ablation methods and inhomogeneous patient selection.…”

The Characteristics of Fear of Recurrence and the Effect of Cognitive-Behavioral Stress Management Intervention in Patients after Radiofrequency Ablation of Atrial Fibrillation

“…Atrial fibrillation is a chronic heart disease with chronic arrhythmia as the main manifestation, and its prevalence increases with age [ 1 ]. The current study shows that the recurrence rate of nonelderly patients within 1 year after radiofrequency ablation (RFA) is 7.50%, and the recurrence rate of elderly patients is as high as 17.14% [ 2 ], which greatly increases the psychological burden of patients and leads to fear of cancer recurrence (FCR) occurs after surgery.…”

Do Elderly Patients with Atrial Fibrillation Have Comparable Ablation Outcomes Compared to Younger Ones? Evidence from Pooled Clinical Studies

“…A total of 27 studies with 113,106 AF patients (8686 elderly patients and 104,420 younger patients) were eligible, including 23 observational two-arm studies [ 6 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ] (8133 elderly AF patients and 104,420 younger AF patients) and four single-arm studies [ 32 , 33 , 34 , 35 ] (553 elderly AF patients). The selection flowchart is displayed in Figure 1 .…”