Outcomes of Catheter Ablation of Atrial Fibrillation in Patients over 65 Years of Age
Authors:
M. Fiala 1,2; L. Škňouřil 1; O. Toman 2; J. Pindor 1; D. Wojnarová 1; V. Bulková 1; J. Chovančík 1; M. Dorda 1; H. Szymeczek 1; R. Neuwirth 1; D. Vavřík 1; Š. Krawiec 1; O. Jiravský 1; L. Rybka 2; R. Lábrová 2; J. Januška 1; J. Špinar 2
Authors place of work:
Oddělení kardiologie Nemocnice Podlesí, a. s., Třinec, přednosta prim. MUDr. Marian Branny
1; Interní kardiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jindřich Špinar, CSc., FESC
2
Published in the journal:
Vnitř Lék 2013; 59(1): 16-22
Category:
Original Contributions
Summary
Purpose:
This study assessed ablation techniques, recurrent arrhythmias, long-term outcomes, and complications of catheter ablation for atrial fibrillation (AF) in patients ≥ 65 years of age.
Methods:
Consecutive patients aged < 65 years (n = 653) vs ≥ 65 years (n = 213), who underwent catheter ablation of AF in the course of eight years, were compared. Ablation strategy and procedure endpoints were left at the operator’s discretion.
Results:
The group of patients ≥ 65 years comprised more females (p < 0.001), and more frequently presented with persistent AF (p = 0.010). These patients less frequently underwent simple pulmonary vein isolation (p = 0.017); on the contrary, extensive ablation including coronary sinus intervention was more common (p = 0.020). There was no difference in repeat ablation procedures (25 % vs 26 % patients; p = 0.823, or 1.4 vs 1.5 ablation procedures/1 patients; p = 0.479, respectively). Spectrum of recurrent arrhythmias did not differ between the groups except for more frequent paroxysmal AF before the first repeat ablation in patients < 65 years (p = 0.050). At the end of 49 ± 26 month total follow-up, stable sinus rhythm (SR) was achieved in 85 % patients < 65 years vs 76 % patients ≥ 65 years (p = 0.318). To maintain stable SR, older patients more often continued to take antiarrhythmic medication (p = 0.054). More serious complication occurred in 3.8 % of the patients ≥ 65 years vs 2.1 % of the patients < 65 years of age (p = 0.207).
Conclusion:
Patients ≥ 65 years of age achieved insignificantly worse long-term outcome after insignificantly fewer repeat ablation procedures, and with more frequent use of antiarrhythmic drugs. SR maintenance and risk of complications were, however, favorable.
Key words:
atrial fibrillation – catheter ablation – age – outcomes
Zdroje
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Štítky
Diabetology Endocrinology Internal medicineČlánok vyšiel v časopise
Internal Medicine
2013 Číslo 1
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