Vol 16, No 2 (2009)
Review Article
Published online: 2009-01-06
Catheter ablation of atrial fibrillation in the elderly: Where do we stand?
Cardiol J 2009;16(2):113-120.
Abstract
Catheter ablation has emerged as an important therapy for the management of drug refractory
symptomatic paroxysmal and persistent atrial fibrillation (AF). Although the elderly account
for the majority of patients with AF, limited data exists regarding the use of catheter ablation
for elderly patients with AF. As AF ablation has become more widespread, ablation techniques
have improved and the complication rate has decreased. As a result, referrals of elderly patients
for catheter ablation of AF are on the rise. Two retrospective analyses have recently demonstrated
that catheter ablation of AF in the elderly can safely be performed and results are
comparable to a younger population with up to 80% or more of patients maintaining sinus
rhythm at 12 months follow-up. We compared the results of 15 consecutive patients ≥ 70 years
old with symptomatic paroxysmal atrial fibrillation who underwent catheter ablation of AF at
our institution to 45 randomly sampled younger patients. The primary endpoint of our study,
presence of sinus rhythm in the absence of symptoms at 12 months follow-up, was present in
60% of elderly patients and 80% of younger patients (p = 0.17). There was no statistically
significant difference in complication rate between the younger and elderly patients. In this
article we present the results of our study and review the published literature to date regarding
the clinical efficacy and safety of catheter ablation for AF in elderly patients with paroxysmal
and persistent atrial fibrillation.
Keywords: atrial fibrillationcatheter ablationelderly patients