open access

Vol 16, No 2 (2009)
Review articles
Published online: 2009-01-06
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Catheter ablation of atrial fibrillation in the elderly: Where do we stand?

Darren Traub, James P. Daubert, Scott McNitt, Wojciech Zaręba, Burr Hall
Cardiol J 2009;16(2):113-120.

open access

Vol 16, No 2 (2009)
Review articles
Published online: 2009-01-06

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.

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.
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Keywords

atrial fibrillation; catheter ablation; elderly patients

About this article
Title

Catheter ablation of atrial fibrillation in the elderly: Where do we stand?

Journal

Cardiology Journal

Issue

Vol 16, No 2 (2009)

Pages

113-120

Published online

2009-01-06

Bibliographic record

Cardiol J 2009;16(2):113-120.

Keywords

atrial fibrillation
catheter ablation
elderly patients

Authors

Darren Traub
James P. Daubert
Scott McNitt
Wojciech Zaręba
Burr Hall

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