Abstract 14837: Catheter Ablation for Cardiac Arrhythmias in Octa- and Nonagenarian Patients: Results from the German Ablation Registry
While underrepresented in earlier clinical trials, ablation for cardiac arrhythmias is applied with increasing frequency to elderly patients. The German Ablation Registry (GAR) is a designed as a multi-center prospective registry for electrophysiologic ablation procedures. It provides patient- and procedural characteristics and short- and long- term outcome data from 55 ablation centers. From March 2007 until May 2010, 16314 consecutive patients undergoing ablation therapy for cardiac arrhythmias were included: 12136 (74.4%) 80 y [group Nonag]. This is the first report about preliminary and one year outcome data.
Results: DM (Young: 7.8%, Octag: 16.9%, Nonag: 17.4, p<0.0001), hypertension (Young: 45.0%, Octag: 71.5%, Nonag: 74.3 p<0.0001) and CAD (Young: 14.4%, Octag: 35.5%, Nonag: 42.7<0.0001) as well as reduced LV systolic function (LVEF<40%: Young: 6.2%, Octag: 11.0%, Nonag: 12.1%, p<0.0001) were more common elderly patients. The table provides immediate and 1 y outcome data. AVRT: AV- nodal reentry tachycardia. Moderate complication: TIA, bleed with medical intervention, tamponade, infection etc. Minor complication: AV-block I, II, minor bleed, LBBB, RBBB without medical intervention. MACE: Death, MI. MACCE: Death MI, Stroke.
Conclusion: Ablation was successful in the majority of elderly and very elderly patients, who underwent less complex procedures than younger patients. 1 year mortality, mostly noncardiac, is high in nonagenarians, and they are much more prone to adverse events acutely and during follow up. Careful patient selection to achieve maximal palliation by ablative procedures is warranted in these patients.
- © 2010 by American Heart Association, Inc.