Abstract 12148: Catheter Ablation of Atrial Fibrillation in Octogenarians: Safety and Outcomes
Introduction. One octogenarian over 10 has atrial fibrillation (AF), which poses a higher risk of death, congestive heart failure and stroke compared to younger patients. Radiofrequency catheter ablation (RFCA) is an effective treatment for AF, although studies evaluating the role of RFCA have largely excluded elderly patients. We report the safety and outcomes of RFCA of AF in octogenarians.
Methods. From 2008 to 2011 out of 2754 consecutive patients referred to our Institution for RFCA of drug-refractory AF, 103 (3.7%) had ≥80 years (age 85±3 years, 4 with >90 years). Pulmonary vein antrum isolation was performed in paroxysmal AF. In non-paroxysmal AF, ablation was extended to the entire left atrial posterior wall and to complex fractionated electrograms. Non-pulmonary vein triggers were disclosed by isoproterenol challenge at the end of the procedure and targeted for ablation.
Results. Octogenarians presented a high rate of female gender (41% vs. 28%, P = 0.006) and non-PV triggers (87% vs. 72%, P = 0.001). Non-pulmonary vein triggers were most commonly mapped in the coronary sinus, left atrial appendage, interatrial septum and superior vena cava. After a mean follow-up of 18±6 months, 71 (69%) octogenarians remained free from AF recurrence after a single procedure (vs. 71% in patients <80 years, P=0.66). The success rate reached 87% after two procedures. Total periprocedural complication rates also did not differ between the two age groups.
Conclusions. RFCA of AF is safe and effective in octogenarians. A high rate of female gender and non-PV triggers is present in these patients.
- © 2011 by American Heart Association, Inc.