Abstract 12840: Clinical Outcomes of Surgical Ablation of Atrial Fibrillation in Elderly Patients
Objectives: In order to minimize complexity and risk, many surgeons do not offer surgical atrial fibrillation ablation (SAFA) as an option to elderly patients undergoing other procedures. We hypothesized that there is no difference in procedural efficacy and morbidity when adding concomitant SAFA to surgery in an elderly cohort as compared to a younger cohort.
Methods: We retrospectively reviewed 60 consecutive patients >74 years old (Group A) who underwent SAFA at a single institution from January 2008 to June 2010 and compared them to 100 consecutive patients <75 years old (Group B) during the same time period. Outcome measures included rhythm success (defined as freedom from atrial fibrillation or flutter by most recent EKG at 3-12 months postoperatively) and major complications and mortality.
Results: There was no difference between groups with respect to AF chronicity or concomitant procedures. Group B patients were more likely to have lone AF surgery(p=.01). Group A patients were more likely to be have a preop history of COPD (p=.01), hypertension (p<0.01), and diabetes (p=.02). There was no difference in rhythm success among the age groups (Group A = 65.1%, Group B = 75.6%, p=0.22). There was no difference in survival to discharge (Group A=98.3%, Group B=99%, p=1.0), or 90 day survival (Group A=95%, Group B=98%, p=0.36). Group A patients had longer hospital length of stay (LOS) than Group B patients (median 7.1 days vs 9.0 days, p=0.02), and were less likely to be discharged to home vs. a facility (62.7% vs 91.9%, p<0.01). There was no difference in major complications between groups (Group A=10%, Group B=4%, p=0.18.)
Conclusion: SAFA is safe and effective in patients 75 or older with success comparable to younger patients. When considering adding SAFA to a concomitant procedure, patient age should not be a deterrent.
- © 2011 by American Heart Association, Inc.