Abstract 20226: Meta-Analysis of Complications and Success of Catheter Ablation for Atrial Fibrillation in Octogenarians
Introduction: The population of the United States is aging and thus the prevalence and incidence of atrial fibrillation are increasing. Morbidity and mortality from this arrhythmia positively correlates with age, attributable to both pharmacologic complications and the disease itself. Therefore, elderly patients in particular may benefit from a procedural treatment. Though radiofrequency catheter ablation (RFCA) techniques are known to be successful and safe in the treatment of atrial fibrillation in patients less than 65 years of age, there is no consensus in the literature regarding these outcomes in an older population.
Methods: We conducted a systematic search of the PubMed database for studies that analyze age-based outcomes of RFCA for atrial fibrillation. In total, 12 were identified. Only studies that report event rates for patients greater than 80 years of age were considered. Five retrospective cohort studies with a total of 7, 402 patients including 413 octogenarians met our inclusion criteria. Two outcomes were found to be comparable across these studies. Success, defined as freedom from atrial tachyarrhythmias 90 days after ablation, and major complications including death, stroke, pericardial effusion and bleeding were analyzed. A meta-analysis of dichotomous data was performed based on a random-effects model. A pooled estimate of the odds ratio (OR) was obtained for each outcome such that an OR less than 1 favors association with octogenarians. Heterogeneity among studies was assessed by calculating the I2 statistic.
Results: The meta-analysis demonstrated no difference between octogenarians and patients less than 80 years of age in terms of success of the procedure (OR, 0.85; 95% confidence interval 0.63 – 1.14; I2 = 0%). There was also no difference between the two age groups in major complications (OR 1.33; 95% confidence interval 0.87 – 2.04; I2 = 0%).
Conclusions: There is no difference in octogenarians in complication and success rate of RFCA for atrial fibrillation. Therefore, patient age alone should not be used as an exclusion factor when contemplating patient selection for this procedure.
Author Disclosures: T. Aliyeva: None. R. Chait: None.
- © 2016 by American Heart Association, Inc.