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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

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[Ablation for atrial fibrillation in the elderly]

Clemens Jilek1, Thorsten Lewalter2

  • 1Peter-Osypka-Herzzentrum München, Kliniken Dr. Müller München, Am Isarkanal 36, 81379, München, Deutschland. forschung@jilek.de.

Herzschrittmachertherapie & Elektrophysiologie
|February 1, 2017
PubMed

Insights

Atrial fibrillation ablation is equally successful in elderly patients compared to younger ones. However, older individuals may face higher stroke risks, particularly those over 80 with heart failure or a history of stroke.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Geriatric Medicine

Background:

  • Atrial fibrillation (AF) is a prevalent arrhythmia, particularly in the elderly population.
  • Current European Society of Cardiology (ESC) guidelines support AF ablation across all age groups without specific data for older adults.
  • There is a need for evidence-based recommendations regarding AF ablation in the elderly.

Purpose of the Study:

  • To summarize efficacy and safety data of atrial fibrillation ablation in elderly individuals.
  • To provide treatment recommendations for AF ablation in older patients.
  • To evaluate stroke risk factors in elderly AF patients undergoing ablation.

Main Methods:

  • Systematic review and meta-analysis of existing cohort studies and clinical trials.
  • Analysis of success rates, complication rates, and stroke incidence.
  • Identification of predictors for adverse events, specifically stroke.

Main Results:

  • Atrial fibrillation ablation demonstrates comparable success rates in elderly patients versus younger cohorts.
  • Cohort studies indicate a trend towards increased stroke rates in elderly individuals post-ablation.
  • Negative predictors for stroke include age >80 years, presence of heart failure, prior stroke history, and a CHA 2 DS 2 -VASc score 6.

Conclusions:

  • Atrial fibrillation ablation is a viable and effective treatment option for elderly patients.
  • Careful patient selection and risk stratification are crucial due to potential increased stroke risk in older adults.
  • Risk factors such as advanced age, heart failure, and high CHA 2 DS 2 -VASc scores necessitate tailored management strategies.

Keywords:
AblationAtrial fibrillationEfficacyQuality of lifeStroke

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