VT ablation in geriatric patients with structural heart disease: Should there still be an age limit?
Angeliki Darma1, Livio Bertagnolli1, Borislav Dinov1
1Department of Cardiac Electrophysiology, Leipzig Heart Center, Leipzig, Germany.
Introduction:
This study sought to examine the feasibility and outcome of ablation of ventricular tachycardias (VTs) in a contemporary cohort of geriatric patients with structural heart disease (SHD).
Background:
Geriatric patients are often underrepresented in large studies. As frailty is becoming an increasing problem, we need to examine the best course of action for this population.
Methods And Results:
We investigated 68 SHD-patients ≥ 75 years old undergoing VT-ablation (men 88%, ischemic cardiomyopathy 77%, electrical storm 72%, mean left ventricular ejection fraction 31%) and divided the cohort into two groups: 75-79 years old (n = 51) and ≥80 years old (n = 17). The two groups showed similar results regarding noninducibility as ablation endpoint (p = .693), major procedure-related complications (p = .488), and VT-recurrence (p = .882) during the 39-month follow-up. At the end of the follow-up, 10 patients in the octogenarian group (59%) versus 16 patients of the other group (31%) died.
Conclusion:
Geriatric patients with SHD including octogenarians showed similar results regarding procedural endpoints, freedom of VT, and major procedure-associated complications after VT-ablation. When ablation is indicated, age alone should not be an inhibiting factor to treat these patients.
Related Concept Videos
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Heart Failure IV: Classification and Diagnostic Evaluation
Pharmacodynamics in Geriatric Patients: Effects of Age
Aortic Regurgitation III: Medical Management
Mitral Stenosis III: Medical Management
Heart Failure V: Medical Management


