Complications Associated With Catheter Ablation in Patients With Atrial Fibrillation: A Report From the JROAD-DPC...

Area of Science:

• Cardiology
• Geriatrics
• Medical Informatics

Background:

• Aging is a significant factor influencing decisions for catheter ablation (CA) in atrial fibrillation (AF) patients.
• Assessing the safety of CA in elderly AF patients is crucial for clinical practice.

Purpose of the Study:

• To evaluate the safety and in-hospital complication rates of catheter ablation (CA) in older patients with atrial fibrillation (AF).
• To determine the association between advanced age and the risk of complications following CA for AF.

Main Methods:

• Utilized the Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination (JROAD-DPC) nationwide claims database (April 2012-March 2018).
• Analyzed data from 135,299 AF patients who underwent CA, stratified by age groups (<60 to ≥85 years).
• Performed multivariate analysis to identify predictors of complications, including age and comorbidities.

Main Results:

• The overall in-hospital complication rate was 3.4%, with cardiac tamponade at 1.2%. In-hospital mortality was 0.04%.
• Older patients exhibited higher rates of comorbidities like hypertension and were more likely to be female.
• Increased age was independently associated with a significantly higher risk of overall complications, with risk escalating in older age brackets (e.g., OR 2.86 for ≥85 years vs. <60 years).

Conclusions:

• The JROAD-DPC database indicates that complication frequency after catheter ablation for atrial fibrillation rises with patient age.
• Age is a significant independent predictor of complications, highlighting the importance of risk stratification in elderly AF patients undergoing CA.