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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Efficacy and Safety of Ablation for Symptomatic Atrial Fibrillation in Elderly Patients: A Meta-Analysis

Wei-Chieh Lee1,2, Po-Jui Wu2, Huang-Chung Chen2

  • 1College of Medicine, Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan.

Frontiers in Cardiovascular Medicine
|October 7, 2021
PubMed

Insights

Elderly patients undergoing atrial fibrillation (AF) ablation face higher recurrence and complication rates, except for those aged 75 and older. This finding highlights age-specific considerations for AF ablation strategies.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Geriatric Medicine

Background:

  • Pharmacological treatments for atrial fibrillation (AF) show variable efficacy with age.
  • Catheter ablation (radiofrequency or cryoballoon) is a key strategy for symptomatic AF.
  • Investigating age-related differences in AF ablation outcomes is crucial.

Approach:

  • A meta-analysis of 18 observational studies (21,039 patients) published between 2008 and 2020.
  • Compared efficacy (AF/atrial tachyarrhythmia recurrence) and safety (complications) between elderly and non-elderly AF patients.
  • Analyzed procedural and fluoroscopic times.

Key Points:

  • Elderly patients (<60 years old) experienced higher AF/atrial tachyarrhythmia recurrence post-ablation (OR, 1.21).
  • Elderly patients also faced increased complication rates (OR, 1.37).
  • Patients aged ≥75 years showed similar recurrence and complication rates compared to younger cohorts.

Conclusions:

  • Elderly patients with non-paroxysmal AF generally have worse outcomes post-ablation than younger patients.
  • Age ≥75 represents a threshold where ablation outcomes may approach those of younger individuals.
  • These findings necessitate tailored approaches for AF ablation in different elderly subgroups.

Keywords:
atrial fibrillationcryoballoon ablationelderlyradiofrequency ablationrecurrence

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