Catheter Ablation in Older Patients with Atrial Fibrillation

The prevalence of atrial fibrillation (AF) increases with age and treatment with catheter ablation is performed frequently. Catheter ablation may have a lower rate of success and a higher rate of complications in older patients.We compared the characteristics, success rates, and complications of catheter ablation in patients with AF categorized into late old-aged (≥ 75 years, n = 148), early old-aged (65-74 years), n = 129), and middle-aged (< 65 years, n = 91) groups. Effects of catheter ablation on cardiac function in the left ventricle (LV) and left atrium (LA), and plasma B-type natriuretic peptide levels were evaluated at baseline and 1 year.AF ablation was successfully performed in older patients and the recurrence rate did not differ between groups (late old-aged: 29.7%, early old-aged: 15.5%, middle-aged: 23.1%). Procedural complications did not statistically differ among the groups (late old-aged: 9.5%, early old-aged: 6.2%, middle-aged: 3.3%). The LA volume index was greater in the late old-aged patients than in the other 2 groups. As comorbidities, hypertension and history of heart failure and stroke were more common in late old-aged patients. At 1 year after ablation, the LV ejection fraction, the LA volume index, and LA emptying fraction were improved, even in late old-aged patients. Plasma B-type natriuretic peptide levels were reduced in both the late old-aged and early-old-aged groups.Our findings indicate that AF ablation in late old-aged patients is effective, particularly with regard to LA structure and function, and the complication rate is similar to that in middle-aged patients.