Cryoballoon Ablation in Older Patients With Heart Failure: Insights From a Large-Scale Multicenter Clinical Study

Area of Science:

• Cardiology
• Electrophysiology
• Geriatrics

Background:

• Cryoballoon ablation (CBA) is effective for atrial fibrillation (AF).
• Feasibility of CBA in elderly patients with heart failure (HF) is not well-established.

Purpose of the Study:

• To evaluate the efficacy and prognosis of CBA in older patients (≥75 years) with HF.
• To compare outcomes between older and younger HF patients undergoing CBA.

Main Methods:

• Analysis of 549 HF patients (185 older, 364 younger) undergoing CBA.
• Comparison of recurrence, mortality, and HF hospitalization rates using survival analyses.
• Evaluation of changes in left ventricular ejection fraction (LVEF) and B-type natriuretic peptide levels.

Main Results:

• Procedural complication rates were similar between older and younger groups.
• Recurrence-free survival and mortality rates were comparable.
• Older patients had a higher HF hospitalization rate (4.0 vs 1.5 per 100 patient-years).
• LVEF and B-type natriuretic peptide levels improved in older patients post-ablation.

Conclusions:

• CBA is feasible for older AF patients with HF, improving cardiac parameters.
• Higher HF hospitalization rates in older patients warrant specific attention and monitoring.
• AF recurrence is linked to HF hospitalizations, particularly after one year.