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Clinical outcomes of radiofrequency catheter ablation of atrial fibrillation in octogenarians—10-year experience of a one high-volume center

BACKGROUND: Prevalence of atrial fibrillation (AF) increases with age. Radiofrequency catheter ablation (RFCA) is an established treatment option superior to antiarrhythmics (AAs). In this study, we investigated safety and efficacy of RFCA of AF in octogenarians. METHODS: From our database, we extra...

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Autores principales: Bulava, Alan, Hanis, Jiri, Dusek, Ladislav
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Science Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641645/
https://www.ncbi.nlm.nih.gov/pubmed/29056956
http://dx.doi.org/10.11909/j.issn.1671-5411.2017.09.007
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author Bulava, Alan
Hanis, Jiri
Dusek, Ladislav
author_facet Bulava, Alan
Hanis, Jiri
Dusek, Ladislav
author_sort Bulava, Alan
collection PubMed
description BACKGROUND: Prevalence of atrial fibrillation (AF) increases with age. Radiofrequency catheter ablation (RFCA) is an established treatment option superior to antiarrhythmics (AAs). In this study, we investigated safety and efficacy of RFCA of AF in octogenarians. METHODS: From our database, we extracted procedural and follow-up data for patients ≥ 80 years with symptomatic AF undergoing RFCA and compared this population to RFCA patients ≤ 50 years. All patients underwent pulmonary vein isolation (PVI) supplemented by linear lesions in PVI-nonresponders. Arrhythmia-free survival was assessed using seven day Holter every three months post procedure. All patients completed their 12 months follow-up. RESULTS: Fifty patients aged ≥ 80 years (80.5 ± 1.6 years) were compared to 259 patients aged ≤ 50 years (43.5 ± 5.5 years). The RFCA complication rate did not vary between groups. No differences in procedural characteristics were seen after being analyzed by type of AF. Among patients with paroxysmal AF, 71.4% octogenarian vs. 84.7% young patients was free of any arrhythmia, without AAs, after single procedure. For non-paroxysmal AF, arrhythmia-free survival without AAs, was considerably lower (58.6% octogenarians vs. 81.2% younger patients, P = 0.023). If AAs were used, arrhythmia-free survival for paroxysmal AF increased to 90.5% and 92.1% in octogenarians and younger patients, respectively; and in non-paroxysmal AF it increased to 79.3% vs. 88.4%. CONCLUSIONS: RFCA is a safe and effective strategy to achieve normal sinus rhythm in a highly selected group of octogenarians. Paroxysmal AF ablation in octogenarians has similar clinical effectiveness as that seen in much younger patients. Non-paroxysmal AF ablation has lower, but still reasonable clinical effectiveness.
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spelling pubmed-56416452017-10-20 Clinical outcomes of radiofrequency catheter ablation of atrial fibrillation in octogenarians—10-year experience of a one high-volume center Bulava, Alan Hanis, Jiri Dusek, Ladislav J Geriatr Cardiol Research Article BACKGROUND: Prevalence of atrial fibrillation (AF) increases with age. Radiofrequency catheter ablation (RFCA) is an established treatment option superior to antiarrhythmics (AAs). In this study, we investigated safety and efficacy of RFCA of AF in octogenarians. METHODS: From our database, we extracted procedural and follow-up data for patients ≥ 80 years with symptomatic AF undergoing RFCA and compared this population to RFCA patients ≤ 50 years. All patients underwent pulmonary vein isolation (PVI) supplemented by linear lesions in PVI-nonresponders. Arrhythmia-free survival was assessed using seven day Holter every three months post procedure. All patients completed their 12 months follow-up. RESULTS: Fifty patients aged ≥ 80 years (80.5 ± 1.6 years) were compared to 259 patients aged ≤ 50 years (43.5 ± 5.5 years). The RFCA complication rate did not vary between groups. No differences in procedural characteristics were seen after being analyzed by type of AF. Among patients with paroxysmal AF, 71.4% octogenarian vs. 84.7% young patients was free of any arrhythmia, without AAs, after single procedure. For non-paroxysmal AF, arrhythmia-free survival without AAs, was considerably lower (58.6% octogenarians vs. 81.2% younger patients, P = 0.023). If AAs were used, arrhythmia-free survival for paroxysmal AF increased to 90.5% and 92.1% in octogenarians and younger patients, respectively; and in non-paroxysmal AF it increased to 79.3% vs. 88.4%. CONCLUSIONS: RFCA is a safe and effective strategy to achieve normal sinus rhythm in a highly selected group of octogenarians. Paroxysmal AF ablation in octogenarians has similar clinical effectiveness as that seen in much younger patients. Non-paroxysmal AF ablation has lower, but still reasonable clinical effectiveness. Science Press 2017-09 /pmc/articles/PMC5641645/ /pubmed/29056956 http://dx.doi.org/10.11909/j.issn.1671-5411.2017.09.007 Text en Institute of Geriatric Cardiology http://creativecommons.org/licenses/by-nc-sa/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License, which allows readers to alter, transform, or build upon the article and then distribute the resulting work under the same or similar license to this one. The work must be attributed back to the original author and commercial use is not permitted without specific permission.
spellingShingle Research Article
Bulava, Alan
Hanis, Jiri
Dusek, Ladislav
Clinical outcomes of radiofrequency catheter ablation of atrial fibrillation in octogenarians—10-year experience of a one high-volume center
title Clinical outcomes of radiofrequency catheter ablation of atrial fibrillation in octogenarians—10-year experience of a one high-volume center
title_full Clinical outcomes of radiofrequency catheter ablation of atrial fibrillation in octogenarians—10-year experience of a one high-volume center
title_fullStr Clinical outcomes of radiofrequency catheter ablation of atrial fibrillation in octogenarians—10-year experience of a one high-volume center
title_full_unstemmed Clinical outcomes of radiofrequency catheter ablation of atrial fibrillation in octogenarians—10-year experience of a one high-volume center
title_short Clinical outcomes of radiofrequency catheter ablation of atrial fibrillation in octogenarians—10-year experience of a one high-volume center
title_sort clinical outcomes of radiofrequency catheter ablation of atrial fibrillation in octogenarians—10-year experience of a one high-volume center
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641645/
https://www.ncbi.nlm.nih.gov/pubmed/29056956
http://dx.doi.org/10.11909/j.issn.1671-5411.2017.09.007
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