Document Detail


Ablation of atrial fibrillation after the retirement age: considerations on safety and outcome.
MedLine Citation:
PMID:  20556499     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although the incidence of atrial fibrillation (AF) progressively increases with age, the vast majority of AF ablation is done in middle-aged patients. We evaluated the feasibility and safety of catheter ablation in patients older than 65 years of age with paroxysmal and persistent AF.
METHODS: Out of a total of 230 consecutive AF ablation procedures, 45 patients were older than 65 years of age and underwent 53 procedures. The ablation strategy consisted of wide-area circumferential lines around both ipsilateral pulmonary veins using a three-dimensional mapping system.
RESULTS: The mean age was 69 ± 3.5 years (35 males). The mean duration for AF was 8.7 ± 6.5 years. Thirty-nine had paroxysmal and six persistent AF despite use of 1.38 ± 0.77 antiarrhythmic drugs. All patients had a structurally normal heart. Eleven had systemic hypertension. Mean procedure time was 187 ± 33 min. Acute procedural success rate with abolition of all pulmonary vein potentials was achieved in all patients. Pericardial tamponade requiring percutaneous drainage occurred in one (1.9%) patient. There were no cardioembolic events. Among the 43 patients whose clinical outcome was assessed at 6 months, 34 (79%) had a significant reduction (>90%) of the total symptomatic AF burden, compared to pre-ablation, with a complete lack of symptomatic AF in 32 (74%) patients. The success rate was higher for patients with paroxysmal versus persistent AF (81 vs. 67%). Six patients (11%) underwent repeat procedures.
CONCLUSIONS: Catheter ablation is a safe and effective treatment for patients over the age of 65 years with symptomatic, drug-refractory AF. Therefore, patients should not be excluded from undergoing AF catheter ablation on the basis of age alone.
Authors:
Laurent M Haegeli; Firat Duru; Evan E Lockwood; Thomas F Lüscher; Laurence D Sterns; Paul G Novak; Richard A Leather
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Publication Detail:
Type:  Journal Article     Date:  2010-06-16
Journal Detail:
Title:  Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing     Volume:  28     ISSN:  1572-8595     ISO Abbreviation:  J Interv Card Electrophysiol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-29     Completed Date:  2011-01-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708966     Medline TA:  J Interv Card Electrophysiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  193-7     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Royal Jubilee Hospital, Victoria, BC, Canada. laurent.haegeli@usz.ch
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Fibrillation / surgery*
Catheter Ablation* / contraindications,  methods
Feasibility Studies
Female
Humans
Male
Patient Selection
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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