Journal of Interventional Cardiac Electrophysiology

, Volume 28, Issue 3, pp 193–197

Ablation of atrial fibrillation after the retirement age: considerations on safety and outcome

  • Laurent M. Haegeli
  • Firat Duru
  • Evan E. Lockwood
  • Thomas F. Lüscher
  • Laurence D. Sterns
  • Paul G. Novak
  • Richard A. Leather
Article

DOI: 10.1007/s10840-010-9490-8

Cite this article as:
Haegeli, L.M., Duru, F., Lockwood, E.E. et al. J Interv Card Electrophysiol (2010) 28: 193. doi:10.1007/s10840-010-9490-8

Abstract

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.

Keywords

Atrial fibrillation Catheter ablation Elderly Safety Outcome 

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Laurent M. Haegeli
    • 1
    • 2
  • Firat Duru
    • 2
  • Evan E. Lockwood
    • 1
  • Thomas F. Lüscher
    • 2
  • Laurence D. Sterns
    • 1
  • Paul G. Novak
    • 1
  • Richard A. Leather
    • 1
  1. 1.Department of CardiologyRoyal Jubilee HospitalVictoriaCanada
  2. 2.Cardiology, Cardiovascular CenterUniversity Hospital of ZurichZurichSwitzerland

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