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Procedural success, safety and patients satisfaction after second ablation of atrial fibrillation in the elderly: results from the German Ablation Registry

  • Thomas FinkEmail author
  • Andreas Metzner
  • Stephan Willems
  • Lars Eckardt
  • Hüseyin Ince
  • Johannes Brachmann
  • Stefan G. Spitzer
  • Thomas Deneke
  • Claus Schmitt
  • Matthias Hochadel
  • Jochen Senges
  • Andreas Rillig
Original Paper
  • 127 Downloads

Abstract

Background

Aged patients are underrepresented in clinical trials on catheter ablation of atrial fibrillation (AF). In addition, results of outcomes after repeat ablation in the elderly are lacking. We report the results of first repeat AF ablation procedures of aged patients from a real-world multicenter prospective registry.

Methods

Patients undergoing second AF ablation included in the prospective, multicenter German Ablation Registry were divided in two groups (age > 70 years (group 1) and age ≤ 70 years (group 2)) and analyzed for procedural characteristics and clinical follow-up.

Results

738 patients were analyzed (108 patients in group 1, 630 patients in group 2). Significantly more aged patients had structural heart disease (56 patients (51.9%) vs. 203 patients (32.2%), p < 0.001). The majority of the patients underwent repeat pulmonary vein isolation (101 patients (93.5%) vs. 593 patients (94.1%), p = 0.98). More aged patients underwent ablation of left atrial linear lesions (78.1% vs. 57.3% of all linear lesions, p = 0.027). There was no difference in the occurrence of peri-procedural complications (7 patients (6.5%) vs. 24 patients (3.8%), p = 0.30). Recurrence of atrial arrhythmias was documented in 45/105 (42.9%) and 252/603 (41.8%) patients with available follow-up in groups 1 and 2 after a median of 447 (400; 532) and 473 (411; 544) days (p = 0.84). A comparable amount of patients were asymptomatic or reported symptom improvement after repeat ablation in both groups (80% (80/100) in group 1 and 77% (446/576) in group 2; p = 0.57).

Conclusion

Repeat ablation for AF in elderly patients can be performed with safety and efficacy comparable to younger patients.

Keywords

Catheter ablation Atrial fibrillation Elderly Repeat ablation 

Notes

Funding

This work was funded by an unrestricted grant from foundation ‘Stiftung Institut für Herzinfarktforschung Ludwigshafen’ (Ludwigshafen, Germany).

Compliance with ethical standards

Conflict of interest

Dr. Metzner received speaker’s honoraria from Medtronic. Dr. Willems received speaker honoraria from Abott, Boston Scientific, Boehringer Ingelheim, Bristol Myers Squibb, Bayer Vital, Acutus and study funding from Abott, Boston Scientific and Acutus. Dr Eckardt consulting fees/speaker honoraria from Bayer Health Care, Daiichi Sankyo, Pfizer, Bristol-Myers, Squibb, Boehringer Ingelheim, Johnson&Johnson, Medtronic, Boston Scientific, Abbott, Novartis and research support by the DFG the German Heart Foundation. Dr Brachmann received consulting fees/honoraria from Biotronik, Biosense Webster, Medtronic, Boston Scientific, and St. Jude Medical. Dr Rillig received travel grants/lecture fees from Biosense, Hansen Medical, Medtronic, EP Solutions and St. Jude Medical and participated at the Boston scientific EP-fellowship. The other authors report no conflict of interest.

Supplementary material

392_2019_1471_MOESM1_ESM.docx (31 kb)
Supplementary material 1 (DOCX 30 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Thomas Fink
    • 1
    • 2
    Email author
  • Andreas Metzner
    • 1
  • Stephan Willems
    • 3
  • Lars Eckardt
    • 4
  • Hüseyin Ince
    • 5
    • 6
  • Johannes Brachmann
    • 7
  • Stefan G. Spitzer
    • 8
  • Thomas Deneke
    • 9
  • Claus Schmitt
    • 10
  • Matthias Hochadel
    • 11
  • Jochen Senges
    • 11
  • Andreas Rillig
    • 1
    • 12
  1. 1.Department of CardiologyAsklepios Klinik St. GeorgHamburgGermany
  2. 2.Department of Cardiology, Angiology and Intensive Care MedicineUniversity Hospital Schleswig-Holstein, Campus LübeckLübeckGermany
  3. 3.Universitätsklinik Hamburg-EppendorfHamburgGermany
  4. 4.Klinik für Kardiologie II: RhythmologieUniversitätsklinikum MünsterMünsterGermany
  5. 5.Klinik für Kardiologie und Internistische IntensivmedizinVivantes Klinikum Am Urban und im FriedrichshainBerlinGermany
  6. 6.Abteilung für Kardiologie, Universitätsmedizin RostockRostockGermany
  7. 7.Klinik für Kardiologie, Angiologie und PneumologieCoburgGermany
  8. 8.Praxisklinik Herz und Gefäße Dresden, Akademische Lehrpraxisklinik der TU Dresden and Institute of Medical TechnologyBrandenburg University of Technology CottbusSenftenbergGermany
  9. 9.Herz- und Gefäßklinik Bad NeustadtBad NeustadtGermany
  10. 10.Städtisches Klinikum Karlsruhe, Medizinische Klinik IVKarlsruheGermany
  11. 11.Institut für Herzinfarktforschung LudwigshafenLudwigshafen am RheinGermany
  12. 12.Charité Herzmedizin Berlin, Campus Benjamin FranklinBerlinGermany

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