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Safety and efficacy of cryoballoon ablation for the treatment of atrial fibrillation in elderly patients

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Abstract

Background

Catheter ablation (CA) is an established therapy for treatment of atrial fibrillation (AF). However, data about AF ablation using the cryoballoon (CB) in the elderly population are sparse. The aim of this single center retrospective study is to evaluate the safety and efficacy of CB ablation in patients ≥ 75 years compared to patients < 75 years.

Methods and results

Fifty-five consecutive patients aged ≥ 75 years (elderly group) were compared with 183 patients aged < 75 years (control group). All patients underwent pulmonary vein isolation (PVI) using the second-generation CB. The mean age in the elderly group was 78 ± 2.8 years and 60.8 ± 9.5 in the control group (p < 0.001). During 11.8 ± 5.4 months of follow-up, single procedure success rate for the elderly and the control group was 72.8 and 76%, respectively (p = 0.37). During redo ablation (n = 40), low-voltage areas in the LA were more frequently observed in elderly patients compared to the control group [1.0 (IQR 0–2.0) segments vs 2.0 (IQR 2.0–3.0) segments, respectively, p = 0.03]. The most common complication was transient phrenic nerve palsy, which only occurred in patients < 75 years (0 vs 7, p = 0.33). No severe complication such as procedure-related deaths, atrio-esophageal fistula, or cerebrovascular embolic events occurred.

Conclusions

Our data strengthen the value of CB ablation for the treatment of AF as an effective and safe procedure in elderly patients, with similar success and complication rates when compared with a younger population.

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Authors and Affiliations

  1. University Heart Center Luebeck, Medical Clinic II (Department of Cardiology, Angiology and Intensive Care Medicine), University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538, Luebeck, Germany

    Amr Abdin, Kivanc Yalin, Evgeny Lyan, Noureddin Sawan, Sypridon Liosis, Roza Meyer-Saraei, Christian Elsner, Stefan A. Lange, Christian-Hendrik Heeger, Charlotte Eitel, Ingo Eitel & Roland Richard Tilz

  2. German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Luebeck, Germany

    Amr Abdin, Ingo Eitel & Roland Richard Tilz

  3. Department of Cardiology, Faculty of Medicine, Usak University, Usak, Turkey

    Kivanc Yalin

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  1. Amr Abdin
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  2. Kivanc Yalin
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  7. Christian Elsner
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  8. Stefan A. Lange
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  9. Christian-Hendrik Heeger
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  10. Charlotte Eitel
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Correspondence to Roland Richard Tilz.

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Conflict of interest

K. Yalin received research and educational grant from Turkish Society of Cardiology. E. Lyan received travel grants and Speaker's Bureau Honoraria from BiosenseWebster, Medtronic, Boston Scientific. R. Tilz received travel grants from St. Jude Medical, Topera, BiosenseWebster, Daiichi Sankyo, Sentrheart and Speaker's Bureau Honoraria from BiosenseWebster, Biotronik, Pfizer, Topera, Bristol-Myers Squibb; Bayer, Sanofi Aventis. Christian Heeger received travel grants and research grants by Medtronic, Claret Medical and SentreHeart. All other authors have no disclosures.

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Abdin, A., Yalin, K., Lyan, E. et al. Safety and efficacy of cryoballoon ablation for the treatment of atrial fibrillation in elderly patients. Clin Res Cardiol 108, 167–174 (2019). https://doi.org/10.1007/s00392-018-1336-x

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  • DOI: https://doi.org/10.1007/s00392-018-1336-x

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