title: The impact of age on the efficacy and safety of catheter ablation for long-standing persistent atrial fibrillation.
abstract: BACKGROUND
  Catheter ablation (CA) has been the most effective treatment for both paroxysmal and persistent atrial fibrillation (AF). However, the impact of age on CA for persistent AF is not well defined.
  
  
  METHODS
  Between January 2010 and August 2011, 258 consecutive patients (85 females, 32.9%), with long-standing persistent AF who underwent CA were prospectively recruited. Age-related differences in clinical presentation, peri-procedural complications, and outcomes were compared.
  
  
  RESULTS
  The study population included 258 patients (85 females, 32.9%): 71 patients in Group I (≤ 55 years), 89 patients in Group II (56-65 years), and 98 patients in Group III (≥ 66 years). Younger patients were more likely to have lone AF (49.3% in Group I, 32.6% in Group II, and 30.6% in Group III; P = 0.029). There was a significant difference in the success rate with advancing age after a single CA (69.0% in Group I, 50.6% in Group II, 40.8% in Group III; P = 0.001). A Cox regression analysis demonstrated age (for each 10 years increase, HR 1.307, CI 1.081-1.580; P = 0.006), sex (HR 1.460, CI 1.017-2.097; P = 0.040) and total AF duration (per year, HR 1.033, CI 1.006-1.060; P = 0.015) as the independent predictors for recurrence after the first CA. However, there was no significant difference in the incidence of peri-procedural complications among the three groups.
  
  
  CONCLUSIONS
  In this consecutive series of patients with long-standing persistent AF, female gender, total AF duration and advanced age were associated with the success of a single CA. The overall rate of complications was similar among all age groups.
authors.affiliation: Department of Cardiology, Shanghai Chest Hospital affiliated to Shanghai Jiaotong University, China.
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Gu
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Jiang
authors.forename: Liang
authors.initials: L
authors.lastname: Zhao
authors.forename: Yuan-Long
authors.initials: YL
authors.lastname: Wang
authors.forename: Yu-Gang
authors.initials: YG
authors.lastname: Liu
authors.forename: Li
authors.initials: L
authors.lastname: Zhou
authors.forename: Jia-Ning
authors.initials: JN
authors.lastname: Gu
authors.forename: Shao-Hui
authors.initials: SH
authors.lastname: Wu
authors.forename: Kai
authors.initials: K
authors.lastname: Xu
authors.forename: Xu
authors.initials: X
authors.lastname: Liu
mesh_terms: D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Age; Atrial fibrillation; Catheter ablation; Complication; Recurrence