Catheter ablation of premature ventricular contractions in elderly patients: feasibility and success.
BACKGROUND
Catheter ablation has become a standard curative treatment for symptomatic, drug refractory premature ventricular contractions (PVC). The aim of this study was to investigate the efficacy and safety of this procedure in elderly patients.


RESULTS
A total of 101 consecutive patients (mean age 50.7 ± 16.9, 53 % women) presenting to our center for ablation of PVC were included and assigned to two age groups (<65 and ≥65 years). Clinical characteristics, procedural parameters, complications and success after 6-month follow up were compared between the two groups. Patients ≥65 years (n = 27) showed a higher rate of hypertension (78 vs. 27 %, p < 0.001), coronary artery disease (19 vs. 12 %, p = 0.01), renal insufficiency (22 vs. 1 %, p < 0.001) and diabetes (22 vs. 3 %, p = 0.001). Left ventricular ejection fraction did not differ between the two groups (56.6 vs. 57.4 %, p = 0.497). In patients <65 years the origin of the PVC was significantly more often in RVOT or LVOT (95 vs. 70 %, p = 0.001). Acute success rates (67 vs. 73 %, p = 0.545) and success rates after 6 months (81 vs. 86 %, p = 0.795) were not different between the two groups. Two complications were observed, both occurred in the <65 years group (1 pericardial effusion and 1 large groin hematoma).


CONCLUSIONS
Catheter ablation of PVC is feasible in elderly patients without overt heart disease. Success rates are not significantly different compared to patients <65 years. Procedural complications are rare in both the groups. Ablation of this arrhythmia can therefore be regarded as a promising curative treatment in advanced age.
Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany. philipp.attanasio@charite.de.
Philipp
http://orcid.org/0000-0002-6559-7499
P
Attanasio
Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Johannes
J
Jungmann
Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Martin
M
Huemer
Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Abdul Shokor
AS
Parwani
Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Leif-Hendrik
LH
Boldt
Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Wilhelm
W
Haverkamp
Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Alexander
A
Wutzler
D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016277:Ventricular Function, Left / Q000502:physiology; D018879:Ventricular Premature Complexes / Q000503:physiopathology / Q000601:surgery*
Ablation; Catheter ablation; Elderly; Idiopathic premature ventricular contractions; Premature ventricular beats