title: The Impact of Age on 5-Year Outcomes After Atrial Fibrillation Catheter Ablation.
abstract: BACKGROUND
  Catheter ablation of atrial fibrillation (AF) is an established therapeutic rhythm approach in symptomatic patients. Many studies have shown that age has little to no impact on outcomes during the first year after ablation. However, AF is a disease of aging and age-based substrate for arrhythmia is likely to progress. To this regard, we examined patients with 5-year outcome data following an index AF ablation procedure to define the impact of age on long-term outcomes.
  
  
  METHODS
  A total of 923 patients that underwent their index AF ablation and had 5 years of follow-up were studied. Patients were followed up for atrial flutter/AF recurrence, heart failure, stroke, death, and cardiac function. Patients were separated and compared in 5 age-based groups (<50, 51-60, 61-70, 71-80, >80).
  
  
  RESULTS
  The average age of the population was 66 ± 11 years and 59% were male. The AF was paroxysmal in 55%, persistent in 27%, and longstanding persistent in 18%. Older patients were more likely female and had higher rates of cardiovascular diseases. For every 10-year increase in age there was a higher multivariate-adjusted risk of atrial flutter/AF recurrence (HR: 1.13, P = 0.01), death (HR:1.91, P < 0.0001), and major adverse cardiac events (HR: 1.09, P = 0.07). Although atrial flutter/AF recurrence rates by age were similar at 1 year, at 5 years, younger patients had significantly lower rates of recurrences.
  
  
  CONCLUSIONS
  Age significantly impacts outcomes after AF ablation when analyzed with long-term follow-up. These data highlight the progressive nature of AF and the need to consider interventions early.
authors.affiliation: Intermountain Medical Center Heart Institute, Intermountain Medical Center, Salt Lake City, Utah.|Stanford University, Palo Alto, California, USA.
authors.forename: T Jared
authors.initials: TJ
authors.lastname: Bunch
authors.affiliation: Intermountain Medical Center Heart Institute, Intermountain Medical Center, Salt Lake City, Utah.
authors.forename: Heidi T
authors.initials: HT
authors.lastname: May
authors.affiliation: Intermountain Medical Center Heart Institute, Intermountain Medical Center, Salt Lake City, Utah.
authors.forename: Tami L
authors.initials: TL
authors.lastname: Bair
authors.affiliation: Intermountain Medical Center Heart Institute, Intermountain Medical Center, Salt Lake City, Utah.
authors.forename: Victoria
authors.initials: V
authors.lastname: Jacobs
authors.affiliation: Intermountain Medical Center Heart Institute, Intermountain Medical Center, Salt Lake City, Utah.
authors.forename: Brian G
authors.initials: BG
authors.lastname: Crandall
authors.affiliation: Intermountain Medical Center Heart Institute, Intermountain Medical Center, Salt Lake City, Utah.
authors.forename: Michael
authors.initials: M
authors.lastname: Cutler
authors.affiliation: Intermountain Medical Center Heart Institute, Intermountain Medical Center, Salt Lake City, Utah.
authors.forename: J Peter
authors.initials: JP
authors.lastname: Weiss
authors.affiliation: Intermountain Medical Center Heart Institute, Intermountain Medical Center, Salt Lake City, Utah.
authors.forename: Charles
authors.initials: C
authors.lastname: Mallender
authors.affiliation: Intermountain Medical Center Heart Institute, Intermountain Medical Center, Salt Lake City, Utah.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Osborn
authors.affiliation: Intermountain Medical Center Heart Institute, Intermountain Medical Center, Salt Lake City, Utah.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Anderson
authors.affiliation: Intermountain Medical Center Heart Institute, Intermountain Medical Center, Salt Lake City, Utah.
authors.forename: John D
authors.initials: JD
authors.lastname: Day
mesh_terms: D000200:Action Potentials; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001282:Atrial Flutter / Q000209:etiology; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018579:Patient Selection; D016016:Proportional Hazards Models; D012008:Recurrence; D012307:Risk Factors; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014589:Utah
keywords: atrial fibrillation; catheter ablation; elderly; outcomes