title: Ablation of atrial fibrillation in patients ≥75 years: long-term clinical outcome and safety.
abstract: OBJECTIVE
  The prevalence of atrial fibrillation (AF) increases with age. Catheter ablation is an established treatment option for patients with symptomatic AF. We sought to determine the safety and long-term clinical efficacy of AF ablation in patients ≥75 years.
  
  
  RESULTS
  Patients ≥75 years with symptomatic, drug-refractory AF were included in the study. Circumferential pulmonary vein isolation (PVI) was performed in all patients, extended to ablation of complex fractionated atrial electrograms, and/or linear lesions in PVI non-responders. Retrospective follow-up (FU) was based on routine outpatient clinic visits and regular telephone interviews. A total of 94 patients (54 male, age 78 ± 2 years, and left atrium diameter 46 ± 6 mm) with drug-refractory AF [55/94 (59%) paroxysmal AF (PAF), 29/94 (31%) persistent AF, and 10/94 (11%) long-standing persistent AF] underwent ablation. Follow-up was obtained in 93/94 (99%) patients. Following a single procedure, 35/93 (38%) patients were in stable sinus rhythm (SR; 46% PAF, 31% persistent AF, and 10% long-standing persistent AF) after a mean FU of 37 ± 20 months. After a mean of 1.5 ± 0.6 procedures, 55/93 (59%) patients were ultimately in stable SR (76% PAF, 41% persistent AF, and 20% long-standing persistent AF). In a total of 137 procedures, 8 major (5.8%) and 26 minor (19%) complications occurred.
  
  
  CONCLUSIONS
  Catheter ablation in patients ≥75 years is associated with a favourable clinical long-term outcome in patients with PAF, while results are less promising in persistent or long-standing persistent patients. The safety profile of AF ablation in patients ≥75 years is comparable with patients of younger age.
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany i.metzner@asklepios.com.
authors.forename: Ilka
authors.initials: I
authors.lastname: Metzner
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany.
authors.forename: Erik
authors.initials: E
authors.lastname: Wissner
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany.
authors.forename: Roland R
authors.initials: RR
authors.lastname: Tilz
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Rillig
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany.
authors.forename: Shibu
authors.initials: S
authors.lastname: Mathew
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Schmidt
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany.
authors.forename: Julian
authors.initials: J
authors.lastname: Chun
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Wohlmuth
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Deiss
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Lemes
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany.
authors.forename: Tilman
authors.initials: T
authors.lastname: Maurer
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fink
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Heeger
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany.
authors.forename: Feifan
authors.initials: F
authors.lastname: Ouyang
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.affiliation: Department of Cardiology, Asklepios-Klinik St. Georg, Lohmühlenstr. 5, Hamburg 20099, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Metzner
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D004351:Drug Resistance; D005858:Germany; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Ablation; Atrial fibrillation; Complications; Elderly; Long-term results; Outcome