title: Urgent Catheter Ablation in Octogenarians with Serious Tachyarrhythmias.
abstract: BACKGROUND
  Urgent catheter ablation is often required for various tachyarrhythmias; however, its efficacy and safety in elderly patients have not been fully elucidated.
  
  
  METHODS
  This study included consecutive octogenarians who underwent urgent radiofrequency catheter ablation (RFCA) for various serious tachyarrhythmias (urgent group, n=28) that were life-threatening, hemodynamically deleterious, or provoking ischemia, and consecutive octogenarians who underwent elective RFCA (control group, n=36). The rate of a successful RFCA, complications, later arrhythmia recurrences, and mortality were compared between the groups.
  
  
  RESULTS
  There was no significant difference in the breakdown of the targeted arrhythmias between the groups, and common-type atrial flutter was most often targeted in both the urgent group (57%) and the elective group (56%). Compared with the control group patients, the patients of the urgent group were older (84±3 vs. 82±2 years P=0.001), with a higher frequency of baseline heart disease (68% vs. 17%, P<0.001) and lower left ventricular ejection fraction (45%±15% vs. 68%±10%, P<0.001). The rates of acute success (100% vs. 100%, P=1.00) and later arrhythmia recurrences (4% vs. 14%, P=0.22) were comparable between the groups. Two patients in the urgent group and 2 in the elective group had procedure-related nonlethal complications (7% vs. 6%, P=1.00): groin hematoma in 2, pressure ulcer in 1, and CO2 narcosis in 1. There were no in-hospital deaths, and mortality during follow-up did not differ between the urgent and elective groups (6.0% vs. 3.9% per year, log-rank P=0.38).
  
  
  CONCLUSIONS
  Even in octogenarian patients, urgent catheter ablation for serious tachyarrhythmias can be safely performed with a high success rate and acceptable prognosis.
authors.affiliation: Department of Cardiovascular Medicine, Nippon Medical School.
authors.forename: Kenta
authors.initials: K
authors.lastname: Takahashi
authors.forename: Meiso
authors.initials: M
authors.lastname: Hayashi
authors.forename: Yu-Ki
authors.initials: YK
authors.lastname: Iwasaki
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyauchi
authors.forename: Kenji
authors.initials: K
authors.lastname: Yodogawa
authors.forename: Ippei
authors.initials: I
authors.lastname: Tsuboi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hayashi
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Oka
authors.forename: Kanako
authors.initials: K
authors.lastname: Hagiwara
authors.forename: Yu-Hi
authors.initials: YH
authors.lastname: Fujimoto
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimizu
mesh_terms: D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000009:adverse effects; D018450:Disease Progression; D005260:Female; D006761:Hospitals; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D010351:Patient Discharge; D011183:Postoperative Complications / Q000209:etiology; D012008:Recurrence; D013610:Tachycardia / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome