title: Complication Rates of Catheter Ablation of Atrial Fibrillation in Patients Aged ≥75 Years versus <75 Years-Results from the German Ablation Registry.
abstract: BACKGROUND
  Despite a rising demand for catheter ablation (CA) of atrial fibrillation (AF) in an elderly population, complication and success rates are not fully elucidated. We sought to compare complication rates of CA of AF in patients ≥75 versus <75 years of age.
  
  
  RESULTS
  Patients with symptomatic, drug-refractory AF were prospectively enrolled from January 2007 to 2010 in this multicenter study. A total of 4,449 patients, group 1 ≥75 years and group 2 <75 years (n = 227, age 77.3 ± 2.2 vs. 59.7 ± 9.8 years, 52.0% vs. n = 4,222, 68.9% male, CHA2DS2-VASc-Score 3.7 ± 1.0 vs. 1.7 ± 1.2; P < 0.001, respectively), with paroxysmal AF (59.9% in group 1 vs. 63.3% in group 2, P = 0.30), and persistent AF (34.8% in group 1 vs. 29.4% in group 2, P = 0.082) underwent CA of AF. A centralized follow-up was obtained in 4,347 patients by the Institute for Myocardial Infarction Research (IHF, Ludwigshafen). There was a significant difference between periprocedural stroke rates in the elderly versus the younger cohort (1.3% vs. 0.1%, P < 0.01). In-hospital severe nonfatal complications did not differ significantly between the groups (4.4% vs. 2.7%, P = 0.14). Other procedure-related, in-hospital complications were not significantly different. After a mean follow-up of 472 ± 99 days (group 1) and 477 ± 94 days (group 2), no differences were found in complication rates.
  
  
  CONCLUSIONS
  CA of AF in patients ≥75 years is associated with higher in-hospital stroke rates. In a 1-year follow-up, complication rates do not differ between the groups.
authors.affiliation: Department of Cardiology-Electrophysiology, University Hospital Hamburg, University Heart Center, Hamburg, Germany.
authors.forename: Julia M
authors.initials: JM
authors.lastname: Moser
authors.affiliation: Department of Cardiology-Electrophysiology, University Hospital Hamburg, University Heart Center, Hamburg, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Willems
authors.affiliation: Department of Cardiology and Internal Medicine, Evangelisches Krankenhaus Hubertus, Charité Berlin, Berlin, Germany.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Andresen
authors.affiliation: Hospital Klinikum Coburg, Teaching Hospital of the University of Würzburg, Coburg, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Brachmann
authors.affiliation: Division of Electrophysiology, Department of Cardiology and Angiology, University of Münster, Münster, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Eckardt
authors.affiliation: Department of Cardiology and Internal Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich Municipal Hospital Group, Munich, Germany.
authors.forename: Ellen
authors.initials: E
authors.lastname: Hoffmann
authors.affiliation: Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.affiliation: Department of Cardiology and Intensive Care, Peter Osypka Heart Center Munich, Hospital Munich-Thalkirchen, Munich, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Lewalter
authors.affiliation: 2nd Department of Medicine, Westpfalz-Klinikum, Kaiserslautern, Germany.
authors.forename: Burghard
authors.initials: B
authors.lastname: Schumacher
authors.affiliation: Praxisklinik Herz und Gefäße-Teaching Hospital of the Technical University of Dresden, Germany.
authors.forename: Stefan G
authors.initials: SG
authors.lastname: Spitzer
authors.affiliation: Institute for Myocardial Infarction Research (IHF), Ludwigshafen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Hochadel
authors.affiliation: Institute for Myocardial Infarction Research (IHF), Ludwigshafen, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.affiliation: Department of Cardiology II/Electrophysiology; Center of Cardiology, University Medical Center, Johannes Gutenberg-University, Mainz, Germany.
authors.forename: Boris A
authors.initials: BA
authors.lastname: Hoffmann
mesh_terms: D000200:Action Potentials; D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D018572:Disease-Free Survival; D005260:Female; D005858:Germany; D006339:Heart Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000209:etiology*; D013997:Time Factors; D016896:Treatment Outcome
keywords: age; atrial fibrillation; catheter ablation; complications; stroke