title: Safety and mid-term outcome of catheter ablation of ventricular tachycardia in octogenarians.
abstract: OBJECTIVE
  Radiofrequency (RF) catheter ablation (CA) is superior to standard medical therapy in controlling recurrent ventricular tachycardia (VT). The majority of procedures have been performed in a middle-aged population. The outcome of VT ablation in the elderly has not been described.
  
  
  RESULTS
  We retrospectively studied the outcome and safety of CA of VT in octogenarians performed in four European centres. The population consisted of patients presenting with recurrent VT refractory to medical therapy. Patients aged over 80 years were compared with younger patients undergoing CA. Clinical characteristics, procedural data, complications, and outcomes were examined. Implantable cardioverter-defibrillator (ICD) therapy data were collected. A total of 54 consecutive octogenarian patients underwent RF CA of VT and represented the study group (42 males, age 82.8 ± 2.7 years) compared with a control group of 104 younger patients (85 males, age 66.7 ± 8.9 years). Mean follow-up was 33 ± 48 months. Implantable cardioverter-defibrillators were present in 81 and 86% of patients, respectively (P = 0.93). Left ventricular ejection fraction was 29% ± 8.2 in octogenarians vs. 34% ± 10.2 in the younger group (P < 0.01). More major complications occurred in octogenarians (18 vs. 2%, P < 0.01). During follow-up, there were more ICD shocks in the octogenarians (28 vs. 15%, P < 0.01). The Kaplan-Meier curve of survival after VT ablation confirms comparable survival rates at 1 year, but the elderly have poor survival in the mid-term. Survival in the elderly post VT ablation is comparable with that in an age-matched cohort with ICDs but no VT storm.
  
  
  CONCLUSIONS
  Octogenarians undergoing CA of VT have more risk factors, higher risk of complications and ICD shocks, but demonstrate comparable short-term survival rates.
authors.affiliation: Bristol Heart Institute, Bristol, UK.
authors.forename: Antonio
authors.initials: A
authors.lastname: Frontera
authors.affiliation: Royal Brompton Hospital, London SW3 6NP, UK.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Panniker
authors.affiliation: St Bartholomew's Hospital, Barts Heart Center, London EC1A 7BE, UK.
authors.forename: Alexander
authors.initials: A
authors.lastname: Breitenstein
authors.affiliation: Bristol Heart Institute, Bristol, UK.
authors.forename: Vito Domenico
authors.initials: VD
authors.lastname: Bruno
authors.affiliation: Bristol Heart Institute, Bristol, UK.
authors.forename: Georgia May
authors.initials: GM
authors.lastname: Connolly
authors.affiliation: Bristol Heart Institute, Bristol, UK.
authors.forename: David
authors.initials: D
authors.lastname: Wilson
authors.affiliation: St Bartholomew's Hospital, Barts Heart Center, London EC1A 7BE, UK.
authors.forename: Teresa
authors.initials: T
authors.lastname: Rio
authors.affiliation: St Bartholomew's Hospital, Barts Heart Center, London EC1A 7BE, UK.
authors.forename: Mehul B
authors.initials: MB
authors.lastname: Dhinoja
authors.affiliation: Royal Brompton Hospital, London SW3 6NP, UK.
authors.forename: Wajid
authors.initials: W
authors.lastname: Hussain
authors.affiliation: St Bartholomew's Hospital, Barts Heart Center, London EC1A 7BE, UK.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Schilling
authors.affiliation: Bristol Heart Institute, Bristol, UK.
authors.forename: Glyn
authors.initials: G
authors.lastname: Thomas
authors.affiliation: Royal Brompton Hospital, London SW3 6NP, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Wong
authors.affiliation: St Bartholomew's Hospital, Barts Heart Center, London EC1A 7BE, UK.
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Hunter
authors.affiliation: Hôpital Haut Léveque, CHU Bordeaux, Pessac, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Sacher
authors.affiliation: Hôpital Haut Léveque, CHU Bordeaux, Pessac, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Jaïs
authors.affiliation: Bristol Heart Institute, Bristol, UK.
authors.forename: Edward
authors.initials: E
authors.lastname: Duncan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation; D004739:England; D005260:Female; D005602:France; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology; D057216:Propensity Score; D016016:Proportional Hazards Models; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Complications; Octogenarians; RF catheter ablation; Ventricular tachycardia