[Catheter ablation of ventricular extrasystoles and ventricular tachycardia in the elderly].
BACKGROUND
The prevalence of structural heart disease increases with higher age, and thereby the basis for ventricular arrhythmias is created. Catheter ablation has been shown to be an effective therapy option that is very safe and achieves good long-term results in patients with recurrent ventricular tachycardia (VT). Data regarding ablation in patients older than 75 years is sparse, although this patient group was included as a minority in most published VT ablation studies. Data from younger patient collectives may not be transferable to older patient cohorts due to differences in patient comorbidities and baseline characteristics.


METHODS
Studies with patient collectives ≥75 years or even ≥80 years show comparable efficacy of catheter ablation for VT; however, the complication rate is higher, mainly due to groin complications, increases. Catheter ablation of ischemic VT appears effective and safe even in ≥75 year olds; however, extensive data for other structural heart diseases are lacking. Epicardial procedures are also possible and safe in older patients (≥80 years). Due to the significant challenges of VT ablation in older patients, including the consideration of complex comorbidities, these should be performed in specialized centers with high expertise.


CONCLUSIONS
The aim of catheter ablation in older patients is, above all, to improve quality of life and morbidity. Long-term survival is significantly lower due to the "near end of life" situation than in younger patients. Careful consideration of alternative therapy options, chances for success of the catheter ablation, and their risks, taking into account specific patient conditions and symptoms, is crucial in these patients.
Klinik für Interventionelle Rhythmologie, Herz- und Gefäßklinik GmbH Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt a. d. Saale, Deutschland.|Uniklinik Marburg, Marburg, Deutschland.
Philipp
P
Halbfaß
Klinik für Interventionelle Rhythmologie, Herz- und Gefäßklinik GmbH Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt a. d. Saale, Deutschland.
Karin
K
Nentwich
Klinik für Interventionelle Rhythmologie, Herz- und Gefäßklinik GmbH Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt a. d. Saale, Deutschland.
Kai
K
Sonne
Klinik für Interventionelle Rhythmologie, Herz- und Gefäßklinik GmbH Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt a. d. Saale, Deutschland.
Elena
E
Ene
Klinik für Interventionelle Rhythmologie, Herz- und Gefäßklinik GmbH Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt a. d. Saale, Deutschland.
Franziska
F
Fochler
Bergmannsheil Bochum, Ruhr-Universität Bochum, Bochum, Deutschland.
Andreas
A
Mügge
Uniklinik Marburg, Marburg, Deutschland.
Bernhard
B
Schieffer
Klinik für Interventionelle Rhythmologie, Herz- und Gefäßklinik GmbH Bad Neustadt, Salzburger Leite 1, 97616, Bad Neustadt a. d. Saale, Deutschland. Thomas.Deneke@kardiologie-bad-neustadt.de.|Bergmannsheil Bochum, Ruhr-Universität Bochum, Bochum, Deutschland. Thomas.Deneke@kardiologie-bad-neustadt.de.
Thomas
T
Deneke
D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000401:mortality* / Q000706:statistics & numerical data*; D015984:Causality; D015897:Comorbidity; D019317:Evidence-Based Medicine / Q000379:methods; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods; D011183:Postoperative Complications / Q000401:mortality* / Q000517:prevention & control; D015995:Prevalence; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000401:mortality* / Q000601:surgery*; D016896:Treatment Outcome; D018879:Ventricular Premature Complexes / Q000401:mortality* / Q000517:prevention & control*
Catheter ablation; Efficacy; Quality of life; Safety; Ventricular tachycardia