Efficacy and safety of atrial fibrillation ablation in patients aged ≥80 years: a retrospective study.

Abstract

Catheter ablation is the first-line treatment for atrial fibrillation. Although the efficacy and safety of this procedure have been reported in older patients, they might diminish with age. Therefore, this study aimed to determine the safety and effectiveness of atrial fibrillation ablation in patients aged ≥80 years. We retrospectively analyzed the features of the catheter ablation and the subsequent clinical course and outcomes of 100 patients with atrial fibrillation aged ≥80 years who underwent ablation between July 2019 and December 2021 at Tosei General Hospital, Seto, Aichi, Japan. The average duration of atrial fibrillation was 6.0 ± 9.5 months, and 83% of the patients were symptomatic. Approximately 30% of patients developed heart failure, with 15% requiring hospitalization within one year before ablation. After ablation, 93% of patients were atrial fibrillation-free, and none required postoperative hospitalization due to heart failure. However, several complications have been observed, including cardiac tamponade, hematoma at the access site, and postoperative bradycardia. Notably, an enlarged left atrial diameter before ablation is a predictor of complications. In patients aged ≥80 years, atrial fibrillation ablation therapy demonstrated a high non-recurrence rate and may alter the progression of heart failure. Although the incidence of complications was relatively low, caution should be exercised when older patients with enlarged left atrial diameters undergo atrial fibrillation ablation.