Catheter ablation for atrial fibrillation in octogenarians: Acute success, complications and follow-up

Abstract

Background: Catheter ablation for atrial fibrillation (AF) in octogenarians poses a challenge due to comorbidities, frailty, and suspected higher complication rates. Data regarding the outcome of catheter ablation in this population is scarce.

Methods: We retrospectively analysed octogenarians with symptomatic AF undergoing catheter ablation in a single centre, including first and re-ablation procedures. Study endpoints were acute success, complications, and arrhythmia-free survival.

Results: A total of 175 patients (mean age 82.1 ± 1.9 years, paroxysmal AF n=54/175, persistent AF n=121/175, mean CHA2DS2-VASc-Score 4.2 ± 1.3) were included. Acute success was achieved in n=175/175 (100%) of patients. The overall complication rate was 6.9% (most commonly bradycardia with pacemaker implantation n=3/175 (1.7%), pulmonary infection n=3/175 (1.7%) and urinary tract infection n=3/175 (1.7%), followed by groin site complications n=2/175 (1.1%) and cardiac tamponade n=1/175 (0.6%)}. After a mean follow- up of 466 ± 179 days, arrhythmia free survival was seen in 69.1% after one year.

Conclusion: Catheter ablation for AF in octogenarians yields acceptable rhythm control and low complication rates. The most common complications in this cohort are bradycardia with subsequent pacemaker implantation and infections.