Safety of catheter ablation for atrial fibrillation in the octogenarian population
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- Jorge Romero
- Montefiore Medical Center Albert Einstein College of Medicine New York
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- Gbolahan Ogunbayo
- Cardiology Center Gill Heart Institute Kentucky
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- Samy C. Elayi
- Cardiology Center Gill Heart Institute Kentucky
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- Yousef Darrat
- Cardiology Center Gill Heart Institute Kentucky
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- Saul A. Rios
- Montefiore Medical Center Albert Einstein College of Medicine New York
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- Juan C. Diaz
- Montefiore Medical Center Albert Einstein College of Medicine New York
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- Isabella Alviz
- Montefiore Medical Center Albert Einstein College of Medicine New York
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- Luis Cerna
- Montefiore Medical Center Albert Einstein College of Medicine New York
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- Mohamed Gabr
- Montefiore Medical Center Albert Einstein College of Medicine New York
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- Elizabeth Chernobelsky
- Montefiore Medical Center Albert Einstein College of Medicine New York
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- Sanghamitra Mohanty
- Texas Cardiac Arrhythmia Institute at St. David's Medical Center Austin Texas
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- Chintan G. Trivedi
- Texas Cardiac Arrhythmia Institute at St. David's Medical Center Austin Texas
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- Domenico G. Della Rocca
- Texas Cardiac Arrhythmia Institute at St. David's Medical Center Austin Texas
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- Andrea Natale
- Texas Cardiac Arrhythmia Institute at St. David's Medical Center Austin Texas
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- Luigi Di Biase
- Montefiore Medical Center Albert Einstein College of Medicine New York
抄録
<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>Catheter ablation (CA) has been shown to be an effective treatment for atrial fibrillation (AF). The complication rates and outcomes among octogenarians remain poorly studied. We aimed to compare trends, morbidity, and mortality associated with CA for AF among octogenarians versus those less than 80 years old.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Using weighted sampling from the National Inpatient Sample database, we identified patients with a primary diagnosis of AF and a primary procedure of CA (2004‐2013). Our primary outcome was mortality. Secondary outcomes included incidence of major and minor complications.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among 86,119 patients who underwent CA for AF, 3,482 were 80 years old or older. Complications were significantly more frequent in octogenarians; [16.2% (564 of 3,482) versus 9.8% (8,092 of 82,637), <jats:italic>P</jats:italic> < 0.001]. Of note, there was no significant difference for the composite of major complications; [3.6% (124 of 3482) in octogenarians versus 2.8% (2286 of 82637), <jats:italic>P</jats:italic> = 0.20]. The total mortality rate was not significant in a multivariate regression analysis (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.35‐2.64; <jats:italic>P</jats:italic> = .94). The presence of chronic renal failure (OR, 4.19; 95% CI, 2.75‐6.36; <jats:italic>P</jats:italic> < 0.001), anemia (OR, 1.75; 95% CI, 1.03‐2.97; <jats:italic>P</jats:italic> = .04), and chronic pulmonary disease (OR, 1.75; 95% CI, 1.11‐2.62; <jats:italic>P</jats:italic> = .015) were predictors of major complications in octogenarians.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Catheter ablation for AF in octogenarians does not confer a higher mortality risk than in those less than 80 years old. The procedure is associated with a higher rate of overall complications but there was no difference in terms of major complications or death. The presence of anemia, CKD or pulmonary disease were predictors of major complications in octogenarians.</jats:p></jats:sec>
収録刊行物
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- Journal of Cardiovascular Electrophysiology
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Journal of Cardiovascular Electrophysiology 30 (12), 2686-2693, 2019-10-13
Wiley