Angelo B Biviano1, Tina D Hunter2, Gopi Dandamudi3, Robert S Fishel4, Brett Gidney5, Bengt Herweg6, Saumil R Oza7, Anshul Mahendra Patel8, Huijian Wang9, Scott J Pollak10. 1. New York Presbyterian Hospital, Columbia University Medical Center, Department of Medicine, Cardiology Division, Columbia University College of Physicians and Surgeons, New York, New York. 2. Health Economics Outcomes Research, CTI Clinical Trial and Consulting Services, Inc., Cincinnati, Ohio. 3. Indiana University School of Medicine, Indianapolis, Indiana. 4. Florida Electrophysiology Associates, West Palm Beach, Florida. 5. Cardiology, Heart Rhythm Center, Santa Barbara, California. 6. Electrophysiology and Arrhythmia Services, Department of Cardiovascular Disease, Tampa General Hospital, University of South Florida Morsani College of Medicine, Tampa, Florida. 7. The Atrial Fibrillation Institute, St. Vincent's Medical Center, Jacksonville, Florida. 8. St. Joseph's Hospital of Atlanta/Emory University, Atlanta, Georgia. 9. Florida Hospital Memorial Medical Center, Daytona Beach, Florida. 10. Arrhythmia and Ablation Center, Florida Hospital, Orlando, Florida.
Abstract
BACKGROUND: Atrial fibrillation (AF) prevalence increases significantly with age. Little is known about the effect of AF ablation on quality of life and healthcare utilization in the elderly. The objective of this study was to quantify the healthcare utilization and quality of life benefits of catheter ablation for AF, for patients ≥65 years compared to patients <65 years. METHODS: Two multicenter U.S. registry studies enrolled patients with paroxysmal AF. Baseline characteristics and acute outcomes were collected for 736 patients receiving catheter ablation with the Navistar® ThermoCool® SF Catheter (Biosense Webster, Inc., Diamond Bar, CA, USA). Healthcare utilization and quality of life outcomes were collected through 1 year postablation for 508 patients. RESULTS: The rates of acute pulmonary vein isolation were high and similar between patients ≥65 years and <65 years (97.5% vs 95.8%, P = 0.2130). Length of stay for the index procedure was similar between age groups with 82.2% of the older group and 83.2% of the younger group having one-day hospitalization. Disease-specific quality of life instrument scores improved significantly and similarly for older and younger patients at 1 year postablation, compared to baseline. AF-related hospitalizations and emergency department visits were similar or lower in older patients compared to younger patients, as reported at 1 year postablation. CONCLUSION: For older patients undergoing catheter ablation for paroxysmal AF, healthcare utilization parameters were lower or not significantly different than for younger patients, and quality of life outcomes were similarly improved. These findings support the use of catheter ablation as a treatment option in older patients with paroxysmal AF.
BACKGROUND:Atrial fibrillation (AF) prevalence increases significantly with age. Little is known about the effect of AF ablation on quality of life and healthcare utilization in the elderly. The objective of this study was to quantify the healthcare utilization and quality of life benefits of catheter ablation for AF, for patients ≥65 years compared to patients <65 years. METHODS: Two multicenter U.S. registry studies enrolled patients with paroxysmal AF. Baseline characteristics and acute outcomes were collected for 736 patients receiving catheter ablation with the Navistar® ThermoCool® SF Catheter (Biosense Webster, Inc., Diamond Bar, CA, USA). Healthcare utilization and quality of life outcomes were collected through 1 year postablation for 508 patients. RESULTS: The rates of acute pulmonary vein isolation were high and similar between patients ≥65 years and <65 years (97.5% vs 95.8%, P = 0.2130). Length of stay for the index procedure was similar between age groups with 82.2% of the older group and 83.2% of the younger group having one-day hospitalization. Disease-specific quality of life instrument scores improved significantly and similarly for older and younger patients at 1 year postablation, compared to baseline. AF-related hospitalizations and emergency department visits were similar or lower in older patients compared to younger patients, as reported at 1 year postablation. CONCLUSION: For older patients undergoing catheter ablation for paroxysmal AF, healthcare utilization parameters were lower or not significantly different than for younger patients, and quality of life outcomes were similarly improved. These findings support the use of catheter ablation as a treatment option in older patients with paroxysmal AF.
Authors: Jesper Eske Sindby; Henrik Vadmann; Søren Lundbye-Christensen; Sam Riahi; Søren Hjortshøj; Lucas V A Boersma; Jan Jesper Andreasen Journal: J Cardiothorac Surg Date: 2018-10-03 Impact factor: 1.637