Christian-Hendrik Heeger1, Barbara Bellmann2, Thomas Fink3, Jan-Eric Bohnen3, Erik Wissner4, Peter Wohlmuth3, Laura Rottner3, Christian Sohns5, Roland Richard Tilz6, Shibu Mathew3, Bruno Reissmann3, Christine Lemeš3, Tilman Maurer3, Jakob Lüker2, Arian Sultan2, Tobias Plenge2, Britta Goldmann7, Feifan Ouyang3, Karl-Heinz Kuck3, Ilka Metzner3, Andreas Metzner3, Daniel Steven2, Andreas Rillig8. 1. Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany; University Heart Center Luebeck, Medical Clinic II (Department of Cardiology, Angiology and Intensive Care Medicine), Division of Electrophysiology, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Luebeck, Germany. Electronic address: christian.heeger@gmx.net. 2. Department of Cardiology, University of Cologne, Germany. 3. Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany. 4. Division of Cardiology, University of Illinois at Chicago, USA. 5. Electrophysiology Bremen, Bremen, Germany; Clinic for Electrophysiology, Herz- Gefäß und Diabeteszentrum NRW, Ruhr-Universität Bohum, Bad Oeynhausen, Germany. 6. University Heart Center Luebeck, Medical Clinic II (Department of Cardiology, Angiology and Intensive Care Medicine), Division of Electrophysiology, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Luebeck, Germany. 7. Department of Cardiology, Asklepios Klinik Harburg, Hamburg, Germany. 8. Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany; Department of Cardiology, Charité, Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Abstract
BACKGROUND: The prevalence of atrial fibrillation (AF) increases with age. Second-generation cryoballoon (CB2)-based PVI has demonstrated encouraging clinical results in the treatment of paroxysmal (PAF) and persistent atrial fibrillation (PersAF). The objective of this study was to assess data on safety, efficacy and long-term clinical success of CB2-based pulmonary vein isolation (PVI) in patients ≥75 years of age. METHODS: CB2-based PVI was performed in 104 patients ≥75 years of age (elderly group) and symptomatic AF (PersAF: n = 44, 42.3%) in three highly experienced German EP centers. The data was compared to propensity score matched patients with age <75 years (n = 104, control group; PersAF: n = 45, 43.3%, p = 0.956). RESULTS: The median age of the elderly group was 77.5 [75, 80] years while it was 63 [52, 70] years of control group patients (p = 0.0001). The median procedure time was 92.5 [75, 120] minutes (elderly group) and 100 [75, 120] (control group), p = 0.124. Major complications were registered in 7/104 (6.7%) elderly patients and 7/104 (6.7%) control group patients (p = 0.999). Clinical success in terms of freedom from AF recurrence after one-year follow-up was 80% (95% CI: 72-88) and 82% (95% CI: 75-90) and after three-year follow-up 59% (95% CI: 47-74) and 49% (95% CI: 37 64) for the elderly group and the control group, respectively (p = 0.7). CONCLUSIONS: CB2-based PVI in patients ≥75 years of age appears safe, is associated with low procedure times and shows promising clinical success rates equal to patients of the younger population.
BACKGROUND: The prevalence of atrial fibrillation (AF) increases with age. Second-generation cryoballoon (CB2)-based PVI has demonstrated encouraging clinical results in the treatment of paroxysmal (PAF) and persistent atrial fibrillation (PersAF). The objective of this study was to assess data on safety, efficacy and long-term clinical success of CB2-based pulmonary vein isolation (PVI) in patients ≥75 years of age. METHODS:CB2-based PVI was performed in 104 patients ≥75 years of age (elderly group) and symptomatic AF (PersAF: n = 44, 42.3%) in three highly experienced German EP centers. The data was compared to propensity score matched patients with age <75 years (n = 104, control group; PersAF: n = 45, 43.3%, p = 0.956). RESULTS: The median age of the elderly group was 77.5 [75, 80] years while it was 63 [52, 70] years of control group patients (p = 0.0001). The median procedure time was 92.5 [75, 120] minutes (elderly group) and 100 [75, 120] (control group), p = 0.124. Major complications were registered in 7/104 (6.7%) elderly patients and 7/104 (6.7%) control group patients (p = 0.999). Clinical success in terms of freedom from AF recurrence after one-year follow-up was 80% (95% CI: 72-88) and 82% (95% CI: 75-90) and after three-year follow-up 59% (95% CI: 47-74) and 49% (95% CI: 37 64) for the elderly group and the control group, respectively (p = 0.7). CONCLUSIONS:CB2-based PVI in patients ≥75 years of age appears safe, is associated with low procedure times and shows promising clinical success rates equal to patients of the younger population.
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