Thomas Fink1,2, Andreas Metzner3, Stephan Willems4, Lars Eckardt5, Hüseyin Ince6,7, Johannes Brachmann8, Stefan G Spitzer9, Thomas Deneke10, Claus Schmitt11, Matthias Hochadel12, Jochen Senges12, Andreas Rillig3,13. 1. Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Germany. thomas_fink47@gmx.de. 2. Department of Cardiology, Angiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany. thomas_fink47@gmx.de. 3. Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Germany. 4. Universitätsklinik Hamburg-Eppendorf, Hamburg, Germany. 5. Klinik für Kardiologie II: Rhythmologie, Universitätsklinikum Münster, Münster, Germany. 6. Klinik für Kardiologie und Internistische Intensivmedizin, Vivantes Klinikum Am Urban und im Friedrichshain, Berlin, Germany. 7. Abteilung für Kardiologie, Universitätsmedizin Rostock, Rostock, Germany. 8. Klinik für Kardiologie, Angiologie und Pneumologie, Coburg, Germany. 9. Praxisklinik Herz und Gefäße Dresden, Akademische Lehrpraxisklinik der TU Dresden and Institute of Medical Technology, Brandenburg University of Technology Cottbus, Senftenberg, Germany. 10. Herz- und Gefäßklinik Bad Neustadt, Bad Neustadt, Germany. 11. Städtisches Klinikum Karlsruhe, Medizinische Klinik IV, Karlsruhe, Germany. 12. Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen am Rhein, Germany. 13. Charité Herzmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Abstract
BACKGROUND: Aged patients are underrepresented in clinical trials on catheter ablation of atrial fibrillation (AF). In addition, results of outcomes after repeat ablation in the elderly are lacking. We report the results of first repeat AF ablation procedures of aged patients from a real-world multicenter prospective registry. METHODS: Patients undergoing second AF ablation included in the prospective, multicenter German Ablation Registry were divided in two groups (age > 70 years (group 1) and age ≤ 70 years (group 2)) and analyzed for procedural characteristics and clinical follow-up. RESULTS: 738 patients were analyzed (108 patients in group 1, 630 patients in group 2). Significantly more aged patients had structural heart disease (56 patients (51.9%) vs. 203 patients (32.2%), p < 0.001). The majority of the patients underwent repeat pulmonary vein isolation (101 patients (93.5%) vs. 593 patients (94.1%), p = 0.98). More aged patients underwent ablation of left atrial linear lesions (78.1% vs. 57.3% of all linear lesions, p = 0.027). There was no difference in the occurrence of peri-procedural complications (7 patients (6.5%) vs. 24 patients (3.8%), p = 0.30). Recurrence of atrial arrhythmias was documented in 45/105 (42.9%) and 252/603 (41.8%) patients with available follow-up in groups 1 and 2 after a median of 447 (400; 532) and 473 (411; 544) days (p = 0.84). A comparable amount of patients were asymptomatic or reported symptom improvement after repeat ablation in both groups (80% (80/100) in group 1 and 77% (446/576) in group 2; p = 0.57). CONCLUSION: Repeat ablation for AF in elderly patients can be performed with safety and efficacy comparable to younger patients.
BACKGROUND: Aged patients are underrepresented in clinical trials on catheter ablation of atrial fibrillation (AF). In addition, results of outcomes after repeat ablation in the elderly are lacking. We report the results of first repeat AF ablation procedures of aged patients from a real-world multicenter prospective registry. METHODS:Patients undergoing second AF ablation included in the prospective, multicenter German Ablation Registry were divided in two groups (age > 70 years (group 1) and age ≤ 70 years (group 2)) and analyzed for procedural characteristics and clinical follow-up. RESULTS: 738 patients were analyzed (108 patients in group 1, 630 patients in group 2). Significantly more aged patients had structural heart disease (56 patients (51.9%) vs. 203 patients (32.2%), p < 0.001). The majority of the patients underwent repeat pulmonary vein isolation (101 patients (93.5%) vs. 593 patients (94.1%), p = 0.98). More aged patients underwent ablation of left atrial linear lesions (78.1% vs. 57.3% of all linear lesions, p = 0.027). There was no difference in the occurrence of peri-procedural complications (7 patients (6.5%) vs. 24 patients (3.8%), p = 0.30). Recurrence of atrial arrhythmias was documented in 45/105 (42.9%) and 252/603 (41.8%) patients with available follow-up in groups 1 and 2 after a median of 447 (400; 532) and 473 (411; 544) days (p = 0.84). A comparable amount of patients were asymptomatic or reported symptom improvement after repeat ablation in both groups (80% (80/100) in group 1 and 77% (446/576) in group 2; p = 0.57). CONCLUSION: Repeat ablation for AF in elderly patients can be performed with safety and efficacy comparable to younger patients.
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