Ken Okumura1, Takeshi Yamashita2, Masaharu Akao3, Hirotsugu Atarashi4, Takanori Ikeda5, Yukihiro Koretsune6, Wataru Shimizu7, Hiroyuki Tsutsui8, Kazunori Toyoda9, Atsushi Hirayama10, Masahiro Yasaka11, Takenori Yamaguchi9, Satoshi Teramukai12, Tetsuya Kimura13, Jumpei Kaburagi13, Atsushi Takita14, Hiroshi Inoue15. 1. Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, Kumamoto, Japan. Electronic address: okumura@hirosaki-u.ac.jp. 2. The Cardiovascular Research Institute, Tokyo, Japan. 3. National Hospital Organization Kyoto Medical Center, Kyoto, Japan. 4. Minami Hachioji Hospital, Tokyo, Japan. 5. Toho University Omori Medical Center, Tokyo, Japan. 6. National Hospital Organization Osaka National Hospital, Osaka, Japan. 7. Nippon Medical School, Tokyo, Japan. 8. Kyushu University, Fukuoka, Japan. 9. National Cerebral and Cardiovascular Center, Suita, Japan. 10. Osaka Police Hospital, Osaka, Japan. 11. National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. 12. Kyoto Prefectural University of Medicine, Kyoto, Japan. 13. Medical Science Department, Daiichi Sankyo Co., Ltd., Tokyo, Japan. 14. Biostatistics and Data Management Department, Daiichi Sankyo Co., Ltd., Tokyo, Japan. 15. Saiseikai Toyama Hospital, Toyama, Japan.
Abstract
BACKGROUND: Benefits of catheter ablation (CA) have been shown for patients with atrial fibrillation (AF), including elderly patients. However, data in patients aged ≥75 years who have undergone CA for non-valvular AF (NVAF) are lacking. This cross-sectional subanalysis of the ANAFIE registry determined the characteristics and status of anticoagulant treatment in elderly NVAF patients with a history of CA at enrollment. METHOD: The ANAFIE registry was a multicenter, prospective, non-interventional cohort study in which elderly ambulatory patients (≥75 years) diagnosed with NVAF by electrocardiogram were enrolled between October 2016 and January 2018. Treatment was prescribed per routine clinical practice by individual treating physicians. The patients were stratified into two groups: the CA and No-CA groups. RESULTS: Among 32,726 NVAF patients aged ≥75 years, 3002 (9.2%) underwent CA before enrollment. Patients who underwent CA were significantly younger (78.9 years vs 81.7 years; p < 0.0001), had significantly greater height and body weight, as well as creatinine clearance rate (CCr) compared with those who did not undergo CA. In both the CA and No-CA groups, the most common type of AF was paroxysmal AF (72.9% and 38.9%). In the CA group, a significantly larger proportion of patients did not receive anticoagulant therapy compared with the No-CA group (13.3% vs 7.6%; p < 0.0001). Direct oral anticoagulant (DOAC) use was similar in the CA (69.9%) and No-CA (66.0%) groups, and standard doses of DOACs were administered more frequently in the CA group than in the No-CA group. A lower proportion of patients in the CA group received warfarin (16.9% vs 26.4%) compared with the No-CA group. CONCLUSIONS: This ANAFIE registry subanalysis showed that patients with NVAF in the CA group tended to have paroxysmal AF; be significantly younger; have greater weight, height, and CCr; receive standard doses of DOACs; and have not used anticoagulant medication compared with No-CA patients.
BACKGROUND: Benefits of catheter ablation (CA) have been shown for patients with atrial fibrillation (AF), including elderly patients. However, data in patients aged ≥75 years who have undergone CA for non-valvular AF (NVAF) are lacking. This cross-sectional subanalysis of the ANAFIE registry determined the characteristics and status of anticoagulant treatment in elderly NVAF patients with a history of CA at enrollment. METHOD: The ANAFIE registry was a multicenter, prospective, non-interventional cohort study in which elderly ambulatory patients (≥75 years) diagnosed with NVAF by electrocardiogram were enrolled between October 2016 and January 2018. Treatment was prescribed per routine clinical practice by individual treating physicians. The patients were stratified into two groups: the CA and No-CA groups. RESULTS: Among 32,726 NVAF patients aged ≥75 years, 3002 (9.2%) underwent CA before enrollment. Patients who underwent CA were significantly younger (78.9 years vs 81.7 years; p < 0.0001), had significantly greater height and body weight, as well as creatinine clearance rate (CCr) compared with those who did not undergo CA. In both the CA and No-CA groups, the most common type of AF was paroxysmal AF (72.9% and 38.9%). In the CA group, a significantly larger proportion of patients did not receive anticoagulant therapy compared with the No-CA group (13.3% vs 7.6%; p < 0.0001). Direct oral anticoagulant (DOAC) use was similar in the CA (69.9%) and No-CA (66.0%) groups, and standard doses of DOACs were administered more frequently in the CA group than in the No-CA group. A lower proportion of patients in the CA group received warfarin (16.9% vs 26.4%) compared with the No-CA group. CONCLUSIONS: This ANAFIE registry subanalysis showed that patients with NVAF in the CA group tended to have paroxysmal AF; be significantly younger; have greater weight, height, and CCr; receive standard doses of DOACs; and have not used anticoagulant medication compared with No-CA patients.