New Research Paper
Safety and Efficacy of Catheter Ablation for Ventricular Tachycardia in Elderly Patients With Structural Heart Disease

https://doi.org/10.1016/j.jacep.2015.03.005Get rights and content
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Abstract

Objectives

This study sought to determine the safety and efficacy of ventricular tachycardia (VT) ablation in elderly patients with structural heart disease.

Background

As patients with cardiomyopathy live longer, the number of elderly patients with VT is increasing. Catheter ablation is an effective treatment for VT; however, outcomes may differ among elderly patients.

Methods

We studied 238 consecutive patients with ischemic or nonischemic cardiomyopathies who underwent catheter ablation for VT refractory to antiarrhythmic medications. Patients were divided into 3 age groups (Group A, <65 years; Group B, 65 to 75 years; and Group C, >75 years).

Results

Compared with Groups A and B, patients in Group C were more likely to have ischemic cardiomyopathy, lower left ventricular ejection fraction, longer mean VT cycle length, and less likely to undergo epicardial ablation. Acute procedural success, complications, 28-day survival, and 1-year VT-free survival rates were similar across groups (p = 0.9, 0.3, 0.3, and 0.9, respectively). As expected, Group C patients had worse survival in long-term follow-up (p < 0.001).

Conclusions

VT ablation can be performed in elderly patients with structural heart disease with similar efficacy and complication rates as in younger patients. VT ablation should not be withheld for older age alone.

Key Words

age
cardiomyopathy
catheter ablation
elderly
ventricular tachycardia

Abbreviations and Acronyms

ICD
implantable cardioverter-defibrillator
VT
ventricular tachycardia

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This work was supported in part by the F. Harlan Batrus Research Fund and the Susan and Murray Bloom Fund. All authors have reported that they have no relationships relevant to the contents of this paper to disclose.