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DOI: 10.1055/s-2007-967557
Ablation of atrial fibrillation in octogenarians: early and mid-term results
Objectives: Ablation has become an effective treatment of atrial fibrillation (AF). We evaluated its results in octogenarians.
Methods: According to age (<80 years [group A, n=172] vs. ≥80 years [group B, n=28]), AF patients (89% vs. 75% permanent AF, A vs. B, p=0.04) undergoing left atrial endocardial ablation as concomitant procedure were prospectively studied after 3, 6, and 12 months (mean 10±4.1 months). Follow up was 95% complete.
Results: In group A and B, AF duration (5.2±7.2 and 4.0±5.3 years), left atrial diameter (49±8.8 and 49±6.1mm), ejection fraction (51±12.6 and 52±14.5%) and aortic cross clamp time (85±32.0 and 90±29.2min) were similar. NYHA class and EuroSCORE were better in group A (2.9±0.81 vs. 3.4±0.67, p<0.05 and 7.4±7.31 vs. 17.3±10.93, p<0.05). In group B, we observed a significantly increased ICU and hospital stay (8±16.9 vs. 4±7.2 days, p<0.05 and 20±23.9 vs. 14±30.8 days, p<0.05) and a trend to prolonged ventilation time (28±41.1 vs. 21±50.3 hrs, p=0.07) and higher 30-days-mortality (14.3 vs. 4.6%, p=0.05). No death was ablation related. Table shows sinus rhythm (SR) conversion rate. Patients in SR presented atrial contraction in 88% and 100% (A vs. B, n.s.) at latest follow up.
|
|
|
Discharge |
3 Months |
6 Months |
12 Months |
|
Group A (<80yrs.) |
% (n) |
62 (101) |
75 (78) |
67 (76) |
70 (66) |
|
Group B (≥80yrs.) |
% (n) |
50 (12) |
76 (13) |
60 (6) |
71 (5) |
Conclusions: Older age is associated with increased perioperative risk as reflected by EuroSCORE. Satisfactory results regarding SR conversion and atrial function justify AF ablation even in octogenerians.