Premium
Safety of catheter ablation for atrial fibrillation in the octogenarian population
Author(s) -
Romero Jorge,
Ogunbayo Gbolahan,
Elayi Samy C.,
Darrat Yousef,
Rios Saul A.,
Diaz Juan C.,
Alviz Isabella,
Cerna Luis,
Gabr Mohamed,
Chernobelsky Elizabeth,
Mohanty Sanghamitra,
Trivedi Chintan G.,
Della Rocca Domenico G.,
Natale Andrea,
Di Biase Luigi
Publication year - 2019
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14165
Subject(s) - medicine , atrial fibrillation , confidence interval , odds ratio , catheter ablation , incidence (geometry) , cardiology , population , mortality rate , complication , surgery , physics , environmental health , optics
Catheter ablation (CA) has been shown to be an effective treatment for atrial fibrillation (AF). The complication rates and outcomes among octogenarians remain poorly studied. We aimed to compare trends, morbidity, and mortality associated with CA for AF among octogenarians versus those less than 80 years old. Methods Using weighted sampling from the National Inpatient Sample database, we identified patients with a primary diagnosis of AF and a primary procedure of CA (2004‐2013). Our primary outcome was mortality. Secondary outcomes included incidence of major and minor complications. Results Among 86,119 patients who underwent CA for AF, 3,482 were 80 years old or older. Complications were significantly more frequent in octogenarians; [16.2% (564 of 3,482) versus 9.8% (8,092 of 82,637), P < 0.001]. Of note, there was no significant difference for the composite of major complications; [3.6% (124 of 3482) in octogenarians versus 2.8% (2286 of 82637), P = 0.20]. The total mortality rate was not significant in a multivariate regression analysis (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.35‐2.64; P = .94). The presence of chronic renal failure (OR, 4.19; 95% CI, 2.75‐6.36; P < 0.001), anemia (OR, 1.75; 95% CI, 1.03‐2.97; P = .04), and chronic pulmonary disease (OR, 1.75; 95% CI, 1.11‐2.62; P = .015) were predictors of major complications in octogenarians. Conclusion Catheter ablation for AF in octogenarians does not confer a higher mortality risk than in those less than 80 years old. The procedure is associated with a higher rate of overall complications but there was no difference in terms of major complications or death. The presence of anemia, CKD or pulmonary disease were predictors of major complications in octogenarians.