Periprocedural complications and one-year outcomes after catheter ablation for treatment of atrial fibrillation in elderly patients: a nationwide Danish cohort study

• Published in: Journal of geriatric cardiology : JGC 2021-11, Vol.18 (11), p.897-907
• Main Authors: Nielsen, Jesper, Kragholm, Kristian Hay, Christensen, Sofie Brix, Johannessen, Arne, Torp-Pedersen, Christian, Kristiansen, Steen Buus, Jacobsen, Peter Karl, Hansen, Peter Steen, Djurhus, Mogens Stig, Polcwiartek, Christoffer, Søgaard, Peter, Thøgersen, Anna Margrethe, Gang, Uffe Jakob Ortved, Jørgensen, Ole Dan, Lindgren, Filip Lyng, Riahi, Sam
• Format: Article
• Language: English
• ISSN: 1671-5411
• DOI: 10.11909/j.issn.1671-5411.2021.11.005

To investigate complications within 30-days following first-time ablation for atrial fibrillation (AF), including a composite of cardiac tamponade, hematoma requiring intervention, stroke or death, in patients ≥ 75 years of age, compared to patients aged 65-74 years. In addition, one-year all-cause mortality and AF relapse were compared. All patients receiving their first catheter ablation for AF between 2012 and 2016 were identified using Danish nationwide registries. Patients aged 65-74 years served as the reference group for patients ≥ 75 years. Relapse of AF within one year was defined as cardioversion following a three-month blanking period, re-ablation or confirmed relapse within follow-up. The composite complication outcome did not differ between the two age groups, with 39/1554 (2.8%) in patients 65-74 years of age, versus 5/199 (2.5%) in older patients (adjusted HR = 0.94), 95% CI: 0.37-2.39, = 0.896). Patients ≥ 75 years or older had no increased hazard of death within 30 days after the procedure, with an incidence of 3/1554 (0.2%) in younger patients and 2/199 (1.0%) in patients ≥ 75 years of age (adjusted HR = 4.71, 95% CI: 0.78-28.40, = 0.091). There was no difference in relapse of AF after one year between age groups (≥ 75 years adjusted HR = 1.00, 95% CI: 0.78-1.26, = 0.969). In patients ≥ 75 years of age selected for catheter ablation for AF, the incidence of periprocedural complications, as well as one-year freedom from AF showed no statistical difference, when compared to patients 65-74 years of age.