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

摘要

OBJECTIVES 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 pa-tients aged 65−74 years.In addition,one-year all-cause mortality and AF relapse were compared.METHODS&RESULTS All patients receiving their first catheter ablation for AF between 2012 and 2016 were identified us-ing 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,P=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 pa-tients and 2/199(1.0%)in patients≥75 years of age(adjusted HR=4.71,95%CI:0.78−28.40,P=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,P=0.969).CONCLUSION In patients≥75 years of age selected for catheter ablation for AF,the incidence of periprocedural complica-tions,as well as one-year freedom from AF showed no statistical difference,when compared to patients 65−74 years of age.