Comparison of long-term outcome between patients aged < 65 years vs . ≥ 65 years after atrial fibrillation ablation.

BACKGROUND: Atrial fibrillation (AF) is the most frequent arrhythmia, and its prevalence is increasing with aging. We aimed to compare the long-term outcome data of patients < 65 years vs . ≥ 65 years who underwent catheter ablation (CA) for drug-refractory AF.

METHODS: Consecutive patients with primary pulmonary vein isolation performed between March 2001 and December 2011, and those who completed a five-year of follow-up were divided into two groups: patients aged < 65 years into group 1, and patients aged ≥ 65 into group 2. Long-term outcome data concerning mortality, thromboembolic events (TE) and success rates were compared between these groups.

RESULTS: A total number of 390 patients were included, group 1 contained 310 patients, and 80 patients in group 2. In group 2, patients had more often impaired renal function ( P < 0.001) and thyroid disease ( P = 0.047). A total of fifteen patients died during the 6.63 ± 2.1 years of follow-up, with a significantly higher incidence in the older group (8/80 vs . 7/310 patients, P = 0.004). The majority of fatal outcome was due to cancerous diseases in both groups. No difference was observed concerning the long-term TE rate (12/310 vs . 4/80 patients, P = 0.75). Rhythm control failed in 25.9% of the patients, with no difference between the groups: 26.4% in group 1 vs . 23.7% in group 2 ( P = 0.67).

CONCLUSIONS: Despite growing prevalence of AF in aging population, the elderly patients are underrepresented in CA procedures. Similar clinical success and TE complication rate are observed between the age-groups. Our data suggest more liberal criteria might be applied while selecting patients for AF ablation.