Safety and efficacy of cryoballoon ablation for the treatment of atrial fibrillation in elderly patients.

BACKGROUND: Catheter ablation (CA) is an established therapy for treatment of atrial fibrillation (AF). However, data about AF ablation using the cryoballoon (CB) in the elderly population are sparse. The aim of this single center retrospective study is to evaluate the safety and efficacy of CB ablation in patients ≥ 75 years compared to patients < 75 years.

METHODS AND RESULTS: Fifty-five consecutive patients aged ≥ 75 years (elderly group) were compared with 183 patients aged < 75 years (control group). All patients underwent pulmonary vein isolation (PVI) using the second-generation CB. The mean age in the elderly group was 78 ± 2.8 years and 60.8 ± 9.5 in the control group (p < 0.001). During 11.8 ± 5.4 months of follow-up, single procedure success rate for the elderly and the control group was 72.8 and 76%, respectively (p = 0.37). During redo ablation (n = 40), low-voltage areas in the LA were more frequently observed in elderly patients compared to the control group [1.0 (IQR 0-2.0) segments vs 2.0 (IQR 2.0-3.0) segments, respectively, p = 0.03]. The most common complication was transient phrenic nerve palsy, which only occurred in patients < 75 years (0 vs 7, p = 0.33). No severe complication such as procedure-related deaths, atrio-esophageal fistula, or cerebrovascular embolic events occurred.

CONCLUSIONS: Our data strengthen the value of CB ablation for the treatment of AF as an effective and safe procedure in elderly patients, with similar success and complication rates when compared with a younger population.