Older patients (≥63) with esophageal fistula after AF ablation had shorter symptom onset (15 vs. 21 days), less brain imaging, more endoscopic treatment, and higher fatality (73% vs. 57%).
Does older age impact the management and prognosis of esophageal fistula following atrial fibrillation ablation?
Older patients who develop an esophageal fistula after atrial fibrillation ablation present earlier, are managed more often with endoscopy alone, and show a trend toward higher mortality compared to younger patients.
Absolute Event Rate: 0% vs 0%
Background Esophageal fistula (EF) is a rare but devastating complication following atrial fibrillation (AF) ablation. Data regarding the impact of age on EF are scarce. Objective To study the impact of age on the management and prognosis of EF following catheter ablation for AF. Methods The POTTER-AF study is a worldwide registry on EF following catheter ablation for AF. A total of 553,729 patients underwent AF ablation in 214 centers between 1996 and 2022. Of them, 138 patients experienced EF, and data regarding age, management, and prognosis were available in 113 patients. The population was divided based on the median age. Results The median age was 63 years; 54 patients were <63 years old (Group 1), and 59 patients were ≥63 years old (Group 2). The groups were similar regarding procedural characteristics. The older population had a shorter time to symptom onset 15.0 (6.0, 21.0) vs. 21.0 (10.0, 25.3) days; p = 0.031. Group 2 was less likely to receive a brain CT or MRI for diagnosis (25.9% vs. 45.3%; p = 0.046). The older population was more likely to undergo endoscopic treatment without surgery (27.6% vs. 11.3%; p = 0.035). Conservative and surgical treatments were used in similar proportions. A trend toward higher fatality was noted in the older patients (72.9% vs. 56.6%; p = 0.078). Conclusion The older population had a shorter time to symptom onset, was less likely to receive a brain CT or MRI, and more likely to be treated by an endoscopic approach only. The older patient group showed a trend toward a higher fatality.
Popescu et al. (Wed,) reported a other. Older patients (≥63) with esophageal fistula after AF ablation had shorter symptom onset (15 vs. 21 days), less brain imaging, more endoscopic treatment, and higher fatality (73% vs. 57%).