Safety and effectiveness of atrial fibrillation ablation in patients aged ≥80 years: a retrospective study

Background Catheter ablation is the first-line treatment for atrial fibrillation (AF). Although the efficacy and safety of this procedure have been reported in older patients, this might diminish with age. Therefore, this study aimed to determine the safety and effectiveness of AF ablation in patients aged ≥ 80 years. Methods We retrospectively analyzed the features of ablation and the subsequent clinical course and outcomes of 100 patients with AF aged ≥ 80 years who underwent ablation between July 2019 and December 2021 at Tosei General Hospital, Seto, Aichi, Japan. Results The average duration of AF was 6.0 ± 9.5 months, and 83% of the patients were symptomatic. Approximately 30% of the patients developed heart failure, with 15% requiring hospitalization within 1 year before ablation. Postablation, 93% of patients remained free of AF, and none required postoperative hospitalization due to heart failure. However, several complications were observed, including cardiac tamponade, hematoma at the access site, and postoperative bradycardia. Notably, an enlarged left atrial diameter before ablation was a predictor of complications. Conclusions In patients aged ≥ 80 years, AF ablation therapy demonstrated a high nonrecurrence rate and altered progression of heart failure. Although the incidence of complications was relatively low, caution should be exercised when older patients with enlarged left atrial diameters undergo AF ablation.