Key result
VT-ablation in octogenarians with structural heart disease showed similar noninducibility (p=0.693), complications (p=0.488), and VT-recurrence (p=0.882) compared to patients aged 75-79 years.
Why the study?
Geriatric patients are often underrepresented in large studies, leaving the feasibility and outcomes of VT ablation unclear as frailty becomes an increasing problem.
Does VT ablation in octogenarians (≥80 years) with structural heart disease yield similar procedural success and complication rates compared to younger geriatric patients (75-79 years)?
Cohort (n=68)
Does VT ablation in octogenarians (≥80 years) with structural heart disease yield similar procedural success and complication rates compared to younger geriatric patients (75-79 years)?
VT ablation is feasible and safe in octogenarians with structural heart disease, demonstrating procedural success and VT recurrence rates comparable to younger geriatric patients.
Supports individualized VT ablation decisions in select geriatric SHD patients; leaves open need for randomized efficacy data.
INTRODUCTION: This study sought to examine the feasibility and outcome of ablation of ventricular tachycardias (VTs) in a contemporary cohort of geriatric patients with structural heart disease (SHD). BACKGROUND: Geriatric patients are often underrepresented in large studies. As frailty is becoming an increasing problem, we need to examine the best course of action for this population. METHODS AND RESULTS: We investigated 68 SHD-patients ≥ 75 years old undergoing VT-ablation (men 88%, ischemic cardiomyopathy 77%, electrical storm 72%, mean left ventricular ejection fraction 31%) and divided the cohort into two groups: 75-79 years old (n = 51) and ≥80 years old (n = 17). The two groups showed similar results regarding noninducibility as ablation endpoint (p = .693), major procedure-related complications (p = .488), and VT-recurrence (p = .882) during the 39-month follow-up. At the end of the follow-up, 10 patients in the octogenarian group (59%) versus 16 patients of the other group (31%) died. CONCLUSION: Geriatric patients with SHD including octogenarians showed similar results regarding procedural endpoints, freedom of VT, and major procedure-associated complications after VT-ablation. When ablation is indicated, age alone should not be an inhibiting factor to treat these patients.
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Darma et al. (2021) conducted a cohort in Ventricular tachycardias in structural heart disease (n=68). Age ≥80 years (octogenarians) vs. Age 75-79 years was evaluated on Noninducibility as ablation endpoint, major procedure-related complications, and VT-recurrence (p=0.693, 0.488, 0.882). VT-ablation in octogenarians with structural heart disease showed similar noninducibility (p=0.693), complications (p=0.488), and VT-recurrence (p=0.882) compared to patients aged 75-79 years.
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